I. GENERAL MEDICAL POSSIBILITIES 

1.Medication Side Effect:Some students may have difficulty with transitions as a side effect of medication.

2. Fatigue:Some students have difficulty with transitions as a result of fatigue (e.g., insufficient sleep).

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II. COGNITIVE/SELF-REGULATORY POSSIBILITIES

1.Specific Flexibility Impairment: Some students may be inflexible and have difficulty with transitions as an isolated deficit, a direct result of frontal lobe injury. (See Tutorial on Flexibility)

2.Organizational Impairment: Some students may have difficulty with transitions as a result of a specific organizational impairment. (See Tutorial on Organization)

3.General Self-Regulation Impairment: Some students may be inflexible and have difficulty with transitions 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; Impulsiveness/Disinhibition; Initiation; Problem Solving)

4.Attention Deficit: Some students may be inflexible and have difficulty with transitions as a result of problems with components of attention. (See Tutorial on Attention)

5.Inhibition Impairment: Some students may be inflexible and have difficulty with transitions as a result of inhibition impairment (i.e., impulse-control problems). (See Tutorials on Self-Regulation; Impulsiveness/Disinhibition)

6.Weak Orientation To Task: Some students may be inflexible and have difficulty with transitions as a result of uncertainty regarding what is required of them. (See Tutorials on Language Comprehension; Organization)

7.Generally Weak Cognitive Functioning: Some students may be inflexible and have difficulty with transitions as a result of excessive demands placed on their memory, organizational ability, academic skill, or other cognitive ability. (See Tutorials on Cognition; Memory; Organization)

8. General Slowness in Information Processing: Some students may be inflexible and have difficulty with transitions as a result of general slowness in information processing. (See Tutorial on Slow Information Processing)

9. Memory/Retrieval Impairment: Some students may be inflexible and have difficulty with transitions 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 have difficulty organizing 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 have difficulty organizing 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 have difficulty organizing 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 be inflexible and have difficulty with transitions 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 be inflexible and have difficulty with transitions 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 be inflexible and have difficulty with transitions as a result of anxiety. (See Tutorial on Anxiety)

3.Frustration: Some students may be inflexible and have difficulty with transitions 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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