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

At Home #3: rarely initiates

Problem: The student does not begin assignments; rarely initiates interaction with peers or adults; is not spontaneous.


I. GENERAL MEDICAL POSSIBILITIES

II. COGNITIVE/SELF REGULATORY POSSIBILITIES

III. BEHAVIORAL POSSIBILITIES

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

IV. SOCIAL- EMOTIONAL POSSIBILITIES

  1. Depression
  2. Anxiety
  3. Frustration


I. GENERAL MEDICAL POSSIBILITIES 

1.Medication Side Effect: Some students may lack spontaneity as a side effect of medication.
               
2. Chronic Pain: Some students fail to initiate activity and interaction as a result of being in chronic pain.

3. Fatigue/Hunger/General Nutrition: Some students fail to initiate activity and interaction as a result of fatigue.

4. Seizures: In rare cases, lack of initiation may be a result of seizures that may or may not be diagnosed. If seizures have been diagnosed staff should ask the physician if initiation impairment is a likely consequence of the seizures. If seizures have not been diagnosed, but are suspected, a seizure evaluation should be recommended. If seizures are diagnosed, the prescribed medication regimen should be followed along with environmental management of the initiation impairment. (See Tutorials on Seizures; Initiation Impairment

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II. COGNITIVE/SELF-REGULATORY POSSIBILITIES

1.Isolated Initiation Impairment: Some students may lack initiation and fail to act spontaneously as a direct result of frontal lobe injury. (See Tutorial on Initiation Impairment)

2.Weak Orientation to Task: Some students may lack initiation as a result of disorientation or uncertainty regarding what is required of them. (See Tutorials on Language Comprehension; Organization)

3.Generally Weak Cognitive and Academic Functioning: Some students may lack initiation as a result of excessive demands placed on their memory, organizational ability, academic skill, or other cognitive ability. They may experience frequent failure in school. (See Tutorial on Cognition; Memory; Organization)

4.General Slowness in Information Processing: Some students may appear to lack initiation and spontaneity as a result of general slowness in information processing. (See Tutorial on Slow Information Processing)

5.Organizational Impairment: Some students may appear to lack initiation and spontaneity as a result of organizational impairment.  (See Tutorial on Organization)

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III. BEHAVIORAL POSSIBILITIES

1.Oppositionality: Some students may appear to lack initiation and spontaneity as a result of oppositional behavior. (See Tutorials on Behavior and Behavior Problems after TBI; Behavior Management; Prevention Strategies)

2.Attention Seeking: Some students may appear to lack initiation and spontaneity as a means of obtaining adult and/or peer attention=on. (See Tutorials on Attention; Behavior Management; Prevention Strategies; Behavior Management: Contingency Management)

3.Manipulativeness: Some students may appear to lack initiation and spontaneity as a form of manipulation. (See Tutorials on Teaching Positive Communication Alternatives to Negative Behavior; Behavior Management: Prevention Strategies)

4.Task Avoidance: Some students may appear to lack initiation and spontaneity 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 lack initiation and spontaneity 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 lack initiation and spontaneity as a result of anxiety. (See Tutorial on Anxiety)

3.Frustration: Some students may appear to lack initiation and spontaneity as a result of feeling frustrated. (See Tutorials on Self Regulation/Executive Function Routines after TBI; Teaching Positive Communication Alternatives to Negative Behavior)

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