Problem: The student appears to perseverate or get stuck doing the same activity over and over or saying the same thing or feeling the same emotion; may have difficulty transitioning from place to place or activity to activity; requests to change topics or activities may be greeted with negative behavior; changes in routine cause problems; the student appears to be inflexible. (See Tutorial on Flexibility.)

Social-Emotional Possibility: Obsessive-compulsive disorder

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.

Obsessive-compulsive disorder: Some students may appear to be inflexible and engage in ritualistic behavior as a result of obsessive-compulsive disorder.

Relevant observations: The student may appear to have an uncontrollable need to perform a particular activity over and over again or to think a certain thought repeatedly. The behavior may occur with drinking, eating, hand washing, checking work, and other physical activities as well as mental activities (e.g., repeating words in ones head). The student may become extremely upset when her routines are interrupted. The student’s routines or rituals take up considerable time every day and interfere with school and social life.

Assessment: If obsessive-compulsive disorder is suspected, referral to an appropriate physician (e.g., child psychiatrist) is recommended.