Problem: The student responds slowly, perhaps after a considerable delay; the student also works slowly.

Cognitive/Self-Reulatory Possibility: Initiation 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.

Initiation impairment: Some students may respond and work slowly as a result of initiation impairment (frontal lobe injury). (See Tutorial on Initiation).

Relevant observations: The student may work at a reasonable rate when prompted or when focus on the task is a collaborative process, but not without such supports. This difficulty does not appear to be a result of any of the other medical, cognitive, behavioral, or emotional possibilities listed. In some students with TBI, frontal lobe injury can produce initiation impairment that is independent of all other problems.

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 initiation-related teaching strategies or supports (See Tutorial on Initiation; Self-Regulation/Executive Function Routines): Create an environment that provides initiation support for the student. Examples: Give the student extra time on tasks. Initiation prompts may be useful (e.g., starting the response for the student). Work collaboratively with the student. Prompt asking for help as a general problem-solving strategy.
3. If the frequency and/or intensity of the problem behavior decreases during intervention, it may be that this student’s problem behaviors are in part a result of general difficulty with initiation. (See Tutorial on Initiation.)

Possible referrals: School psychologist for initiation assessment; instructional support specialist for instructional strategies; behavior specialist for behavior management strategies