Fwd: OCD story

[Guest guest]

To the list, I contacted the reporter of the Philadelphia Inquirer article

.....here it is.

Publication: PHILADELPHIA INQUIRER

ID: 3513243

Date: Wednesday, Apr 10, 2002

Section: FEATURES MAGAZINE

Edition: CITY-D

Graphics: PHOTO

Published caption: DAVID SWANSON / Inquirer Staff Photographer

Dante Falcone, 6 1/2, plays in his treehouse. His compulsions came on

suddenly at age 5 but have been successfully treated.

DAVID SWANSON / Inquirer Staff Photographer

Dante Falcone, now 6 1/2 and greatly improved, mugs for the camera,

with his mother, Severn, and little brother, Dario, in the background.

Behavior therapy and treatment for strep throat have quelled Dante's

compulsions - repeated hand-washing and acute fear of contamination.

Severn Falcone, hugging Dante, was once virtually housebound because of

his fears. She is thrilled that he is " back to his old self. "

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Kids and compulsions

A malady more often associated with adults is, therapists say,

" a hidden epidemic " among children: Obsessive-compulsive disorder.

By Lini S. Kadaba INQUIRER STAFF WRITER

Around his fifth birthday, Dante Falcone washed his hands. Then again. And

again.

He'd scrub them raw. " We'd go to church, and the [sunday school]

teacher said, 'We spent the whole hour in the bathroom,' " said his mother,

Severn Falcone, 39, of Villanova.

That weekend 19 months ago she and her husband, , left Dante and

his younger brother with a sitter. Before the Falcones could leave the

driveway, the sitter came running out.

Dante was in a rage. Frustrated by a toy, the usually easygoing child

had kicked a huge hole in the plaster wall of the kitchen. " I was just

floored, " his mother said. " I didn't know how to react because I had never

seen this. "

A week later, Dante was diagnosed with obsessive-compulsive disorder,

also known as OCD. " It all happened that quickly, " Severn Falcone said. " I

felt like I was drowning. "

OCD - more often associated with adults - has become a " hidden

epidemic " among children, therapists say.

Once considered rare, this neurological illness of " rational

irrationality " is now thought to afflict as many as 1 in 100 children -

about a million children - according to studies. More boys are affected than

girls.

Therapists say the higher numbers can be attributed to better awareness

and diagnosis.

" The conclusion about OCD is that it is not rare, but that it is rarely

diagnosed, " psychologist Tamar Chansky writes in Freeing Your Child From

Obsessive-Compulsive Disorder. " OCD lacks household recognition.. . . OCD is

not generally discussed in supermarket lines or at PTA meetings. "

Though it often occurs gradually, OCD showed itself in Dante overnight

- a hallmark of a particular kind of OCD that doctors believe is triggered

by strep infections.

Researchers at the National Institute of Mental Health (NIMH) think

strep may account for as many as one-third of the childhood cases of OCD.

Discovered more than a decade ago, this diagnosis, known as PANDAS -

pediatric autoimmune neuropsychiatric disorders associated with strep -

remains controversial.

It's believed that the body's immune system, geared up to fight the

strep, attacks the brain's basal ganglia, which affects the filtering of

information. The strep antibodies appear to bring on - though not cause -

OCD in children genetically predisposed to it.

Walkup, associate professor of child and adolescent psychiatry at

s Hopkins Medical Institutions, is among the skeptics. " The data

regarding PANDAS is limited, and much of it has been unconfirmed or not

replicated, " he said.

At NIMH, researchers are investigating specific treatments for PANDAS,

including prophylactic use of antibiotics against strep. " The preliminary

results are very encouraging, " said Swedo, chief of NIMH's pediatrics

and developmental neuropsychiatry branch.

*

Though most childhood OCD begins around age 10, cases have involved

children as young as 2. A small percentage of children grow out of OCD, but

most require treatment - therapy or antidepressants - through adulthood.

Some OCD sufferers also have attention deficit problems or Tourette's

syndrome.

People with OCD have " sticky thoughts, " said Chansky, director of the

Children's Center for OCD and Anxiety in Plymouth Meeting, and Dante's

therapist. " Odd thoughts get stuck in your mind, and you can't get rid of

them. "

Dante, now 6 1/2 and a kindergartner, described his OCD: " My head was

telling me things. I tried not to listen but I had to. "

Therapists say children with OCD often suffer from constant worries

about germs and contamination; the need to check and redo things; extreme

perfectionism; and horrible thoughts of harming themselves or others.

" The obsessive-compulsive is never satisfied with once, " said Lee

Fitzgibbons, director of the children's program at the Anxiety and

Agoraphobia Treatment Center in Bala Cynwyd. " They have to do better, they

have to jump higher, they have to wash longer. "

In most cases, OCD occurs so gradually that families may explain away

early signs - the need to precisely line up blocks, for example - as

personality quirks.

Tommy Joye, 8, another patient of Chansky's, was diagnosed as having

the more common, non-strep-related OCD at age 5, after three years of odd

behavior that became impossible to overlook, said his mother, Joye,

44, of Bethel Township. Tommy hoarded food, had long bouts of crying and

screaming, and couldn't stand the feeling of socks on his feet.

At first, his mother accepted the behavior as part of Tommy's

personality, his " strong will, " as his pediatrician put it. But life became

increasingly difficult. " It's very emotional, very draining, " she said.

Even young children often realize something's wrong but can't stop the

strange, harmful behavior.

When Tommy was 4, he began screaming because the first-floor elevator

button at the mall only pointed up. His mother remembered the preschooler's

saying, " Mommy, I don't know why I'm doing this, and I don't like it. "

For parents of a child with OCD, it can be painful and frustrating. " I

was very depressed, " Severn Falcone, Dante's mother, said. " I saw this

little boy I didn't know how to help. "

But with treatment - behavior modification, medication, or both - the

children and their families can regain a measure of control. " There is a lot

of reason to hope, " Fitzgibbons said.

*

By October 2000, about a month after his diagnosis, Dante Falcone

couldn't touch crayons or toys or food for fear of contamination, the most

common OCD compulsion.

At preschool, he would pull his sleeve over his hand to lift a graham

cracker to his mouth. Often, Dante would sit in a corner alone.

His play dates fell apart. " He'd get so worked up about contamination, "

his mother said. " And he'd make kids wash their hands. "

At one point, he so feared stepping on sidewalk cracks, truly believing

his mother's back would break, that he nearly walked in front of a truck.

For days, his mother was essentially housebound because Dante's fears

were overwhelming.

Relatives thought Dante was acting out. Or that his parents made too

much of his need to wash his hands. " I stopped wanting to go places, "

Falcone said.

Even she didn't fully understand Dante's turmoil until she asked one

day why he was furiously picking his nose.

" Because they'll kill me if I don't, " Dante said.

" Who will kill you? "

" My heart will kill me, " he said.

*

Therapists say OCD is like a bully pushing a kid around. As part of

therapy, the child has to learn to push back.

" You're in charge, " Chansky would tell Dante. " Your heart can't boss

you around. "

With behavior therapy, children learn to recognize OCD - even assigning

names to their fears, such as Mr. Germy or the Perfect Man - and to

literally talk back to the OCD.

Chansky would challenge Dante with games designed to increase his

tolerance for his fears. The two would play catch with a ball, and whoever

dropped it had to eat a sticky orange or buttery popcorn.

" At first, he was asking his mom constantly to wash his hands, " she

said. " He would throw a fit if he didn't get to wash them. "

Over a few weeks, he was able to wait longer and longer to wash his

sticky hands. Eventually, he would drop the ball on purpose to get an

orange.

During therapy, Dante, who has a history of frequent strep since age 3,

enrolled in the NIMH study on PANDAS and prophylactic antibiotics. His

brother, Dario, 4 1/2, also has had several strep infections, but he has not

been diagnosed with OCD.

" I'm constantly on edge, " Falcone said. " I'm constantly watching. "

Dante finished the trial this year and continues to take antibiotics to

ward off strep. He has not needed other anti-OCD drugs.

Once his strep was treated, many of the symptoms began to subside

almost as suddenly as they had started.

" He could sit. He was happy. He was able to pick up food. Normal

bathing. No anger. Truly, it was like day and night, " his mother said,

smiling.

Of course, she still has concerns. When Dante began chewing his shirt

sleeve, she worried it was OCD. But his kindergarten teacher said other kids

did that too. The behavior soon passed.

With periodic visits to Chansky, Dante has continued to improve. He

enjoys coloring again and his play dates. At lunch on a recent day, he poked

his finger into a bowl of pasta and happily licked off the sauce.

" He's truly back to his old self, " Falcone said.

A year ago at Easter, Dante couldn't stand to have the Easter egg dye

on his hands. His mother had to bleach them clean.

This year, she said, " we dyed some eggs and the color stayed on his

hands for two days. It was pretty neat. "

Contact Lini S. Kadaba at or lkadaba@....

Signs of OCD

Obsessive-compulsive behaviors:

Are time-consuming

Are disruptive of normal routines

Create distress or frustration

Appear bizarre or unusual

Become more elaborate and demanding with time

Must be executed precisely, the child thinks, to prevent adverse

consequences

- From Freeing Your Child From Obsessive-Compulsive Disorder by Tamar

E. Chansky

For More on OCD

Contact the Obsessive-Compulsive Foundation at or

www.ocfoundation.org;

National Institute of Mental Health PANDAS Program at 1- or

www.nimh.nih.gov.

Index terms:

CHILDREN BEHAVIOR MENTAL HEALTH DISEASE

Lini S. Kadaba

Staff Writer

Philadelphia Inquirer

400 N. Broad St.

Philadelphia, PA 19130

(phone)

(fax)

lkadaba@...

---------------------------------

[Guest guest]

Hi !

Thanks for posting the OCD story. It turns out the version printed

here was a condensed version, and I enjoyed being able to read the

full article. I think it did a good job of explaining some OCD

behaviors, frustrations for the child and family, and hope for

treatment.

Marlys in SC

[Guest guest]

Hi !

Thanks for posting the OCD story. It turns out the version printed

here was a condensed version, and I enjoyed being able to read the

full article. I think it did a good job of explaining some OCD

behaviors, frustrations for the child and family, and hope for

treatment.

Marlys in SC