Pathways and Triggers Brought to Life 51obtain rewards and avoid punishments. Indeed, the pro-
gram actually seemed to frustrate him further, but the
psychologist encouraged the parents to stick with it, cer-
tain that Casey’s behavior would improve. It didn’t, so
the parents discontinued the program after about three
months. They often tried to talk to Casey about his be-
havior, but even when he was in a good mood, his capac-
ity for thinking about his own behavior seemed limited;
after a few seconds, he would yell “I can’t talk about this
right now!” and run out of the room.
Casey had difficulties at school, too. His first-grade
teacher reported that Casey would occasionally hit or
yell at other children during less structured activities,
particularly when he did not get his way. Like the par-
ents, Casey’s teacher was impressed by his factual knowl-
edge but concerned by his poor problem-solving skills.
When lessons called for recall of rote information, Casey
was the star of the class. When lessons required the ap-
plication of this information to more abstract, complex,
real-life situations, his responses were disorganized and
off the mark. When he was frustrated by a particular
classroom situation or task, he would yell “I can’t do
this!” and would become quite agitated or start crying;
sometimes he would run out of the classroom. On sev-
eral occasions, he ran out of the school, which caused
great concern for his safety. Sometimes he regained his
composure quickly; other times it took twenty to thirty
minutes for him to calm down. Afterward, Casey was ei-