Problem: The student engages in off-task and possibly distracting behavior.

Medical Possibility: Chronic Pain.

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

Chronic Pain. Some students engage in off-task and possibly distracting behavior as a result of being in chronic pain.

Relevant observations: The student may appear agitated or frequently complain of aches and pains. He may also appear fatigued, tired, and/or restless.

Useful experiments:

1. Compare the frequency and/or intensity of the off-task behavior under the following conditions.
   1. Under medical supervision, observe the student’s behavior when not receiving any type of pain management. These observations should take place across a variety of settings, such as during math class, in the cafeteria, and during recess.
   2. Under medical supervision, administer the prescribed pain management. Again observe and record the frequency and intensity of targeted behavior.
2. Compare the student’s behavioral differences when receiving pain management versus when not. Specifically look to see if the targeted behaviors have decreased under pain management conditions.
3. If the off-task behavior has decreased under pain management conditions, then chronic pain may be one of the contributors to the problem behavior.

Possible Referral: Physician who prescribed the medication; other clinician responsible for pain management.