A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State.
Problem: The student appears to do the first thing that comes to mind; has difficulty delaying gratification; appears to act without thinking.
Cognitive/Self-Regulatory Possibility:
Attentional impairment

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

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.

Attentional impairment: Some students may think and act impulsively as a result of difficulty attending (See Tutorial on Attention).

Relevant observations: The student does not maintain focus for expected periods of time or on one activity at a time. The student frequently ‘fidgets’ and may have difficulty completing tasks or comprehending tasks. The student has difficulty doing two things at once (e.g., listening to the teacher and taking notes). The student has difficulty shifting from one focus of attention to another. This behavior may interfere with the student’s ability to learn and retain information. Medical records may indicate a neurological basis for this difficulty. Note: A correlation between attention problems and impulse regulation problems may suggest that impulse regulation problems are the cause of the attention problems rather than attention problems causing impulse control problems. In either case, both problems should be addressed in intervention and support programs.

Useful experiments for assessment and intervention:

  1. Observe and record the frequency and/or intensity of the problem behavior when a new teaching strategy or support is being implemented versus when it is not being implemented.
  2. Possible attention-related teaching strategies or supports (See Tutorial on Attention): Create an environment that provides support for the student to maintain attention. Examples: (a) The student may benefit from a quiet, distraction-free area to complete assignments; (b) Attention-focusing printed cues, timers, or other external strategies may help; ( c) Frequent changes in activity may help focus attention; (d) It may be beneficial to reward the student for on-task behavior; (e) With younger students, a game can be made out of maintaining focus.
  3. If the targeted behavior decreases as a result of the intervention, then this student’s difficulty with attention may be contributing to the problem behavior. (See Tutorial on Attention.)

Possible referrals: Physician to explore possible neurological basis and possible medication intervention; school psychologist for assessment of attentional functioning

A program of the Brain Injury Association of New York State, and funded by the Developmental Disabilities Planning Council.

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The Brain Injury Association of New York State
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