A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State.
 
Problem: The student appears to need directions repeated; he often does not do what he is supposed to do; he either does not begin or does not complete assignments; he may at times appear to be defiant.
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. There are 4 categories: General Medical, Cognitive/Self-Regulatory, Behavioral, Social-Emotional

Click on "MORE" after any of these possible explanations to view suggestions for exploring that possible explanation.


General Medical Possibilities:

Medical #1: Medication side effect: Some students may appear to need directions repeated as a side effect of medication. MORE...

Medical Possibility #2: Chronic pain. Some students may appear to need directions repeated as a result of being in chronic pain. MORE...

Medical Possibility #3: : Fatigue, hunger, general nutrition: Some students may appear to need directions repeated as a result of fatigue (e.g., insufficient sleep) or hunger. MORE...

Medical Possibility #4: : Hearing impairment: Some students may appear to need directions repeated as a result of hearing impairment. MORE...

Medical Possibility #5: : Seizures: In rare cases, lack of compliance may be a result of seizures that may or may not be diagnosed. If seizures have been diagnosed, staff should ask the physician if difficulty persisting in activities 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 a possible lack of compliance. (See Tutorials on Seizures.) MORE...

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Cognitive/Self-Regulatory Possibilities:

Cognitive/Self-Regulatory Possibility #1: Initiation impairment: Some students may appear to need directions repeated as a result of initiation impairment. The student may not start the requested activity. Alternatively, staff or parents may start the student on the activity, but when it comes to initiating the next phase of the activity, the student’s initiation impairment may block further work. (See Tutorial on Initiation Impairment). MORE...

Cognitive/Self-Regulatory Possibility #2: Weak orientation to task: Some students may appear to need directions repeated as a result of disorientation or uncertainty regarding what is required of them. (See Tutorials on Language Comprehension; Organization.) MORE...

Cognitive/Self-Regulatory Possibility #3: Generally weak cognitive and academic functioning: Some students may appear to need directions repeated 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 Tutorials on Cognition, Memory, Organization.) MORE...

Cognitive/Self-Regulatory Possibility #4: General slowness in information processing: Some students may appear to need directions repeated as a result of general slowness in information processing. (See Tutorial on Slow Information Processing.) MORE...

Cognitive/Self-Regulatory Possibility #5: Organizational impairment: Some students may appear to need directions repeated as a result of organizational impairment. (See Tutorial on Organization.) MORE...

Cognitive/Self-Regulatory Possibility #6: Attention deficit: Some students may appear to need directions repeated as a result of an attention deficit. (See Tutorial on Attention.) MORE...

Cognitive/Self-Regulatory Possibility #7: Inhibition impairment: Some students may appear to need directions repeated as a result of inhibition impairment (i.e., impulse-control problems). (See Tutorials on Self-Regulation, Inhibition.) MORE...

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Behavioral Possibilities:

Behavioral Possibility #1: Oppositionality: Some students appear to need directions repeated as a result of oppositional behavior (See Tutorials on Oppositional Behavior; Behavior Management: Prevention Strategies). MORE...

Behavioral Possibility #2: Attention seeking: Some students may appear to need directions repeated do as a means of obtaining adult and/or peer attention. (See Tutorials on Attention Seeking; Behavior Management: Prevention Strategies; Behavior Management: Contingency Management) MORE...

Behavioral Possibility #3: Manipulativeness: Some students may appear to need directions repeated as a form of manipulation. (See Tutorials on Manipulation; Behavior Management: Prevention Strategies.) MORE...

Behavioral Possibility #4: Task avoidance: Some students may appear to need directions repeated as a way to avoid specific tasks. (See Tutorials on Task Avoidance; Behavior Management: Prevention Strategies; Behavior Management: Contingency Management.) MORE...

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Social-Emotional Possibilities

Social-Emotional Possibility #1: Depression: Some students may appear to need directions repeated because they are upset, depressed, and/or lack positive relationships with peers and/or adults. (See Tutorials on Depression; Peer Relationships.) MORE...

Social-Emotional Possibility #2: Anxiety: Some students may appear to need directions repeated as a result of anxiety. (See Tutorial on Anxiety.) MORE...

Social-Emotional Possibility #3: Frustration: Some students may appear to need directions repeated as a result of feeling frustrated. (See Tutorial on Frustration.) MORE...

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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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