Monday, December 17, 2012

CASE STUDY: He Just Needs A Little Discipline



BACKGROUND
Matt is a struggling eighth-grade student who is dealing with several personal and at-home issues. He has been diagnosed with attention deficit hyperactivity disorder since the second grade. He is emotionally suffering with the loss of his mother, difficult for anyone at Matt’s age. And, his father, Mr. Snyder, denies the positive effects of pharmacological treatment (Ritilan) have previously had on Matt’s behavior.
Mr. Snyder’s approach to Matt’s issues of impulsivity, emotional outbursts of frustration, anxiety, and poor academic performance is to reinforce strict discipline. He often yells at Matt, physically pulls his arm to gain his attention and grounds him for a month when Matt’s behavior results in his dismissal from the boys’ basketball team. We can also assume Mr. Snyder is juggling many personal issues including the loss of his wife, Matt’s constant behavioral and academic issues, as well as the stress of running a small business. More importantly for this case study is Mr. Snyder has run out of solutions in parenting Matt. He is frustrated and is acting emotionally to Matt’s issues. It is quite possible Matt is mirroring his father’s behavior.
Matt’s teachers have tried several approaches to mostly negative results. The case study focuses more on his frustration and outbursts in language arts, a class Matt’s teachers know he does not like. His team of teachers, which includes Jill the special education specialist, has modified several aspects of Matt’s day. He is provided lecture notes and often paired him with another student on writing assignments. He is also given extra time to finish work and is offered a secluded area in which to do it. Jill has taken further steps by working with him individually for nearly half the class period and developed a contract rewarding extra computer time.
Even with these modifications, Matt’s behavior persisted. Finally, the team and school principal agreed to send Matt to the office and call home when his disruptions escalated warranted it. This caused further problems as Matt’s father would yell at him over the phone. This caused great anxiety in Matt. And he appeared to feel helpless.
ANALYSIS
Mr. Snyder’s apprehension concerning his son’s Ritalin prescription is understandable. He doesn’t want Matt to be dependent on the drug to behave. Mr. Snyder would prefer Matt changes his behavior on his own. The issue at hand is Matt does not seem capable of self-control at this point in his life. It is also telling that Matt was required by his father to stop taking Ritalin after Ms. Snyder passed away. Maybe the question we should be asking is how does Mr. Snyder’s behavior affect his son’s behavior at school.
Research has shown a combination of pharmacology and behavioral modifications lend the most effective results in students. Also, such an approach alleviates child anxiety, improves academic performance, parent-child interaction and oppositional behavior (U.S. Department of Education, 2002). It appears this approach would best fit Matt current situation. His relationship with his father is strained at best; he demonstrates strong anxiety when the principal threatens to call his father and his academic performance is suffering from his inability to focus. But, keep in mind this is not a pharmacology-only method. The team of teachers should use proven academic and behavioral methods and home-school interventions tested on students diagnosed with ADHD. Mr. Snyder should be educated on this fact. A prescription of pharmacology should also be matched with a collaborative, structured behavior modification plan, similar to that which the teachers currently employ. Jill and Matt’s teachers should continue to use the secluded area of the classroom so he can better focus on his work. They should chunk the lesson into smaller parts so he may focus on one step of the lesson at a time without distraction – not as punishment (U.S. Department of Education, 2004). They should continue to provide him with lecture notes. They could also gear assignments to Matt’s personal interests, like basketball. The school could also try to reunite Matt with the basketball team – maybe not as a player, but as a team manager. They could also ask Matt about his mother. Does he miss his mother? What does he remember the most? Have him think about her and have him express his feelings through writing, conversation, pictures, or drawings. If he can control his behavior and demonstrate impulse control while unlocking some inner feelings, this could help alleviate some of the anxieties he may hold.
To be honest, the world is an unhappy place in Matt’s view. He is frustrated with school, home, and himself. He needs support and not the kind he is receiving from his father in its present form. The school can help by not making every school-to-parent interaction a negative one. Research shows that effective school-to-home communication in imperative (Davern, 2004). Instead of sending Matt to call his father every time Matt disrupts class, Jill should try to simply remove him from the classroom. She should talk with Matt about his behavior, try to calm him down, discuss with him as to what are acceptable choices and get right back to work. The team of teachers and the school counselor should devise a daily behavior plan showing both positive and negative behaviors, improvement, and failures. Then, they should communicate such progressions and digressions to the father. No matter how frustrating life may seem to Matt and his father, they need to feel progress is being made. Every communication cannot be a here-we-go-again moment.
There are several aspects of this case study that do not provide enough information to examine Matt’s case further. The following are several questions, as an outsider, I would like to know about the school, his team of teachers, his past academic and behavioral status and his social life.
Who are Matt’s friends? How does he act outside of the classroom with peers? Are his peers positive influences? Does he share his feelings or display impulsivity around his friends? These are important questions because he may use his friends as an outlet to blow off steam about school and life. Also, there is the possibility that peers can be a good or bad influence on Matt’s behavior. Matt may feel he needs pharmacology to help his current status (after all, he is a thinking, feeling human being). Is he using drugs or alcohol outside of school to help cope with his inner feelings? Such a situation would further disrupt Matt’s progress at school and raise further questions as how to deal with Matt’s behavior. There is no evidence in this case study to accuse Matt of such drug or alcohol use, but as an educator of middle school students and early adolescents, such issues are of immediate importance, especially knowing his prior use of pharmacological stimulants. If he has positive peer influences, who are they? When do they see Matt behave rationally/irrationally? What triggers do they see which cause him to snap outside of school? What is their perception of how he interacts with his father?
As far as the school structure is concerned: What have his sixth- and seventh-grade teachers experienced with Matt’s behavior. How did they deal with his outbursts? What worked? What didn’t? Does the current eighth-grade team meet daily and do they communicate about Matt’s behavior? How does Matt behave in his exploratory courses such as art, music, technology or physical education? Is there a person in the district who is a trained grief counselor? Are there other students in the school district who have experienced a death of a parent? Are there peer group organizations for such an issue? Are there single-parent organizations? Does the school have the capacity to organize such a group?
Mr. Snyder has a strong contention on his singular issue – Matt must eventually be able to regulate his behavior on his own. But, Matt is still a 14-year-old boy dealing with several personal, home and school issues. He has been diagnosed with a learning disability, which, with proper medication and behavior modification, can be controlled to make his life in the present more sustainable. But, now is not the time to say Matt should be on his own behavioral path. He is ill equipped to handle such a burden. A multi-modal approach of medication and behavioral modification should be administered. Matt needs to express his thoughts about school, the loss of his mother and his relationship with his father. His father should be the primary direction of communication, but that communication should not be all negative. Mr. Snyder should see foundations of progress and be encouraged that there is hope. The teachers should not react impulsively to Matt’s outbursts but react calmly, displaying a sense of control and understanding. They should also be firm in explaining such outbursts are not acceptable in the classroom and that there are consequences for such actions. Matt requires specific modifications to the daily structure of school. A collaboration of understanding and a positive relationship between the team of teachers, Matt’s father, and Matt himself would be best to direct Matt to a hopeful future. All parties are involved and invested in this one boy’s future. They must be understanding, firm, truthful, and open to ideas.
In the end, this case study is describing one child in several hundred at this particular school, all of which have their own unique, tragic, hopeful, needy and immediate concerns. A school should not silence those needs to promote a false sense of harmony, or deal with them in the easiest, most deflective manner. They should attempt to take on such challenges, using up-to-date psychological and educational literature, to create systems, lines of communication and interactive designs with the goal of meeting each student’s needs. There are many restraints and the school organization will come up short in many instances. But, the will of the individuals who truly care about the students coming through their path will, in the end, make an impact – however small or large – in each child’s life.
WORK CITED
Davern, L. (2004). School-to-home notebooks: What parents have to say. TEACHING Exceptional Children, 36(5), 22-27.

U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs, Identifying and treating attention deficit hyperactivity disorder: A resource for school and home. Washington, D.C., 2002. Retrieved December 6, 2004, from http://www.ed.gove/about /reports/annual/osep/index.html.

U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs, Teaching children with attention deficit hyperactivity disorder: Instructional strategies and practices. Washington, D.C., 2004. Retrieved on December 6, 2004, from http://www.ed.gov/about/reports/annual/osep/index.html.

University of Kansas, Lawrence, The Beach Center on Families and Disability. (n.d.). How to maximize fathers’ involvement with their children who have disabilities. Retrieved December 7, 2004, from http://www.idonline.org/article.php?max=20&id-989&loc=103

Zuna, N., McDougall, D. (2004). Using positive behavioral support to manage avoidance of academic tasks. TEACHING Exceptional Children, 37(1), 18-24.

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