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Excoriation Disorder: Does Your Child Have It?

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Excoriation Disorder: Does Your Child Have It?

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Parents and educators--make sure you are seeking qualified mental health professionals if you fear a child may be struggling with this disorder.

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This disorder is also known as skin-picking disorder. Ask your school counselor for a referral if you suspect your child may have this disorder.

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What is excoriation disorder?

Excoriation disorder (or skin-picking) is a mental health condition that can cause children to pick at their skin constantly. Children with excoriation disorder pick at their skin so much that they cause harm and pain to the spots they pick at. They can't stop picking even if they want to.

Some kids pick at their skin because it makes them feel good, and it can be triggered by stress or anxiety. Many children do not even know they are doing it. Skin picking can cause bleeding, scabs, infection and scars. It can also cause shame and embarrassment if other people see the damage. Excoriation disorder usually starts in the early teen years.

Children who have obsessive-compulsive disorder (OCD) are more likely to develop excoriation disorder.

What are the symptoms of excoriation disorder?

Marks or scabs on the child's body from picking their skin are the main symptom. Some children pick at the same spot over and over. Others move from one spot to another. Usually, kids with excoriation use their own fingernails to pick, but some might use tweezers or other tools.

Children with excoriation disorder may pick at any part of their body. The face is the most common area. Other common spots that kids might pick include arms, legs, back, gums, lips, shoulders, scalp, stomach, chest, fingernails, toenails and cuticles.

How is excoriation disorder diagnosed?

Three things have to happen for a child to be diagnosed with excoriation disorder:

They must pick at their skin so much and for so long that the picking causes wounds.

They must have tried and failed to stop on their own.

The picking must make them very upset or cause problems in their day-to-day activities.

How is excoriation disorder treated?

Usually, skin picking can be stopped with the help of a therapist. Cognitive behavioral therapy (CBT) can help the child become aware of what feelings and situations make them pick. CBT teaches kids other ways to deal with the feelings that cause them to pick.

Medication is not usually used to treat excoriation. However, some kids benefit from taking antidepressants while also getting CBT.

This guide was last reviewed or updated on September 13, 2022.

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Quick Guide to Excoriation Disorder - Child Mind Institute

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Excoriation disorder (or skin-picking) is a mental health condition that can cause children to pick at their skin constantly.

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Parents, here is a wonderful resource about BDD including signs and treatments.

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Students there is help for BDD and other mental health disorders. Talk to your counselor who can refer you to a mental health professional.

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'Because I'm Ugly:  Body Dysmorphic Disorder (BDD) and me.'

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Parents, learn the facts about OCD and get help for your student with managing the disorder.

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Did you know that "according to the National Alliance on Mental Illness (2010), 4 million children and adolescents in the United States experience a significant mental health problem during their school years, but only about 20% receive appropriate services?"

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"Failure to address students’ mental health needs is linked to poor academic performance, behavior problems, school violence, dropping out, substance abuse, special education referral, criminal activity, and suicide."

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Five Core Skills That All Educators Should Have to Help Students

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Five Core Skills That All Educators Should Have to Help Students

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Educators are in unprecedented times with student needs at an all-time high and teacher morale at a discouraging low. Yet, it remains our job to support and encourage students-especially if they're dealing with mental health issues.

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Helping Teachers Help Our Kids | It Takes a Village

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Parents, if you suspect that your child may be displaying signs of bipolar disorder, it is important that you reach out to your school counselor. He/she can refer you to mental health professionals that are qualified to first diagnose and then help your student manage their disorder.

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How Counselors Help Students Manage Their Mental Health

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How Counselors Help Students Manage Their Mental Health

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According to the attached article, school counselors create programs that encourage growth both academically and personally. When it comes to mental health, they do this by:

Increasing awareness of mental health in schools

Refer students with mental health issues to mental health professionals, but also provide short-term counseling or crisis intervention if needed

Being aware of signs and symptoms of possible mental illness, such as sudden changes in grades or attendance, disciplinary problems, or visible problems at home.

Focus on individual students who may be struggling with issues such as depression, anxiety or management of anger.

Provide resources and support for teachers, administrators, and parents

"Although school counselors typically do not act as long-term therapists, they help foster an environment where mental health stigma is erased, help bridge the gap between student and community resources, and make sure the developmental needs of all students are met."

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Parental Support and Healthy Mental Health

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Parental Support and Healthy Mental Health

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Parents, when children feel supported, they are more likely to confide in you when something is wrong. Review the tips above to see how to promote healthy mental health in your child's life.

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This presentation gives parents, administrators, and other stakeholders information about the role of a school counselor.

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This presentation gives parents, administrators, and other stakeholders information about the role of a school counselor.

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Teacher's Guide to Obsessive Compulsive Disorder(OCD)

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Teacher's Guide to Obsessive Compulsive Disorder(OCD)

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Teachers, look no further than this fact sheet on how to help your students who have been diagnosed with OCD.

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Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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Behavioral Disorders:  Strategies That Help in the Classroom                                                            National Science Teaching Association (NSTA)

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Behavioral Disorders:  Strategies That Help in the Classroom                                                            National Science Teaching Association (NSTA)

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Educators, these strategies can work in any classroom where a student with behavioral disorder needs support to be successful.

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result, their presence severely constrains the ability of the school systems to educate students effectively. The prevalence of behavioral problems among children and young adults is substantial. Many surveys indicate that behavioral disorders vary among young adults, ranging from 2 and 6 percent among K-12 students. This percentage translates into 1.3 to 3.8 million cases of behavioral disorders among the school and pre-college population.

Behavior disorders have also been referred to in a variety of different terminologies, including but not limited to:

1. Emotional and Behavior Disorders (EBD)

2. Emotional Conflict (EC)

3. Serious Emotional Disturbance (SED)

Behavioral disorders become apparent when the student displays a repetitive and impact persistent pattern of behavior that results in the significant disruption of other students. Such disturbances may cause significant impairments in academic, social, and or occupational functioning. Among the characteristics of a behavioral disorder among children and adolescents are:

General Strategies

Multidisciplinary educational teams, including parents, must design programs to meet the individual behavioral and academic needs of identified SED students. Most students can benefit from supportive treatments provided in general education programs. For others, at least temporary placements in special education classrooms, schools, or institutional programs may be appropriate.

Special education programs usually attempt to provide a structured environment where students experience a high degree of success; rules and routines are predictable; and students are consistently rewarded for appropriate behavior. Behavior management techniques, such as positive reinforcement, token economies, contracting, and time-out, which rely on direct measurement and monitoring of behavioral change, are commonly used in SED programs. The assessment and systematic teaching of social skills through modeling, discussion, and rehearsal are frequently used to help students increase control over their behavior and improve their relations with others. In addition, supportive therapies involving music, art, exercise, and relaxation techniques, as well as affective education, individual, and group counseling are sometimes employed to improve self-understanding, self-esteem, and self-control. The following are strategies that may be effective with students with EBD:

Teacher Presentation

Laboratory

Group Interaction and Discussion

1. Acknowledge the contributions of the student with an emotional disorder.

2. Call for responses and participation commensurate with the student's socialization skills.

3. As the student's comfort level rises and when a safe topic is available, encourage the student to be a group spokesperson.

4. Along with the student, devise a contingency plan in which inappropriate forms of response are replaced by appropriate ones.

5. Gradually increase the challenges in the student's participation in group exercises while providing increased positive reinforcement.

6. Help the student to feel as though he or she has something worthwhile to contribute to the discussion.

7. Some students may experience considerable strain in social adjustment in a group context. It may be necessary to work gradually toward group activities. One can devise a strategy of progressing from spectatorship to one-to-one instruction and eventually to small group discussion.

8. Should monitor carefully to ensure that the nondisabled students do not dominate the discussion or detract in any way from the successful performance of the student with the behavioral disorder.

Reading

1. It is necessary to target specific pro-social behaviors for appropriate instruction and assessment to occur such as:

1. Taking turns, working with partner, following directions.

2. Reading in group or with others.

3. Increasing positive relationships by means of awards when they read appropriately.

4. Demonstrating appropriate reading

2. Instructional strategies involving self-control, self-reinforcement, self-monitoring, self-management, problem solving, cognitive behavior modification, and metacognitive skills should be focused on teaching students reading skills

Research

1. Review and discuss with the student the steps involved in a research activity. Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.

2. Use appropriate laboratory and field strategies.

3. Depending on the site of the research check the previous two sections.

4. Show clear examples of what the students should expect as an outcome of their research.

Field Experiences

1. Use appropriate general strategies.

2. Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.

3. In field activities acknowledge the contributions and assistance of the student with an emotional disorder.

4. Help the student to feel as though he or she has something worthwhile to contribute to the field trip.

5. Use a buddy system.

6. Gradually increase the challenges in the student's participation in field exercises while providing increased positive reinforcement.

7. Group participation in field activities is highly desirable because it enhances social contacts.

8. Make the student with the behavioral disorder become one of the field trip leader of an activity which can often reduce their disorder.

9. Special efforts should be made to get students with behavioral disorders to interact with other students.

10. You should encourage students to practice field skills during their free hours.

11. Every effort should be made to arouse the interest of such students in activities, so they will learn to perform the activities with success and pleasure with appropriate behaviors.

Testing

1. Be sensitive to the student's reactions to the various aspects of assessment.

2. For each student, accumulate in his or her portfolio several examples of work (quizzes, assignments, projects) that demonstrate knowledge of the subject matter or the unit of study.

3. Make special arrangements for the student with an emotional disorder according to what their special needs are and that they do not compromise the integrity of the testing situation.

4. Stay on top of student progress through informal assessment, don't wait until it's too late to discover that there is a problem.

5. Provide private room/smaller group setting/alternative test site (with proctor present); alternatively screens to block out distractions.

Organizations

Council for Exceptional Children-Council for Children with Behavior Disorders (CCBD)
The Council for Children with Behavioral Disorders (CCBD) is dedicated to supporting the professional development and enhancing the expertise of those who work on behalf of children with challenging behavior and their families. It is a division of the Council for Exceptional Children (CEC).

CCBD Foundation
The CCBD Foundation was founded in 1997 by the Council for Children with Behavioral Disorders (CCBD), to support its mission of improving the education of children and youth with emotional or behavioral disorders (EBD).

Resources

Council for Exceptional Children (Behavior Disorders/Emotional Disturbance)
The Council for Exceptional Children (CEC) page on EBD. The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving the educational success of individuals with disabilities and/or gifts and talents.

BehaviorDisorder.org
The site offers information on behavior disorders, conduct disorders, and other behavior problems.

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result, their presence severely constrains the ability of the school systems to educate students effectively.

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Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and Disruptive Behavior Disorder (DBD) Fact Sheet for Parents

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Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and Disruptive Behavior Disorder (DBD) Fact Sheet for Parents

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Parents, has your child been diagnosed with Oppositional Defiant Disorder, Conduct Disorder, or Disruptive Behavior Disorder and you don't know how to help him/her? Start with this fact sheet:

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National Eating Disorders Association (NEDA)

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National Eating Disorders Association (NEDA)

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Teachers and staff,
Do you suspect that one of your students may have an eating disorder? NEDA provides information and resources specifically geared towards educators or those who work in a school setting. Click on the link to learn more.

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Learn more about feeding and eating disorders by reviewing the presentation below:

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Learn more about feeding and eating disorders by reviewing the presentation below:

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Though we may all experience anxiety from time to time, when it comes to trying to explain to youngsters the ins and outs of how anxiety works, we may be at a loss.

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Parents, if you are concerned about behavior that your child is exhibiting, go to the child mind institute and click on symptom checker. This is one of the "tools" in our school counselor kit, that helps parents in identifying behaviors that could be signs of a mental or learning disorder. Per the Child Mind Institute, "Remember, this tool is not a substitute for a diagnostic evaluation by a medical or mental health professional. If you believe your child has a psychiatric or learning disorder, please consult a professional."

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Anxiety Disorders: Summary and Information on Separation Anxiety Disorder and Social Phobia

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Anxiety Disorders: Summary and Information on Separation Anxiety Disorder and Social Phobia

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Eating Disorders: Information on Anorexia, Bulimia, and Binge-Eating for Middle and High School Teachers

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Eating Disorders: Information on Anorexia, Bulimia, and Binge-Eating for Middle and High School Teachers

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Teen depression is on the rise, so it is up to the adults to become educated about teen depression--what it looks like and how to help. If you are a parent of a teen and you suspect they may be struggling, there is help. Reach out to your student's school counselor who can help with referrals and resources. Do not take "I am fine" as a response when asked if they are okay. Sometimes they are not.

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Teen depression is on the rise, so it is up to the adults to become educated about teen depression--what it looks like and how to help. If you are a parent of a teen and you suspect they may be struggling, there is help. Reach out to your student's school counselor who can help with referrals and resources. Do not take "I am fine" as a response when asked if they are okay. Sometimes they are not.

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ADHD and Effective Classroom Strategies for Educators and Other Stakeholders

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ADHD and Effective Classroom Strategies for Educators and Other Stakeholders

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Teachers, if you are in need of strategies to assist your students with ADHD in becoming more successful in the classroom, read on to find out more.

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ADHD and Effective Classroom Strategies That Encourage Student Success

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Parents, if your student is struggling with any type of mental disorder, please reach out to me at 817-744-5300, ext. 5311, or at Tina.Thomas@Kellerisd.net. I can provide resources and facilitate referrals so your child can get the help they need. We care about your child's academic, as well as their personal and mental health needs.

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Parents, if your student is struggling with any type of mental disorder, please reach out to me at 817-744-5300, ext. 5311, or at Tina.Thomas@Kellerisd.net. I can provide resources and facilitate referrals so your child can get the help they need. We care about your child's academic, as well as their personal and mental health needs.

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Referrals and Tiering: What Educators Need to Know

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Referrals and Tiering: What Educators Need to Know

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Teachers, do you have students with behavioral issues and are unsure how to proceed in getting them the help they need? It begins with a process called tiering. Here is what you need to know: