A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State.
Problem: The student hits, shoves, or pushes peers and/or adults, or uses aggressive or threatening language.
Medical Possibility: Seizures.

Step 1: Organize observations relevant to the problematic behavior/issue

  • Who is reporting the problem?
  • When does it occur? (Include time of day, activities etc).
  • Where does it occur?
  • What tends to precede the problematic behavior/issue?
  • What tends to follow the problematic behavior/issue?
  • What is the age and functioning level of the student?
  • Previous documentation/charts?

Step 2: Identify possible contributors to the problematic behavior/issue

In many cases, there are several contributors to the student’s identified problem. These contributors may interact with each other, therefore, it may be necessary to combine tests from different categories of possibilities. The existence of several interacting contributors may become obvious as you proceed through individual intervention experiments.

Seizures: In rare cases, aggression may be a result of temporal lobe seizures that may or may not be diagnosed. If temporal lobe seizures have been diagnosed, staff should ask the physician if aggression is a likely or possible consequence of the seizures. If seizures have not been diagnosed, but are suspected, a seizure evaluation should be recommended. When students with TBI engage in aggressive acts that are unpredictable and incompatible with the student’s normal behavior, consultation with a physician or neuropsychologist may help staff understand the source of the aggression. Aggression that is neurologically based should be managed with a comprehensive environmental effort to prevent the aggressive behavior. (See Tutorial on Behavior Management: Prevention Strategies.) If seizures are diagnosed, the prescribed medication regimen should be followed along with environmental management. (See Tutorial on Seizures.)

Possible referrals: A physician (e.g., neurologist) who can evaluate the student for possible seizures.

A program of the Brain Injury Association of New York State, and funded by the Developmental Disabilities Planning Council.

Copyright 2006, by
The Brain Injury Association of New York State
10 Colvin Avenue, Albany, NY 12206 - Phone: (518) 459-7911 - Fax: (518) 482-5285

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