Group_1_Michael

=Michael's Case Study=

**Pathways Inventory**

 * **Executive Functioning Skills** ||
 * _X || Difficulty handling transitions, shifting from one mindset or task to another (shifting cognitive set) ||
 * _X || Difficulty doing things in a logic sequence or prescribed order ||
 * _ || Poor sense of time ||
 * _ || Difficulty reflecting on multiple thoughts or ideas simultaneously ||
 * _ || Difficulty maintaining focus for goal-directed problem-solving ||
 * _X _ || Difficulty considering the likely outcomes or consequences of actions (impulsive) ||
 * _X_ || Difficulty considering a range of solutions to a problem ||
 * **Language Processing Skills** ||
 * _X || Difficulty expressing concerns, needs, or thoughts in words ||
 * _ || Difficulty understanding what is being said ||
 * **Emotion Regulation Skills** ||
 * _X_ || Difficulty managing emotional response to frustration so as to think rationally (separation of affect) ||
 * _X_ || Chronic irritability and/or anxiety significantly impede capacity for problem-solving ||
 * **Cognitive Flexibility Skills** ||
 * _ || Difficulty seeing the “grays”/concrete, literal, black-and-white, thinking ||
 * _ || Difficulty deviating from rules, routine, original plan ||
 * _X || Difficulty handling unpredictability, ambiguity, uncertainty, novelty ||
 * _ || Difficulty shifting from original idea or solution/difficulty adapting to changes in plan or new rules/possibly perseverative or obsessive ||
 * _X || Difficulty taking into account situational factors that would suggest the need to adjust a plan of action ||
 * _X_ || Inflexible, inaccurate interpretations/cognitive distortions or biases (e.g., “Everyone’s out to get me,” “Nobody likes me,” “You always blame me, “It’s not fair,” “I’m stupid,” “Things will never work out for me”) ||
 * **Social Skills** ||
 * _X_ || Difficulty attending to and/or accurately interpreting social cues/poor perception of social nuances ||
 * _X_ || Difficulty starting conversations, entering groups, connecting with people/lacking other basic social skills ||
 * _X_ || Difficulty seeking attention in appropriate ways ||
 * _X_ || Difficulty appreciating how his/her behavior is affecting other people; often surprised by others’ responses to his/her behavior ||
 * _X_ || Difficulty empathizing with others, appreciating another person’s perspective or point-of-view ||
 * _X_ || Difficulty appreciating how s/he is coming across or being perceived by others

Instructions: Now that you’ve identified the skills the child lacks, it’s time to conduct a situational analysis by listing the specific situations in which the child tends to have difficulty. Think of when, where, with whom, and over what issues the difficulties arise. What triggers the child? What are the antecedents or precipitants? What are the chronic problems causing frustration for the child or the adults around the child? //Be as specific as possible!//

1. Michael reverts to baby behavior when he is around other children. It happens in the classroom and in the hallways when he sees kids from older classes. He seems to be triggered by the mere presence of other kids but also by his failed attempts to connect with them. Michael tries to humor the others with his gory stories and when they shy away from him he begins to act like a silly baby. The baby behavior is causing frustration for Michael as it sets him apart from the other kids socially and frustration for the teacher as it disrupts the class. Michael also seems flustered and frustrated by the other kids lack of interest in his humor.

2. Michael seems to act out during Writer's Workshop time if the teacher turns her back on him for even a moment. He begins drawing scenes of graphic violence and acting them out, this upsets the other children. He seems to be triggered by the teacher's absence during writing time.

3. Michael will do and say inappropriate things to other children in the class and in other classes as well. He will say things of a sexual nature and touch girls' chests. He seems to be triggered by the absence of the teacher and perhaps by the desire to connect socially but the inability to know how.

4. Michael makes up stories that are not true and passes them off as the truth. This happens in the classroom and during class trips (museum of natural history). He tells the stories to the other kids and the teachers. He seems to be triggered by his imagination during reading and trips but instead of keeping his thoughts to himself he says everything out loud and then has trouble shifting his focus back to the task at hand. He also has inappropriate emotional responses to the stories (extreme fear over the animals on the loose story and crying over the grandfather story). He might possibly also be triggered by his need to connect with the other kids during an activity where their focus is not on him. He seems to try to shift the focus back to him but does it in a negative way.

5. Michael has significant difficulty during writing time because he struggles with handwriting. In order for him to get any work done a teacher has to sit with him the whole writing time and either type or write for him. This must cause extreme frustration for Michael as well as embarrassment over his lack of independence during writing time.

6.

Finally try to prioritize which problems you’d like to solve first using the following questions as your guide: • Which problems or triggers are causing challenging behavior most often? • Which problems or triggers are causing the most severe behavior? • Which problems or triggers are most conducive to resolution?

1. Inability to connect socially with the other kids seems to be causing the most challenging behavior. It appears to be the trigger for his baby behavior, his outlandish stories and his inappropriate use of sexual and violent language and inappropriate touching.

2. Michael's difficulty with handwriting seems to be causing him to be embarrassed which further sets him apart from the other kids. His difficulty is also causing him to act out when he does not have the teacher's full attention.

3. Michael needs more outlets for his theatrical and imaginative talents. A class play would be a great way for him to shine and garner respect from his peers. Hopefully his confidence would grow from this. In general, Michael needs more explicit encouragement and positive feedback from all of the adults in his life! || = =

Strengths
__**Principal:**__ There is no question here that Michael is a very bright kid. He has a wonderful imagination (even if it veers toward violence at times) and he has a wonderful sense of theatricality. He is able to talk to adults, so we know the intellectual capacity is there.

Weaknesses
Michael was fortunate to have his letter-sound correspondence, gross-motor and sequencing deficiencies identified early on. I think the issues are more social at this point, and I would recommend that Michael begin seeing the school therapist at least once a week. We were hesitant to initially push for this so as not to further separate him from his peers and take him out of valuable classtime, but his inappropriate sexual outbursts and perplexing behavior (sucking his thumb, alienating himself from the other students) need to be addressed immediately.
 * __Principal:__**

Recommendations for Further Inquiry At this point I cannot comment any further until I have spoken with the school psychologist, whom I hold in very high esteem. His ongoing work with him, observations and evaluations will tell us all a great deal, I believe. At that point we can move forward based on the therapist's recommendations. 
 * __Principal:__**

 Interventions __**Principal:**__ ====Again, I think he needs to work with the school psychologist on an intensive and consistent basis. I also think as an intermediary step, he should be sent to my office when such outbursts that have been described occur. That way I can notify his parents where I see fit and have a running record of his classroom behavior.  ====

Accommodations We need to look into getting a laptop for Michael and teaching him to use it. He is the type of kid who would benefit a great deal from the use of this modern technology in school. Because his gross motor skills in regards to writing slow him down, if he could become really proficient on a computer, that would be really great to see, and increase his confidence I believe.
 * __Principal:__**

Strengths
__**Perspective of Michael’s mother:**__ Michael has a great imagination and loves stories. He has always had a good vocabulary and is very verbal so it was frustrating to find out that he was having trouble with his reading and also his writing.

Weaknesses
__**Perspective of Michael’s mother:**__ It is difficult to see Michael having such a hard time in school. The school is providing special services for him but I worry that his learning issues make him feel different from the other kids, especially during the writing workshop time when he has to have someone write for him and the other children don’t need that. I also know that he is having a hard time socially and I suspect that the learning difficulties he has may be contributing to his self esteem and thus his inability to form friendships. Since he is coming from a place where he feels different academically I think it transfers over into his feeling different in social situations too. I was surprised to hear about the social behaviors that he exhibits at school such as thumb-sucking and “baby talk” since we don’t see that when he is at home. More disturbing however was when I learned that he had shown violent themes in some of his writing and play.

Recommendations for Further Inquiry __**Perspective of Michael’s mother:**__ I would like more information on how the teachers are handling his social issues. Is he being teased and if so, how does he react? Does it seem to upset him or does it just bring out more of the exhibited behavior, such as the “baby-talk”? How does the teacher handle it? Would it be a good idea for Michael to have a play date with a child from class outside of school to see if it is just the school setting that he has a hard time in or is it all social situations with children, no matter the setting? Could strategies such as rewards for positive behavior work in his case?



 Interventions __**Perspective of Michael’s mother:**__ I think at this point it is going to take a lot of help and intervention to get him on the right track socially. I think it would be wonderful if Michael would be able to make just one friend in class but I worry that the label he has as the "weird kid" is going to be a tough one to change in people's minds. I have heard about groups that you can enroll your child in to help them with their social skills and I think that is something that would benefit him. It appears that he is very angry and I would even consider getting him a private therapist or counselor to work with him. I strongly believe that we have to look at the whole child and not just one aspect to make change. The violent themes may stem from his frustration with feeing different academically and socially I think working with a professional therapist would help us find out what he is feeling. I don’t think the other issues will get resolved until we get to the root of where the anger is coming from and how we can work with him to diffuse it and then move forward.

Accommodations __**Perspective of Michael’s mother:**__ I would love it if the teacher could give Michael a special job to be in charge of in the classroom to try and help him feel more included and respected. Also, I would like to get a feeling from both him and then teacher regarding which children he feels most comfortable being around. Being grouped with or seated next to children that he would like to be friends with and that might be open to being friends with him might would be helpful.

Strengths
__**Perspective of Mr. Kors: Student Teacher:**__ Michael is a very creative kid. He has the ability to make up elaborate stories that seem to even convince him that they are true! I think Michael might be an actor one day or a writer or artist. He tells very convincing stories. Although Michael doesn't seem to have the social skills to connect positively with the other kids in the class he does have the __desire__ to connect which I see as a strength. In terms of other strengths, Michael does have an excellent vocabulary and can be very talkative and charming when the two of us are alone, which is not very often. He also has a real love of fiction stories.

<span style="color: rgb(0, 0, 255);">Weaknesses
__**Perspective of Mr. Kors: Student Teacher:**__ Michael says outrageous things a lot of the time. He seems to lack very basic skills in being able to connect socially to the other kids in the class. He acts like a baby a lot of the time and I'm not sure why. I think it is his way of trying to get the attention of the other kids and make them like him but he just doesn't know how to do it. He has not been responsive to our attempts at stopping his baby like behavior, in fact, when we remind him not to do it it just makes him do it more. He lies about his family, vacations he has been on and even lied about his grandfather dying in a tornado. It seems to me that Michael just doesn't know how to get positive attention from his peers. He also engages in inappropriate displays of emotion that are brought on by lies. For example, Michael told a whole story about his grandfather dying in a tornado and even began to cry because of it. We later found out from his parents that that was completely made up. Academically Michael is not advancing very quickly in reading. He has poor sound-symbol correspondence and difficulty sequencing. He also struggles tremendously with writing, particularly handwriting. He needs a teacher to sit right next to him during writing time and write for him.

<span style="color: rgb(0, 0, 255);">Recommendations for Further Inquiry __**Perspective of Mr. Kors: Student Teacher:**__ <span style="color: rgb(0, 0, 0);">I would like to better understand Michael's feelings about himself. I think he may be feeling embarrassed by his academic struggles. I would also like more concrete information on the exact areas that Michael is struggling with to know why he is struggling. I am curious as to whether Michael understands the difference between fiction and non-fiction in terms of the stories he tells. Does he really believe the lies he is telling? Finally, how can Michael be helped with his social skills and his desire to fit in with the other kids? Does Michael understand the difference between positive and negative attention? What is Michael like in social situations outside of school? How would he behave at a birthday party or on a playdate?

<span style="color: rgb(0, 0, 255);"> Interventions __**Perspective of Mr. Kors: Student Teacher:**__ First I will give my ideas for academic interventions that might help Michael: -Michael definately needs extra support in the area of reading and phonics. I think it would be beneficial for him to meet one-on-one with the reading support person as well as continuing with the inclass small group work he is already doing. The reading specialist could imploy a specific program for Michael that includes multi-sensory reading activities. -Michael would benefit from doing extra reading work at home as well. He should be playing computer games that stress phonics and sound-symbol correspondence. His parents should provide Michael with a basket of books that he can be successful reading and place them in a special reading corner in his room or somewhere in the house. -Michael should work with flashcards, a little bit each day. -Michael should be encouraged to read books that are of interest to him. -Michael should play reading games that focus on phonics and association of sounds with symbols. -Michael would benefit from listening to books on tape and following along in the book as it is read by another person. -Michael should not be asked to read infront of his peers unless he has been well prepared for it. -Michael should be given shorter reading assignments and may need additional time to complete them. -Michael should be allowed to use the computer during wriitng time. Maybe he would be able to get his ideas down faster by typing. -Michael could record his stories in a tape recorder for later transcription by an adult. -Michael should have targeted work on his pencil grip and could keep a writing book at home where he writes just a sentence or two each night focusing on his handwriting. -Michael should be given more time to complete writing assignments and the assignments should be broken down into manageable chunks. He should also be given more time for written responses on tests. -Michael should be given paper with larger lines and maybe even raised lines to assist him in handwriting. -Michael's writing should not be looked at by his peers unless he has perfected a piece to put on display. These are social interventions that might help Michael: -Michael would benefit from working with a school therapist who can work specifically on social skills. The therapist could accompany Michael to social activities during school and give him frequent reminders about behaviours there are working on. Additionally, Michael's parents could do the same thing at home when he has a play date. -Michael's parents should avoid involving him in too many social situations. He should be encouraged to develop a few working relationships. -Michael should be supported if he has a desire to spend time alone at home. He should not feel pressured to have playdates or be involved in sports or after school activities. -Michael's parents can have discussions and role play situations with him that address social situations. -Michael should join a social skills group at school. -A class discussion could be had about fitting in socially. The kids could be asked to brianstorm what it is that makes a person desirable to spend time with. The kids could be asked to look at what qualities of a person are attractive to them. -Michael should be given responsibilities in the classroom that place him in a position to act with maturity. -Michael could work with the teacher to develop a checklist of social behaviors that he could work on developing. During the day Michael could receive frequent reminders to remain focused on the particular social behaviors and at the end of the day I could sit with him to go over his checklist. -Michael could be encouraged to focus his storytelling ability in a postive way by developing appropriate fiction stories that could be shared with the class.

<span style="color: rgb(0, 0, 255);">Accommodations __**Perspective of Mr. Kors: Student Teacher:**__ -More time to complete reading and writing assignments. -More time to complete tests. -Reading and writng tasks should be broken down into manageable chunks. -Use of computer or word processor. -Use of tape recorder. -Additional types of assignments that express the given topic, ie. a diorama with some written explanantion. -Special paper with larger lines for writing. -Responsibilities in the classroom that help Michael act with maturity. -Checklist to focus on social behaviors and time to complete it.

<span style="color: rgb(0, 0, 255);">Strengths
__**Perspective of Michael's father:**__ Michael is a smart, creative boy. At home and with our friends and family, he always impresses the adults with how charming and precocious he is. He loves making up stories, and he has a great sense of humor. He's not shy or scared of anyone either.

<span style="color: rgb(0, 0, 255);">Weaknesses
__**Perspective of Michael's father:**__ Of course I'm worried about Michael's reading and writing skills. He's been having a really hard time learning how to read, which is especially unfortunate because he loves stories so much. I always thought he'd be a great reader, and maybe he still will be but it just hasn't clicked yet. And then there are all of his social issues... I never see this at home, but apparently he acts weird around the kids at school. They say he sucks his thumb and talks in a baby voice, and it makes the other kids uncomfortable. I can't even imagine doing that when I was his age. I don't know what he's thinking. I guess it's a ploy to get attention. And now apparently he's started saying and doing creepy things to the girls in his class, which definitely has to stop. We got a call last week saying he inappropriately touched and made a lewd comment to one of the girls in his class. I don't know why he's acting out this way--we don't show him violent or sexually explicit movies at home, so I'm not sure where he's learning this stuff. I'm worried about it though because he clearly pushes the other kids away. He doesn't have many friends. He blames the other kids, the teachers, the school, everyone but himself. He doesn't see how his behavior makes them not want to be around him. It's hard for me to imagine how he acts at school though because he's so different with us. It's like he has split personalities or something. When he's at home, he's this funny, charming kid. He can be a smart aleck sometimes, but he never shows a mean or nasty side, and he would never dream of saying the things he apparently says at school.

<span style="color: rgb(0, 0, 255);">Recommendations for Further Inquiry __**Perspective of Michael's father:**__ <span style="color: rgb(0, 0, 0);">I want to know where he's picking up this foul language and all these violent ideas. He certainly doesn't get it from us. If he's got some deeper issues, maybe he needs professional help. I'd also like to know what we can do to punish him when we don't see any of his inappropriate behaviors at home. When we get calls from the school we try to talk about it with him, but it's hard when he denies everything or blames someone else and we're never around to see what actually happened. His mother always believes him when he says it's someone else's fault. Of course I don't think the school's out to get him, and I don't think we'd be getting all these phone calls if he weren't really acting up. But short of calling my son a liar, I'm not sure what to do to get him to recognize when he's done something wrong.

<span style="color: rgb(0, 0, 255);">Interventions __**Perspective of Michael's father:**__ I think Michael needs to face the consequences of his behavior. I don't think the other kids should lay off him when he's acting like a weirdo. He needs to learn that he's too old to suck his thumb and baby talk. His behavior is getting out of control, and it doesn't help him recognize his role in his problems if the teachers make the other kids be nice to him when he's acting inappropriately. There are certain things kids just can't say and do to each other, and Michael simply hasn't learned that yet. And it's only going to get worse as he gets older. When I was his age, I never would've gotten away with the stunts he pulls. I do think he needs to keep getting extra help with his reading and writing. I know he feels bad that he's so far behind the rest of his class, and maybe if he felt like he could keep up academically, he wouldn't antagonize the other kids so much. I can see it being a defensive reaction, or a way to get attention. He just doesn't understand that not all attention is good attention.

<span style="color: rgb(0, 0, 255);">Accommodations __**Perspective of Michael's father:**__ I think the teachers need to figure out a way to get through to him that his thumb sucking and baby talk are not a good way to get attention at school. He would never do that at home because he knows I wouldn't put up with it. I think it's a discipline problem: they need to figure out how to lay down the law with Michael and stick to it. He needs consistency and clear expectations. I don't think forcing other kids to be nice to him is going to help. He'll never learn if they do that. With respect to the violent stories, I wonder if there may be something deeper going on with Michael, in which case he might need some professional help. I'm not qualified to make that decision though.

<span style="font-size: 80%; color: rgb(0, 0, 255);">Strengths ** Classroom Teacher: ** Michael has a very creative imagination. He is very expressive and has shown a lot of interest in fiction stories. His stories show his creative imagination. He is also very verbally expressive. He is very charming when he is talking to adults and he seems to talk more to adults rather than other children. He also seems to be very good at acting out situations. He can play a part very well and seems to be very focused on something to the point that he believes what he is acting out. <span style="font-size: 80%; color: rgb(0, 0, 255);">Weaknesses ** Classroom Teacher: ** Michael seems to have some problems with sequencing difficulties, and poor sound-symbol correspondence. He also has difficulties with handwriting and although he is receiving occupational therapy, he needs someone to sit with him and type or handwrite his words. He is unable to make friends and has done a lot of inappropriate things and said a lot of inappropriate remarks. An example of this is when Michael made an inappropriate comment to one of his classmates and touched her inappropriately. When he does this, he does not take responsibility for his actions and often says that its his classmate’s fault. He also seems to revert to tendencies such as sucking his thumb and speaking in “baby talk”. He does this with everyone in his class and has even started doing this with the older kids. He also has a very overactive imagination to the point that he starts to believe the stories that he has made up and cannot function because of it. He uses some vulgar language and has many violent tendencies, pretending to stab himself or cut his throat. He used to overact to his classmates accidentally hitting him and would try to start an argument with them. Recommendations for Further Inquiry **Classroom Teacher:** I think that Michael needs to talk to a psychologist. He seems to have problems socially and he needs help finding ways to deal with his problems. There also does not seem to be a clear reason as to why Michael is acting the way he is. Talking or seeing someone might be able for all of us to help understand why and what he is thinking and doing. I think that Michael would also benefit from being observed more. We need to understand the reasons of why Michael is acting this way and explore more ways that could help Michael with his behavior. One of the reasons that he may be acting this way could be because he is looking for attention or he gets embarrassed and does not know how to deal with it. Looking at all factors, not only at Michael’s behavior but studying what sets him off may be a way for us to help him. I also want Michael to understand and take responsibility for his actions. He does not seem to understand what he has done wrong and he often blames other people for his actions. I am curious to see what Michael thinks about his behaviors and why he does what he does. Also I want to find out where he is learning the inappropriate behavior and language that he makes. Lastly, I want to find out why his actions are so different at home from school. I want to find out if there is anything that we could do at school that they do at home. If there is anything different that they have done, maybe we are able to accommodate it or use it in the classroom. Interventions **Classroom Teacher:** Working with a psychologist or someone that will be able to find out the reason why Michael acts the way that he does. Also talking about the violent themes and inappropriate behavior might be able to help us discover the reasons on why Michael has a lot of inappropriate behavior. I also think that finding out ways to help him and for me as a teacher to work with the psychologist and parents of Michael might be able to help him. Talking to the class in trying to help Michael and understanding or explaining that he may need help or how to help him might also be a good thing. Maybe helping Michael try to interact with his classmates, telling him what to say or helping him deal with situations might help him. Enrolling him in a social skills class might also be able to help him with his social skills and help him talk and interact more with his classmates. I also think that he should continue on in his occupational therapies. He might also need some extra support and could work one-on-one with a reading specialist or working in small groups. He might also benefit from working with a partner and teachers might be able to help him work with the partner. He might also need some support from his parents at home. Letting him read rather than watch too much tv or play in the park or have children from his neighborhood or his parents friends come over might help him. Children that don’t really know how he acts in school might be able to help Michael as he won’t need to start over. He should not be overwhelmed with a lot of people though and should focus on developing some relationships. Having a laptop might be able to help him also in class in completing writing assignments and also organizing his work. He also should be able to be prepared everyday and reminded by his teacher on how he is supposed to act or what he is supposed to do. Michael should also be given responsibilities in class. Teachers, Parents and others who help Michael should treat him consistently. They should treat him the same way in anyway that he behaves so that he is able to understand that his behavior is not okay. He should be given an organized schedule where he is busy all the time so that he has no time to goof of.

Accommodations **Classroom Teacher:** Having a laptop for Michael where he can use it to write his assignments and do his work will be a big difference for him. Having also responsibilities for Michael in his classroom will help him feel included. He will be more comfortable in the classroom. Having also a tight and organized schedule will help Michael. It will keep him busy enough so that he won’t have time to goof of. Having more time to also complete his reading and writng assignments. Using his special skills like his ability to story tell to help include him in the classroom. Giving him more skills that will deal with his being able to get attention Working with parents and other people to figure out a routine or interventions in the classroom