At School #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.
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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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