Her parents say she is affectionate with them, especially when she is calm, but she does not always respond when her name is called. Sometimes she repeats phrases from cartoons or make animal noises instead of answering questions directly.

The teacher notices that transitions are especially difficult for Lina, such as moving from free play to circle time or from classroom activities to music class. During music class, she often covers her ears and may cry or hide under the table.

Her parents are worried, but they are unsure whether this is “just her personality.” They say, “She is very intelligent, so maybe she will grow out of it.” Because they do not want to upset her, they often avoid changing her routines at home. For example, they let her eat from the same plate, sit in the same chair, watch the same cartoon repeatedly.

The teacher feels that Lina may need more support, but the parents are hesitant about assessment because they worry that a label might harm her.

• Predisposing: What vulnerabilities may be present?

• Precipitating: What environments trigger distress?

• Perpetuating: What keeps the problem going?

• Protective: What helps the child?