Note to the Gym Teacher

Written for:
7-year-old boy
Fetal alcohol effects, DSI
Self-contained special-ed class
One-on-one aide
Response to gym teacher's concern
By Terri Mauro

Thank you for the progress report. I'm not sure how much we can really do about this from home, but one thing I will commit to is trying to find him some physical activity for him to do outside of school to possibly practice more controlled movements and waiting his turn. We're looking at a gymnastics class, because he has shown some ability and willingness in that area in the past. The problem we run into, of course, is that he is about as poorly behaved there as he is in your class, but private providers are not obligated to put up with him. We'll try it again. He has been doing one-on-one therapeutic horseback riding for the past eight weeks (concluding today), and in eight weeks will start again with one other child in his class. Not too much misbehaving he can do when he's stuck on the back of a horse.

I've been thinking since our discussion about what might be going on with him in gym and what could be done about it. [Classroom teacher] confirms that he is not sleepy every morning at 9 a.m., just mornings when he has gym, so I think there's probably a connection. We agreed that it might have to do with there being so many transitions in a row on those mornings. He often does tend to shut down when he's overwhelmed. It's also a nice, passive way to keep from doing what he doesn't want to do. You may be able to talk or joke him out of it by suggesting that if he's too sleepy to do gym, he's too sleepy to do something he likes to do. Or that if he's so sleepy, he should go to the nurse's office and lie down. Or that you'd better call me to come pick him up and take him home and put him to bed for the day. This will most likely perk him right up.

I don't know how much of his neurological profile you've been given, but I can see a few things that probably make gym seem difficult for him and therefore drive him to distraction:

Low muscle tone. This makes it physically difficult for him to be still, balance, or hold a position. His movements are generally headlong and disorganized because he's going on momentum to keep him erect. This is a kid who was able to walk before he was able to stand unsupported. Any activity that involves stillness, balance, or specific positions--even as a small increment--will be hard for him. And more importantly, he will perceive it as being hard, or impossible, and will look for any distraction or evasion. Or he may have trouble getting past the part of it that's easy and comfortable for him to do if he feels that the next step is something he can't do. Having something (or someone) to hold on to or lean against may help, if at all applicable.

Sensory integration dysfunction. He has particular problems processing information from his proprioceptive and vestibular senses, and generally seeks input to those areas rather aggressively. I've enclosed some information about sensory integration in general and proprioceptive and vestibular dysfunction in particular. What applies most here, though, is the fact that he needs a certain amount of motion to remain alert. Unfortunately, he seems to have a very thin band of optimal alertness surrounded by very wide areas of understimulation and overstimulation. My theory is that he is basically understimulated, and so constantly seeks out movement and stimulation in an attempt to make himself more alert; in doing so, he ricochets to overstimulation, and we all know what that looks like. It may be that since you have made efforts to keep him from running around uncontrolled, he is slipping into an understimulated state, and then when you allow him opportunity for movement, he goes overboard. It's rather like when your foot falls asleep. You could, with a great degree of self control, walk normally or do specific movements someone else instructs you to do with your foot abuzz, but your strong desire would be to just stand there and stomp the thing. My son, at this point in his development, does not have a great degree of self control. And at some point, he may feel that regulating his nervous system is more important than any incentive or punishment.

Motor planning. I've also included a sheet on this. My son has trouble translating an idea into the appropriate movements. And he still has a very quick shut-down mechanism for things he feels are too complicated. Happily, fewer and fewer things are too complicated for him. But an activity outlined in gym, when he already has a certain amount of distracting stress from being in a big echoing room and having made a transition from the classroom, may appear too complicated--even if he is physically able to do it. So again, he will seek distraction and evasion. Breaking activities down into tiny, tiny pieces and repeating them excessively may help, but may be impractical with other kids to deal with.

Impulsiveness. Due to his neurological condition, the part of his brain that knows the rules and wants to follow them, and the part of his brain that has the impulses, do not communicate particularly well. As his stress level rises, that communication gets worse and is sometimes nonexistent. So by the time the message gets through not to do something, he's already done it. He can know the rule, tell you the rule, break the rule, and be genuinely contrite. One side of his brain literally does not know what the other side is doing. It's still disobedience, but it may not always be willful.

I recently attended a workshop sponsored by the special-ed department about eliminating unwanted behaviors, and the theory presented there was that in order to shape a behavior, you have to change either the antecedent or the consequence. The antecedent is the who, what, when, where of an activity, and the consequence should if at all possible be positive. This is something that has always worked well for us with our guy, and I wonder if we could figure out a way to implement it in gym. I don't think changing the antecedent is possible--this would be something like changing the timing so gym isn't the first thing in the morning, or partitioning off a corner of the gym so that he's not distracted by that large, beckoning, echoing space. These might be effective for him, but impractical for you.

However, there may be something to be done with positive consequences. Is there any activity he enjoys that you could let him do if he does what you want? I know riding the scooters is his favorite thing, and theoretically you could say that if he acquits himself well for most of the period he can finish on the scooters; but then you'd have to do that for everybody, and that may be impossible or undesirable. I wonder if there's some way he could do a controlled run--maybe around the very edges of the gym, right up against the stage and bleachers--while he's waiting for his turn, or go in a corner and jump, or hang from a bar, or--? Something that would be a legitimate phys-ed activity, but might give him some self-determined movement to get all his systems in line. It may be that [classroom teacher] can think of something that would be a positive consequence back at the classroom if he gets a good report from you. He can't wait too long for a payoff, but he might be able to wait that long.

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