Case Study

Amy is an eight-year-old second grader at Layton Primary School where she has attended since kindergarten. She has not repeated any grades and attends school regularly. Amy has solid "B" averages in reading and language arts. She has always struggled with math and was placed in Tier 2 of the Response to Intervention process for academic intervention as her math grades began falling and she obtained an average of "70/D" for the previous term. Amy has average to above average intelligence.She is typically pleasant and makes friends easily. She is eager to please and wants to do well. Amy has average language functioning but sometimes interprets things literally or does not understand the intent of questions. She can become somewhat oppositional and may experience an outburst when she is frustrated or does not understand a task. She has experienced test or task anxiety, more so with math.

The interventionist, Ms. Hahn, determined that Amy does not have instant recall of addition and subtraction facts (0-18) and is integrating Touch Math into the Great Leaps intervention. Touch Math provides students with a tactile, systematic approach to solving simple addition and subtraction problems. Great Leaps emphasizes concrete manipulation of objects, representations of numerical equations, and abstract use of numerals. Great Leaps recommends that 8-year-olds correctly answer 25 problems in 1 minute. Amy's scores for addition facts ranged from 10 to 27 with a mean of 19 and a goal of 25 correct responses per minute. A review of her data indicates uneven, sporadic progress.

Amy's teacher, Ms. Green, reports that Amy has difficulty sustaining attention and poor concentration. She has difficulty staying on-task and completing tasks. Amy has proficient reading skills and is capable of making "A's"; however, incomplete assignments and careless errors sometime lower her grades. While her overall math skills are not significantly deficient at this point, her grades are affected by her poor recall of basic facts, fluctuating performance, and incomplete assignments.

Two momentary time-sampling observations were conducted, one during reading and one during math. Momentary time-sampling requires that the observer look at the target student at one set point during each time interval, record relevant behaviors observed, and then not again observe and record those behaviors until the same point in the next interval. For this component, two students are necessary. One is the target student and the other chosen randomly to be observed in the same observation period as a comparison student.The students are observed for on-task and off-task behaviors. During the observation in reading, Amy was on-task 80% of the time-sample observation, while the peer was on-task 95%. She raised her hand and participated in class. She occasionally looked around and appeared to be daydreaming. She was compliant when the teacher told her "to get busy" or "pay attention." She played with her pencil and swung her feet. During the math observation, Amy was on-task 45% of the time-sample observation, while the peer was on-task 93%. She frequently looked around, leaned back in her chair, sat on her foot, and bobbed her head. She began working on the worksheet when instructed to do so but became distracted and did not complete the assignment.

An ABC Analysis Chart showed that when Amy was given verbal as well as written directions to complete an assignment, she exhibited inattentive behaviors such as looking around the room, staring into space, or appearing to daydream. This resulted in incomplete assignments and low grades.

A functional behavioral assessment was conducted and the following problem behaviors were found:

inattention; has trouble paying attention to math examples and then trying them on her own; if it is something she feels is hard, she will not always pay attention; she either has trouble with verbal directions or with the operations/steps. It was noted that the problem behaviors most likely occur in the morning or afternoon but always in math class. The people present when the behaviors occur include peers, teachers, and staff. The problem behaviors are less likely to occur when Amy completely understands the math objectives and she is given frequent redirection. The consequences after the behaviors of concern occur are typically that Amy escapes or avoids teacher attention, non-preferred activity, task, or setting, or a difficult task or frustrating situation. She has an inability to focus and maintain concentration.

Both parent and teacher completed anorm-referenced screening instrument that is designed to identify individuals who present severe behavioral problems that may be indicative of attention deficit hyperactivity disorder. The parent's and the teacher's ratings yielded ADHD Quotients that indicated Amy has a very likely probability of having ADHD.

After collecting baseline data for five days, Ms. Green and Ms. Hahn created a behavior intervention, Sticker Bracelets, to address incomplete assignments to be reviewed after ten days. At the beginning of each school day, Amy was given a bracelet made from painters' tape to wear with a verbal reminder of the target behavior of completing assignments. A small sticker was placed on the bracelet for each completed assignment, and she was praised by Ms. Green describing her specific good behavior. Since the number of daily assignments varied, Ms. Green chose the number of stickers required for Amy to select a reinforcer each day. Amy was allowed to select a reinforcer from a menu designed by Ms. Green and Amy. Ms. Green recorded the percentage of completed assignments daily. She set the goal at a mean of 80% compliance over a period of ten days.

1. Based on the ABC Analysis, what was the

a. antecedent -

b. behavior -

c. consequence(s) -

2. According to the Functional Behavior Assessment (FBA), when were the problem behaviors most likely to occur?

3. According to the FBA, what were the consequences of the problem behaviors?

4. What was the dependent variable or target behavior of the behavior intervention plan?

5. Why was this particular target behavior chosen for intervention?

6. What was the independent variable?

7. What was the mean of the intervention data collected? Did Amy meet the goal of the intervention?

8. What type of intervention design did you create in the graph?

9. List at least three positive statements about Amy that Ms. Green and Ms. Hahn can make to Amy's parents at the beginning of a conference.

10. Using the data and pieces of information collected, list at least three things that can be shared with Amy's parents to support a need for further assessment of ADHD with a medical doctor.