Group_4

Group 4's Page

Click on "Edit This Page" above to get started.

Click on "Home" to return to the main page.

**Michael**

 * Child's Name:** __Michael__ Date 3/16/2009_


 * Instructions: The Pathways Inventory provides a list of cognitive skills frequently found lagging in children with social, emotional and behavioral challenges. The skills are organized according to five categories or “Pathways”. Use the Pathways Inventory as your discussion guide to try to arrive at a consensus about which lagging skills are contributing to the child’s challenging behavior. Your goal is to identify specific skills deficits within the categories – not to simply identify the categories themselves.**
 * **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 ||
 * x_ || Difficulty reflecting on multiple thoughts or ideas simultaneously ||
 * x_ || 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) ||
 * _ || 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 ||
 * x_ || Difficulty shifting from original idea or solution/difficulty adapting to changes in plan or new rules/possibly perseverative or obsessive ||
 * _ || 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. Difficulty with peers. When Michael is looking for attention he does something inappropriate. If he does not get the attention he was seeking, he gets flustered and does something else even sillier.

2. Taking Things Too Literally - Seems to believe that everyone is "out to get him." He overreacts- for example if a child bumps into him he will get really upset and yell something like " Why do you always do this to me?"- as if it was on purpose and it happens all the time (although it might). He needs to be told that it was just an accident and given the correct way to appropriately respond to that situation. Similarly, Michael gets extremely caught up in his stories to the point where he takes what he saying very literally and to be true even when it is not. He also says means things like "That's why you have no friends." Is he saying this to another child- yet referring to himself?

3. Perseveration - Violence- Does not know how or when to use some language. He uses inappropriate language as well- sometimes in the correct context- but not always. Using term such as "whores," "Bithes" and "lesbains" in school. He also draws violent or graphic pictures regardless of the story topic. Also talks a lot about violent things (such as blood).

4. Possible Self Stimulatory Behavior - It appears that Michael tends to resort to sucking his thumb when a situation arises that he does not know how to deal with or respond to. This seems like a comfort behavior for him when he is unsure of how to react to something. It appears that he needs to be guided through situations like this and helped with ways to respond to his peers.

5. Making up stories/Lying - Michael makes up stories as another avenue for attention. He takes these stories to the point where he upsets himself because he seems to believe they are actually true. These stories escalate to the point where they involve many different parties in the school.

6.

7.

8.

9.

10.

• 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?**
 * Finally try** **to prioritize which problems you’d like to solve first using the following questions as your guide:

1. Learning how to interact with peers - Facilitating social engagement between Michael and his peers.

2. Images/use/exposure to violent topics/ideas

3. using inappropriate/hurtful language to others

4. reverting/regressing to child like behaviors (sucking his thumb and rolling up into the fetal position)

4.

5.

6.

7.


 * Discuss Michael’s case as a group and generate a list of his strengths and weaknesses, as well as recommendations for further inquiry, interventions, and accommodations at school.**


 * Michael's Teacher**-Michael's weaknesses include: reading skills, poor sound symbol correspondence, sequencing difficulties, handwriting, social interactions with others. His strengths include: a love for fiction stories and excellent vocabulary. He is also improving on his reactions to the "minor things", such as bumping into another student. Though Michael displays many issues at school, I would recommend that one or two issues be chosen to focus on and intervened. Since he is having severe social/behavoiral issues with his peers, I would recommend working with Michael to A.) talk about the violence and reasons for anger and B.) come up with some sort of strategy/behavior chart-/reward chart for him and just pour positive reinforcement on him. Michael is looking for any type of attention, good or bad. Give him plenty of good attention so he feels good about himself and wants it more. Making simple comments on not overreacting such as "Michael! I noticed in the hallway when another child accidentally bumped into you, you said ""excuse me" and continued on your way. I am so proud of you! That positive behavior earned you another sticker for your chart! Wow- thats five already today!. Positive reinforcement is key with this child!


 * Michael's Student Teacher-** Some of Michael's weaknesses are interaction with peers, knowing what language is appropriate/inappropriate, and making up stories (lying). His strength is his creativity, which is actually both a strength and a weakness, as seen in his propensity to make up stories. I would recommend trying to focus his creativity in a positive way. Writing time could be a time to do this. He could spend some time brainstorming with a teacher about appropriate topics that interested him, or he could think of scenarios like the ones he makes up, and expound on them to make stories. He is very believeable and his stories would be very interesting for the class to be able to read. Writing down the stories and sharing them as stories might also help him to differentiate between fantasy and reality, and be able to keep them seperate. Being able to share his stories with the class may also help with peer interaction. If he had a positive outlet for his fantasies, he may be seen in a more positive light by his classmates.


 * Michael's Mom-** These "problems/weaknesses" are for attention. Michael is aware of being watched and analyzed by all of the teachers. The only way he can rebel is by being "annoying" or by acting out with "baby talk" and thumb sucking. What Michale needs is to be given a chance to regain confidence in himself. He is a funny child with a great sense of humor and great impressions. It's only a matter of time until the other chidren are at his level and can appretiate his talent. Michael is also bright he can pick up on things quickly. For example, he has great verbal skills with adults and a excellent vocabulary. In my opinion, I feel that the school is trying to transform him into a perfect model of what they would consider a "star student". He may be different from other children but that does not mean that there is something wrong with him.


 * Michael's Dad-** Michael needs a wake-up call. Intervening hasn't done much so far, so maybe it's time to leave him alone and let Michael and his peers figure this stuff out the way kids do. Clearly his strengths are his intelligence and his sense of humor, and his weaknesses are his ways of relating to other students in his class. I think that what Michael needs is a set of strict rules and consequences for specific behavior and that adults should not interfere beyond enforcing that set. If we let him learn "by fire," maybe his peers will have more luck getting through to him to change his inappropriate behavior.


 * Micheals Principal-** Michael's main weakness seems to be his inability to recognize the difference between whats appropriate and whats inappropriate. He spends a lot of time perseverating on violent things such as blood and gore. He is constantly making sexual comments as well. On the other hand, he is an extremely precocious child in other ways. It is also apparent that he is trying to make friends, but seems to struggle with knowing how to do that effectively. I don't think that he is a bad kid, but it is evident that he needs some extra help. I am afraid that he is not learning at this school. I think that by calling a team meeting and also having Michael evaluated, we as a school will be able to better help Michael overcome his difficulties and succeed.


 * Allegra **

When Allegra is asked to complete a task, she often forgets the actual objective for the task. She is unable to understand abstract concepts like time and size, and cannot grasp or understand such abstract ideas as "let's pretend". The kinds of tasks that prove to be difficult for her are playing games and following the rules. She also does not have strong fine and gross motor skills making tasks such as riding a bike difficult for her. She also has difficulty with number sequence. Though she has the desire, Allegra has difficulty with socialization as well. She has trouble playing with and relating to peers, some difficulty in forming relationships and sustaining conversation. She also has increased difficulty with attention and concentration; it is easy for her to veer off of a task. This is typically when she becomes over excited about something. Lastly, her mother observed that Allegra is able to understand some rules and concepts (classroom rules and expectations for example), however she is unable to actually follow them herself. Looking at all of the tasks which proove to be difficult for Allegra, it is obvious that structure and routine are essential in her life.
 * Question 1: What types of tasks are difficult for her? **

One pattern I noticed is that Allegra understands and wants to do what is expected of her, but is unable to do so. In except #1, this is demonstrated by her knowledge of how a school functions and what is expected of students, and her mother’s question of why she is unable to this when she is the student. In excerpt #2, Allegra continues to want to play with her younger stepsiblings, but time after time misunderstands a rule in the game and so is unable to do so. She knows that her piece is supposed to move in Chutes and Ladders, but cannot identify how many spaces it should move, and so gets accused of cheating. In excerpt #3, her teachers note her frustration at her inability to excel like the other students. If she did not know how she was supposed to perform, or care about her performance, this frustration would probably not be there. Instead, by continually trying and failing (in her eyes) to do what is expected of her, she upsets herself and gets frustrated as was noted.
 * Question 2: What patterns do you notice over time? **

Another pattern I noticed is her skill at interpersonal interaction. In excerpt #1, she makes a social situation for herself by playing school with her dolls. She wants this interaction and she is good at it, as evidenced by her knowledge of how a school functions. In excerpt #2, though she has difficulty playing the game that her stepsiblings are playing, she continues to go back to it, showing that she likes to interact with people and craves this communication. In excerpt #3, her teacher notes in her report that “Allegra is a cheerful, friendly and polite young lady. She is quick to establish a rapport and engage in social conversation.” This shows that she continues to have strength in these areas.

Another pattern is that Allegra's strengths seem to lie in her language abilities: she consistently showed some ability in rhyming, expressive language, and interest in written words. This was evidenced by her interest in reading to her dolls, her ability to explain what she was doing and start conversations, her success at the rhyming portion of her initial assessment, and that her later assessment established possible growth in spelling and language skills. Math and quantitative skills may be more difficult for Allegra to master, but if her teachers and parents continue to encourage and praise her developing, and strong, language skills, the extra hard work in arithmetic and math may not seem so daunting. When Allegra was young, she exhibited weaknesses in her attention systems. From the example in which she is playing school she mimics her teachers reminding her to pay attention and focus. While at a young age, Allegra may have met the criteria for AD/HD, as she got older, it is clear that she experiences challenges in other areas beyond that of attention.
 * Question 3: How does her profile relate to the disability categories that you have investigated? **

Allegra has some challenges that are very similar to autism. Children with autism rely heavily on structure and routine. They also have difficulty with attention and staying on task. Complex and abstract concepts such as time, size, and pretend play are increasingly difficult. Motor skills and sequencing also prove to be challenging at times. Holding a conversation and staying on topic is very difficult for people with autism. The one aspect that made me immediately think of autism was the realm of pretend play. Allegra was unable to comprehend the idea of pretend. She took what was said to be pretend as real. Taking things literally is something that most children with autism do a lot. It is hard for them to grasp the concept of real and pretend.

According to the DSM manual Autism is diagnosed meeting specific criteria developed of phenotypes (behavioral patterns of strengths and weaknesses of specific disorders). In Allegera’s case she meets several of these behavioral patterns. She exemplifies qualitative impairments in social interaction such as lack of social or emotional reciprocity. She exemplifies impairments in communication, spontaneous make-believe play or social imitative play appropriate to developmental level. She also engages in restricted repetitive and stereotyped patterns of behavior, interests and activities, for example she is inflexible to adherence to specific nonfunctional routines or ritual. Lastly, she has abnormal intensity to focus.

= = =James= //This is a start… Jenna great start! I am having real difficulty thinking of what could be added!-Ashleigh//

//As a group, identify and discuss the main issues for James in his school setting as brought out from each individual’s responses. Which attention controls appear to be weak in his case? What are the strengths and drawbacks of each teacher’s approach to James? Come up with a list of recommendations for James, his family, and his teachers, drawing from Levine’s suggestions.//

• James experiences challenges paying attention during unstructured activities and self-monitoring his behavior and focus during independent work. • James experiences difficulty staying on task. • It is hard for James to sit still for long periods of time and to do work quietly for a long period of time. • James has a difficult time interpreting and responding appropriately in social situations (understanding, sympathizing and interacting with peers). • James experiences challenge in writing when the assignment and expectations are very structured or difficult for him. • James demonstrates disorganization with his assignments and school materials. He often crumples and wrinkles paper and misplaces them.
 * Main Issues for James in his School Setting**

James appears to have a weak production control system especially in the areas of self-monitoring, previewing, and facilitation and inhibition. He also experiences weakness in his processing control system. He experiences great challenge in maintaining focus. James’ mental energy control system also seems to be slightly weak as he has difficulty putting forth appropriate mental effort in certain tasks, subject areas and assignments. He also shows inconsistency, especially in writing and art.
 * Which Attention Controls appear to be weak in his case?**


 * What are the strengths and drawbacks of each teacher’s approach to James?**

Mrs. Skelly: Mrs. Skelly has tried many approaches to address James difficulty in her class. The strengths are that she has tried many different approaches that used positive reinforcement and rewards instead of ridicule and punishment. These approaches have not been successful which brings into question whether it is the approach or the way the approach has been implemented that is impacting effectiveness. Another factor that can come into play is how long Mrs. Skully tried each approach before she gave up. This could be a critical aspect since a lot of times consistency is key. James is clearly having difficulty working in groups and it does not seem that Mrs. Skelly has done much to specifically address this as she could change the role that James plays in the group (allowing him to do his part on his own and only be responsible for a set part so as to not cause the other members to depend on him). Mrs. Skelly has demonstrated great patience but it is now running out and she feels frustrated.

Mrs. Sutton Mrs. Sutton has had success in finding a way to get James to work silently and diligently on a writing task for an entire class period. She has activated his interests and artistic abilities to help in the process. She has allowed James to write his assignments as comics rather than essays. This shows that Mrs. Sutton is very understanding of James’ own needs and abilities and is willing to work with him. The approach really helped James become excited, motivated and confident in writing after he expressed frustration and doubt. This approach is limited though as it does not challenge James to meet the expectations and standards of the class. Along with the other students, James needs to acquire basic writing skills that will be necessary for him to be successful in future school years. These will involve writing essays and paragraphs so allowing James to always write comics is not realistic or appropriate.Though using the approach to start slow, and work his way toward more writing and less comic drawing, Mrs. Sutton's method is beneficial and proven to be effective. The expectations of James just needs to stay high and slowely worked toward meeting them.

Art Teacher Mr. Davis has not had much luck with James. He is open to his new ideas and creativity and allows James the freedom to express these things in class, although he never does. It seems that James can easily come up with ideas, yet he unable to carry them out, He seems to lack the motivation needed to put his ideas into action. Mr. Davis could help James out by really stressing to him how much he loves his idea and how much he would love to see James' finished product. Once he realized that a few classes had passed and James still had not brought in the materials he should have either brought in the materials himself and given them to James (how much can feathers and beads possibly cost?) or tell James that he had to continue the project without those materials. James seems to be interested in art and have great ideas that should not be put to waste. If Mr. Davis had helped him to get the materials he needed he may have finished the project the way he wanted to, thus being motivated. Additionally, it probably was not the best idea to just let James continue to sit through art class just sketching. Although they are good drawings, he still has not finished his assignment. As the teacher, Mr. Davis needs to buckle down a little and help James to get the work that needs to be done finished.

James’ Father James’ father does not seem to recognize that many of the challenges that James experiences in school are linked to weakness in his attention controls. Helping his father understand that he is experience difficulty in this area could change his mindset and approach to dealing with James’ school performance. His father seems annoyed with the school and bothered by the issues that they are having with James. Instead of blaming the teachers and viewing them as not doing their job, James’ parents need to work WITH his teachers to best meet his needs. Building a relationship between James’ parents and his teachers is incredibly important to helping him succeed.

• When doing group work, James’ task and role should be clearly defined for him and the group members. This could be something that the teacher discusses with the group before they begin working as to prevent James’ work from impacting the entire group. He should still be required to work in groups as the skill of doing so is important. • An assignment book could be introduced in which James could record all of his assignments and things that he needs to bring to school. If his teachers make sure that he records his assignments inside the notebook each day, and his parents check it each evening, he may have more success following through with what he needs to prepare, do and bring to school with him. • Pathways for regular communication between James’ teachers and his parents need to be set up. This could involve regular meetings as well as a notebook where teachers can write notes to his parents and the parents can respond each night. This would help James’ parents assist him at home and help them get a clear sense of what is expected from him at school. • Becoming involved in an extracurricular activity, sports team, or other type of structured social setting (possibly art focused since that is an area where he experiences strengths) could help James develop positive relationships with peers as well as improve his social skills. • Counseling from a school psychologist or social worker regarding social relationships and social skills could be helpful. James may need explicit models and examples for when and how to interact with people.
 * Recommendations for James, his family, and his teachers**
 * Providing James with some ABA (Applied Behavoir Analysis) would help him to improve his behavoir learning the consequences of his actions as well as learn how to control his body when he becomes aggressive.

• Providing James with tools and strategies to become more organized could benefit him. If a binder is set up with an area for each different class then his teachers could remind him to put his work in the appropriate spot and his parents could go through the binder with him in the evening to make sure everything is in the appropriate place and the assignments that need to be finished or turned in are done so.