|        A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State.|
Step 1: Organize observations relevant to the problematic behavior/issue
In many cases, there are several contributors to the student’s identified problem. These contributors may interact with each other, therefore, it may be necessary to combine tests from different categories of possibilities. The existence of several interacting contributors may become obvious as you proceed through individual intervention experiments.
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).
Relevant observations: The student’s lack of initiation does not appear to be a result of any of the medical, cognitive, behavioral, or emotional possibilities listed. In some students with TBI, (dorsal) frontal lobe injury can produce initiation impairment that is independent of all other problems. Medical records suggest dorsal (upper side) prefrontal injury.
Useful experiments for assessment and intervention:
Possible referrals: Physician to explore possible neurological basis and possible medication intervention; school psychologist for initiation assessment; instructional support specialist for instructional strategies; behavior specialist for behavior management strategies
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