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  1. Chapter 1. Educating Everybody's Children: We Know What Works—And What Doesn't
  2. Educating Everybody's Children: We Know What Works—And What Doesn't
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  4. Community Publications

Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in patients with OCD. There appears to be a connection between the OCD symptoms and abnormalities in certain areas of the brain, but that connection is not clear. Research is still underway.

Chapter 1. Educating Everybody's Children: We Know What Works—And What Doesn't

Understanding the causes will help determine specific, personalized treatments to treat OCD. An association between childhood trauma and obsessive-compulsive symptoms has been reported in some studies. More research is needed to understand this relationship better. OCD is typically treated with medication, psychotherapy, or a combination of the two. Although most patients with OCD respond to treatment, some patients continue to experience symptoms.


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Sometimes people with OCD also have other mental disorders, such as anxiety, depression, and body dysmorphic disorder, a disorder in which someone mistakenly believes that a part of their body is abnormal. It is important to consider these other disorders when making decisions about treatment. SRIs often require higher daily doses in the treatment of OCD than of depression and may take 8 to 12 weeks to start working, but some patients experience more rapid improvement. If symptoms do not improve with these types of medications, research shows that some patients may respond well to an antipsychotic medication.

Although research shows that an antipsychotic medication may help manage symptoms for people who have both OCD and a tic disorder, research on the effectiveness of antipsychotics to treat OCD is mixed. Other medications have been used to treat OCD, but more research is needed to show the benefit of these options.

For the most up-to-date information on medications, side effects, and warnings, visit the FDA website. Psychotherapy can be an effective treatment for adults and children with OCD. Research shows that certain types of psychotherapy, including cognitive behavior therapy CBT and other related therapies e. As with most mental disorders, treatment is usually personalized and might begin with either medication or psychotherapy, or with a combination of both. NIMH is supporting research into other new treatment approaches for people whose OCD does not respond well to the usual therapies.

These new approaches include combination and add-on augmentation treatments, as well as novel techniques such as deep brain stimulation. You can learn more about brain stimulation therapies on the NIMH website. Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions.


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The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future. Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers.

We have new and better treatment options today because of what clinical trials uncovered years ago. Talk to your doctor about clinical trials, their benefits and risks, and whether one is right for you. To learn about clinical trials conducted at NIMH, contact or nimhcore mail.

Unless otherwise specified, NIMH information and publications are in the public domain and available for use free of charge.

Educating Everybody's Children: We Know What Works—And What Doesn't

Citation of the NIMH is appreciated. Hours: a. Skip to content. Mental Health Information. About Us.

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Obsessive-Compulsive Disorder. Identity safe classrooms: Places to belong and learn. London, UK : Corwin Press. This is especially important given the societal and school-based aggressions many children, especially those living under adverse conditions, experience. For all these reasons, and because children develop through individual trajectories shaped by their unique traits and experiences, teachers need to know students well to create productive learning opportunities.

These insights from the science of learning and development suggest the following principles for practice in this domain, which we discuss further below: School and classroom structures should be designed to create and support strong attachments and positive, long-term relationships among adults and children that provide both academic and social-emotional support for cultivating developmentally-appropriate skills, emotional security, resilience, and student agency.

School practices should be designed to strengthen relational trust and promote cultural competence among educators, school staff, and families to provide deeper knowledge regarding children and greater alignment between the home and school. Personalizing the educational setting so that students can be well-known by adults and their needs can be better met is a powerful lever that can change student outcomes. While this kind of personalization may sometimes include uses of technology, that is not its main goal or only tool.

As we detail in this section, smaller learning environments and structures that allow for stronger, adult-child relationships can improve attendance, attachment, achievement, and attainment. Often, it is because of close adult-student relationships that students who are placed at risk for a variety of negative outcomes like dropping out are able to attach to school and gain the academic and other kinds of help they need to succeed. Student-centered schools: Closing the opportunity gap.


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The organization of effective secondary schools. Review of Research in Education, 19 , — The one best system: A history of American urban education Vol. These schools were not designed based on knowledge of how people learn and develop optimally. Unlike schools in many countries, where teachers often stay with their students for two or three years in primary school and have more extended relationships in secondary school, U.

This reduces the extent to which teachers can build on personal knowledge in meeting their needs. Handbook of adolescent psychology. New York : Wiley Publishing. Focus on the wonder years: Challenges facing the American middle school. Rand Corporation. The design of most U. Depersonalized contexts are most damaging when students are also experiencing the effects of poverty, trauma, and discrimination without supports to enable them to cope and become resilient.

Building conditions for learning and healthy adolescent development: Strategic approaches. Doll , W. Yoon Eds. New York : Routledge. Ecological changes that create personalized environments with opportunities for stronger relationships among adults and students can create more productive contexts for learning. Can small high schools of choice improve educational prospects for disadvantaged students?

Journal of Policy Analysis and Management, 33 2 , — High school size, organization, and content: What matters for student success? Brookings papers on education policy, 9 , — Educational Psychologist, 42 4 , — School Size. These settings include smaller schools as well as small learning communities created within large school buildings, where staff and students work in together in smaller units that function as close-knit communities.

Optimum size varies by student needs and school design, with high school sizes below having been found more conducive to student success than larger schools, all else equal. Many studies in high-poverty urban areas have found strong improvements in student outcomes in small schools. Small schools: Great strides, A study of new small schools in Chicago.

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Personalizing Structures. Small size alone is not enough to produce these effects, however. For example, in a study of high schools, Lee and Smith, Lee, V. Effects of high school restructuring and size on early gains in achievement and engagement. Sociology of Education, 68 4 , — Similarly, in a set of studies of redesigned schools, including randomized controlled trials, quasi-experiments, and case studies, Felner and colleagues found that small learning communities stimulate positive outcomes for students, with the greatest benefits in larger schools with more students from high risk backgrounds.

In effective advisory systems , each teacher advises and serves as an advocate for a small group of students usually 15—20 over two to four years. Teachers facilitate an advisory class that meets regularly to support academic progress, teach social-emotional skills and strategies, and create a community of students who support one another. In a distributed counseling function, advisors support students on academic and nonacademic issues that arise and serve a point person with other faculty teaching the same student.

The advisor functions as a bridge between student, school, and home so that students are provided the supports they need in a coherent way that allows them to navigate school in a productive and positive manner. Each teacher sees half as many students, and students see fewer teachers. This smaller pupil load allows teachers to provide more attention to each student and to engage in more in-depth teaching practices. Block scheduling in the high school. Researchers digest. This structure allows teachers to share their knowledge about students in planning curriculum to meet student needs, while creating more continuity in practices and norms, which supports students emotionally and cognitively.

How childhood trauma affects health across a lifetime - Nadine Burke Harris

As the authors note:. Effective interdisciplinary teaming reduces the levels of developmental hazard in educational settings by creating contexts that are experientially more navigable, coherent, and predictable for students. Interdiscipinary teaming can also create enhanced capacity in schools for transformed instruction through enabling the coordination and integration of the work of teachers with each other, including in instruction, and as ongoing sources of professional development and support for each other p.

School size in Chicago elementary schools: Effects on teachers' attitudes and students' achievement. American Educational Research Journal, 37 1 , 3 — To accomplish this, schools need structures and practices that allow staff to develop collective expertise about their students as well as to develop trust with them. Continuity of relationships is a key principle in this regard, especially important for children who have minimal continuity outside of school. Strategies found effective in this regard include looping from grade to grade, and longer grade spans at the school level.

These organizational designs create sustained relationships, reduce cognitive load and anxiety for students when they do not need to learn new systems and reestablish their identity, and expand learning time because staff carry their knowledge about students and families forward from year to year. Looping , through which teachers stay with the same students for more than one year, can occur when teachers teach the same students in fourth and fifth grade, for example, or when a secondary teacher has the same students for 9 th and 10 th grade English.

Reinventing high school: Outcomes of the coalition campus schools project. American Educational Research Journal, 39 3 , — The strong relationships and deep knowledge of student learning supported by these longer relationships between adults and children can substantially improve achievement, especially for lower-achieving students Bogart, Bogart, V. The effects of looping on the academic achievement of elementary school students.