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| A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State. |
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Click on "MORE" after any of these possible explanations to view suggestions for exploring that possible explanation.
Medical Possibility #1: Medication side effect: Some students may lack spontaneity as a side effect of medication. Medical Possibility #2: Chronic pain. Some students fail to initiate activity and interaction as a result of being in chronic pain. Medical Possibility #3: Fatigue, hunger, general nutrition: Some students fail to initiate activity and interaction as a result of fatigue (e.g., insufficient sleep) or hunger. Medical Possibility #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 or possible 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
Cognitive/Self-Regulatory Possibility #1: Isolated initiation impairment: Some students may lack initiation and fail to act spontaneously as a direct result of frontal lobe injury. (See Cognitive/Self-Regulatory Possibility #2: : Weak orientation to task: Some students may lack initiation as a result of disorientation or uncertainty regarding what is required of them. (See Cognitive/Self-Regulatory Possibility #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 Cognitive/Self-Regulatory Possibility #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 Cognitive/Self-Regulatory Possibility #5: Organizational impairment: Some students may appear to lack initiation and spontaneity as a result of organizational impairment. (See Behavioral Possibility #1: Oppositionality: Some students may appear to lack initiation and spontaneity as a result of oppositional behavior (See Behavioral Possibility #2: Attention seeking: Some students may appear to lack initiation and spontaneity as a means of obtaining adult and/or peer attention. (See Behavioral Possibility #3: Manipulativeness: Some students may appear to lack initiation and spontaneity as a form of manipulation. (See Behavioral Possibility #4: Task avoidance: Some students may appear to lack initiation and spontaneity as a way to avoid specific tasks. (See
Social-Emotional Possibility #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 Social-Emotional Possibility #2: Anxiety: Some students may appear to lack initiation and spontaneity as a result of anxiety. (See Social-Emotional Possibility #3: Frustration: Some students may appear to lack initiation and spontaneity as a result of feeling frustrated. (See
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Problem: The student does not begin assignments; rarely initiates interaction with peers or adults; is not spontaneous.
Please review the list of possible explanations to the problem. Click on a possibility to learn about relevant observations and experiments to further determine the source of the problem 
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