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"Leah" - A Case Study Part One: by Chavi Hornig, M.S.

Updated: Sep 2, 2019

"Leah" is a second grader in Bnos Sarah. Her family moved to America from Israel at the beginning of the 2008-2009 school year. The family is English speaking, so oral language is not an issue for Leah.


Leah is academically gifted. Although she could not put 'cvc' words together when she arrived, she is already the very best reader in her class, and she reads voraciously. She gets so absorbed in a book that it is difficult to get her attention and pry her away from her book.

Her mother and teachers describe her as being immature.


Leah has difficulty, however, in the area of non-verbal skills. She is impulsive and very fidgety. She touches everything she sees and demands attention NOW, no matter what else is going on. She cannot wait patiently. She constantly blurts out inappropriate comments. Her mother and teachers describe her as being immature. She seeks attention by doing silly things. She is unable to take perspective and put herself in another's place, or imagine how they might be feeling. She is unfamiliar with the concept of respecting another's personal space. She often gets too close to the person to whom she is speaking without realizing it. She has great difficulty following directions and following rules. Her immediate desires take precedence over all else. There is nothing malicious in any of her behavior; she genuinely does not realize that her behavior is inappropriate and she is genuinely contrite when her gaffes are pointed out to her.


Leah is having difficulty making friends. She feels that her classmates don't like her, but she has no idea why. She spends every recess reading books.


Leah lacks a sense of proper personal hygiene. Her nose is frequently running, and she seems oblivious to it.


I met with Leah for half an hour in early March, after having spoken to her mother at length. I wanted to get to know her a little, and to get a feel for the issues I'd be dealing with.


At the beginning, when I asked her if she has friends, she told me she does, but she quickly became more comfortable with me. She showed me some of the silly things she does, discussed very openly her problem behaviors, and when I asked her which thing we should work on first, she told me "friends."


At our first full session, we discussed the traffic light, as well as red and green behaviors, and yellow feelings. I focused very much on yellow, which can lead us to do red if we're not careful. I told her that not only children have to be careful about yellow feelings which could make them do reds, but adults, too, have to be careful.

This activity forced her to put herself in someone else's shoes and to understand how another person would feel in a given situation.


I presented a scenario in which a mother has spent the entire day cleaning her house and is tired, and then the children come home from school and pull out all of the toys and make a mess. I asked her, "How do you think the mother is feeling?" Leah was able to tell me the mother is sad and upset. "What red behavior might the mother do if she's not careful?" Yell at the kids. "But are kids really allowed to play with toys? Of course they are! So what green behavior could the mother do instead?" Leah had all the correct answers. She was very good at identifying the red behaviors and coming up with a variety of green solutions that could be done instead. I praised her for her creative solutions, even though we hadn't even talked about solutions yet.


Then we did some role playing of different scenarios, and acted out red and green behaviors for each scenario. I also did a role reversal with her. I told her that she would be her mother and I was going to be Leah. She instinctively wanted to protest, thought better of it almost immediately, and cooperated with the activity. This activity forced her to put herself in someone else's shoes and to understand how another person would feel in a given situation. I could see the light dawning as we did this activity.

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