Diagnosis with Autism and ADHD

Full Answer Section

1. Operational Definition of the Problem Behavior:
   • The problem behavior is defined as: "Refusal to engage in assigned academic tasks" and "Disruptive Behavior".
     • "Refusal to engage in assigned academic tasks" is defined as:
       • Failure to begin the assigned task within 2 minutes of the teacher's instruction, which includes directions such as, "Start your math worksheet," or "Please read this page."
       • Verbally stating "no," "I won't," or "I can't" in response to the teacher's instruction to start or continue an academic task.
       • Physically walking away from the assigned task or work area after instruction is given
     • "Disruptive behavior" is defined as:
       • Throwing classroom objects (e.g., chairs, desks, pencils).
       • Screaming or yelling loudly (above conversational level)
       • Kicking or hitting classroom furniture or materials.
       • These behaviors must occur in direct response to a demand or instruction to complete an academic task.
2. Explanation of Collaborative Discussion:
   • A collaborative discussion was held with the classroom teacher, MV’s parents, and the school counselor.
   • The teacher provided detailed descriptions of MV's behavior in the classroom, including specific examples of tasks he refuses, the frequency and intensity of his disruptive behaviors, and the impact on the classroom environment.
   • MV's parents shared information about his behavior at home, noting that he sometimes struggles with transitions and can become easily frustrated when faced with challenging tasks. They also provided insights into his interests and preferred activities.
   • The school counselor contributed information regarding MV's diagnoses (Autism and ADHD), his current therapy services (speech, occupational, and counseling), and strategies that have been successful in other settings, such as the use of visual schedules and reinforcement.
   • All parties agreed that the primary goal of the intervention is to increase MV's engagement in academic tasks and decrease his disruptive behaviors in the classroom.
3. Discrepancy Between Current and Desired Level of Performance:
   • Current level of performance: MV currently completes 0% of assigned academic tasks during classroom instruction time. He exhibits disruptive behavior (throwing objects, yelling) on average 3-4 times per day, directly interfering with his learning and the learning of his classmates. His grades are failing.
   • Desired level of performance: The desired level of performance is for MV to independently engage in assigned academic tasks for at least 80% of the scheduled instructional time, with disruptive behaviors occurring no more than once per week. We want MV to actively participate in classroom activities, complete his assignments, and demonstrate academic progress appropriate for his grade level, as evidenced by improved grades.
4. Develop a Baseline:
   • Baseline data was collected over a period of one week (5 school days) prior to the intervention.
   • Data collected included:
     • Percentage of assigned academic tasks initiated within 2 minutes of instruction.
     • Frequency of disruptive behaviors (throwing objects, yelling) per day.
     • Duration of time spent engaged in academic tasks per day.

1. Perform a Functional Analysis:
   • A functional analysis was conducted through observation, interviews, and review of records to determine the potential function of MV's behavior.
   • Antecedents:
     • Presentation of academic tasks (worksheets, reading assignments, etc.).
     • Teacher directives to begin or complete work.
     • Transitions between activities, especially from preferred to non-preferred activities.
   • Behavior:
     • Refusal to engage in assigned academic tasks.
     • Disruptive behaviors (throwing objects, yelling).
   • Consequences:
     • Avoidance or escape from the academic task.
     • Teacher attention (verbal reprimands, redirection).
     • Removal from the classroom (time-out).
   • Potential Function of the Behavior: The functional analysis suggests that MV's behavior is primarily maintained by negative reinforcement (avoidance/escape from aversive academic tasks). He engages in disruptive behavior to avoid or escape the demands placed upon him. Teacher attention, while negative, may also inadvertently reinforce the behavior.
2. Develop Hypotheses:
   • Hypothesis 1: MV's refusal to engage in academic tasks and disruptive behavior are a means of avoiding or escaping tasks he finds aversive or challenging.
   • Hypothesis 2: MV's behavior may also be maintained by attention from the teacher, even negative attention.
   • Hypothesis 3: MV's Autism and ADHD contribute to his difficulties with task initiation, sustained attention, and emotional regulation, making academic demands particularly challenging.

1. Define Goals of Intervention:
   • Goal 1: MV will independently initiate assigned academic tasks within 2 minutes of instruction on at least 80% of opportunities.
   • Goal 2: MV will exhibit disruptive behaviors (throwing objects, yelling) no more than one time per week.
   • Goal 3: MV will increase his time spent engaged in academic tasks to at least 80% of the scheduled instructional time.
2. Describe Intervention:
   • The selected intervention is a personalized schedule with planned breaks and a sensory corner/preferred activity component. This intervention is designed to address the hypothesized functions of his behavior (avoidance/escape, and potentially attention), while also accommodating his needs related to Autism and ADHD.
     • Personalized Schedule: A visual schedule will be created for MV, outlining the sequence of daily activities, including academic tasks and scheduled breaks. The schedule will use pictures and simple words to ensure MV understands the expectations.
     • Planned Breaks: MV will be allowed two 5-minute breaks within a designated instructional period. The timer will clearly indicate the start and end of each break.
     • Sensory Corner/Preferred Activity: During his breaks, MV will have access to a designated "sensory corner" in the classroom, equipped with calming tools (e.g., weighted blanket, fidget toys) or the option to engage in a preferred activity (e.g., drawing, looking at a book).
     • Contingency: Access to the sensory corner and preferred activities is contingent on MV engaging in academic tasks when he is not on a break.
   • Link to Goals: The intervention is directly linked to the goals:
     • The personalized schedule provides structure and predictability, which can reduce anxiety and increase task initiation (Goal 1).
     • Planned breaks provide a predictable way for MV to escape the task, reducing his need to engage in disruptive behavior to escape (Goal 2).
     • Gradually increasing the time between breaks will increase his overall engagement in academic tasks (Goal 3).
   • Basis in Data and Hypothesis: The intervention is based on the data from the functional analysis and hypothesis testing, which indicated that MV's behavior is maintained by avoidance of aversive tasks. The planned breaks provide a predictable alternative to escaping tasks, while the visual schedule adds structure.
   • Evidence-Based: The use of visual schedules, planned breaks, and sensory strategies are evidence-based practices for students with Autism and ADHD.
     • Visual schedules are supported by research as effective tools for improving task initiation and reducing anxiety in individuals with Autism Spectrum Disorder (ASD) (National Autism Center, 2015).
     • Planned breaks are a common intervention used to address attention and behavioral issues, providing students with a structured way to regulate themselves.
     • Sensory strategies are often incorporated into interventions for students with ASD and sensory processing difficulties, as they can help to promote self-regulation.

Sample Answer

1. Referral Source and Reason for Referral:
   • Referral source: MV was referred by his classroom teacher.
   • Reason for referral: MV exhibits a consistent refusal to engage in academic tasks, leading to disruptive behaviors such as throwing furniture (chairs, desks, pencils). This behavior disrupts the learning environment for other students and significantly impacts MV's academic progress. The teacher reports that when presented with academic demands, MV escalates quickly, making it impossible to redirect him.