A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State.
 

At Home #2: perseverate

Problem: The student appears to perseverate or gets stuck doing the same activity, saying the same thing or feeling the same emotion; may have difficulty transitioning from place to place or activity to activity; requests from teachers or parents to change topics; activities may be greeted with negative behavior; changes in or disruptions of routines cause problems; the student appears to be rigid and inflexible.


I. GENERAL MEDICAL POSSIBILITIES

  1. Medication Side Effect
  2. Fatigue/Hunger/Nutrition

II. COGNITIVE/SELF REGULATORY POSSIBILITIES

  1. Specific Flexibility Impairment
  2. Organizational Impairment
  3. General Self-Regulation Impairment
  4. Attention Deficit
  5. Week Orientation to Task
  6. Generally Weak Cognitive/Academic Functions
  7. General Slowness in Information Processing
  8. Memory/Retrieval Impairment

III. BEHAVIORAL POSSIBILITIES

  1. Oppositionality
  2. Manipulativeness
  3. Attention Seeking
  4. Task Avoidance

IV. SOCIAL- EMOTIONAL POSSIBILITIES

  1. Depression
  2. Anxiety
  3. Frustration
  4. Obsessive-Compulsive Disorder


I. GENERAL MEDICAL POSSIBILITIES 

1. Medication Side Effect: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routine as a side effect of medication.
               
2. Fatigue/Hunger/General Nutrition: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routine
as a result of fatigue or hunger. (See Tutorial on Fatigue)

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II. COGNITIVE/SELF-REGULATORY POSSIBILITIES

1.Specific Flexibility Impairment: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routine as an isolated deficit, a direct result of frontal lobe injury. (See Tutorial on Flexibility)

2. Organizational Impairment: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of a specific organizational impairment. (See Tutorial on Organization)

3.General Self-Regulation Impairment: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of general difficulty with self-regulation (e.g., rigidity, impulse-control problems, disorganization). (See Tutorials on Self-Regulation; Self-Monitoring and Self- Evaluating; Organization; Problem Solving; Impulsiveness/Disinhibition, Initiation; Problem Solving)

4.Attention Deficit: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of problems with components of attention. (See Tutorial on Attention)

5.Weak Orientation to Task: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of uncertainty regarding what is required of them. (See Tutorials on Language Comprehension; Organization)

6.Generally Weak Cognitive Functioning: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of excessive demands placed on their memory, organizational ability, academic skill, or other cognitive ability. (See Tutorials on Cognition; Memory; Organization)

7. General Slowness in Information Processing: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of general slowness in information processing. (See Tutorial on Slow Information Processing)

8.Memory/Retrieval Impairment: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of difficulty with memory/retrieval (See Tutorials on Retrieval; Word Retrieval)

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III. BEHAVIORAL POSSIBILITIES

1.Oppositionality: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of oppositional behavior (See  Tutorials on Behavior and Behavior Problems after TBI; Behavior Management: Prevention Strategies)
               
2.Manipulativeness: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a form of manipulation (other than oppositional behavior). (See Tutorials on Teaching Positive Communication Alternatives to Negative Behavior; Behavior Management: Prevention Strategies)

3.Attention Seeking: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a way to seek adult and/or peer attention. (See Tutorials on Attention; Behavior Management: Prevention Strategies; Behavior Management: Contingency Management)

4.Task Avoidance: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a way to avoid specific tasks. (See Tutorials on Noncompliance; Errorless Learning; Problem Solving; Behavior Management: Prevention Strategies; Behavior Management: Contingency Management)

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IV. SOCIAL-EMOTIONAL POSSIBILITIES

1.Depression: Some students may appear to be inflexible and have difficulty with topics shifts, attention shifts, activity transitions, and changes in routines because they are upset, depressed, and/or lack positive relationships with peers and/or adults. (See Tutorials on Depression; Peer Relationships)

2.Anxiety: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of anxiety. (See Tutorial on Anxiety)

3.Frustration: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of feeling frustrated. (See Tutorials on Self Regulation/Executive Function Routines after TBI; Teaching Positive Communication Alternatives to Negative Behavior)

4.Obsessive-Compulsive Disorder: Some students may appear to be inflexible and have difficulty with topic shifts, attention shifts, activity transitions, and changes in routines as a result of obsessive-compulsive disorder. (See Tutorial on Self Regulation/Executive Function Routines after TBI; Teaching Positive Communication Alternatives to Negative Behavior)

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