Functional Behavioral Assessment Consent

Functional Behavioral Assessment Consent

Functional Behavioral Assessment Consent

SS 3.121

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The purpose of this document is to clarify the requirement for securing written parental consent prior to conducting functional behavioral assessments.

MNPS requires written parental consent prior to conducting functional behavioral assessments (FBA) for initial evaluation, reevaluation, individualized education programming, and disciplinary actions. Documentation of written parental consent must be maintained in the child’s education record.

If the parent refuses to provide written consent, or fails to respond to a request for written consent, MNPS may request a due process hearing and seeking a judicial order for a functional behavioral assessment.If a parent disagrees with a functional behavioral assessment, the parent is entitled to request an independent educational evaluation at the MNPS’s expense.

The guidelines for obtaining written parental consent are outlined below:

  • Initial evaluation- Indicate need for FBA on Initial Consent for Assessment & document on Prior Written Notice (PWN), get FBA Consent form signed by parent/guardian
  • Reevaluation- On the reevaluation summary, indicate the need for the FBA and document on PWN, get FBA Consent form signed by parent/guardian
  • Individualized Education Plan (IEP)-(annual or addendum)-give a minimum of 10 days notice, document need for FBA on both PWNs, indicate FBA on the Narratives tab, complete the Annual/Addendum IEP as appropriate, get FBA Consent form signed by parent/guardian
  • Disciplinary action- Give a minimum of 24 hours notice for a meeting, document need for FBA on both PWNs, indicate FBA on the Narratives tab, complete the Addendum IEP as appropriate, get FBA Consent form signed by parent/guardian

NOTE:If the parent does not attend the disciplinary meeting, the FBA Consent Form, IEP, and 15-day signature letter should be sent to the parent via certified and regular US Mail.

References/Authority

34 C.F.R. 300.301

34 C.F.R. 300.303

34 C.F.R. 300.324

34 C.F.R. 300.530(f)

34 C.F.R. 300.507

34 C.F.R 300.502.

FBA Written Consent Form

Functional Behavioral Assessment Consent Form

Dear Parent/Guardian,

As a way to best serve your child, ______, we would like to conduct a functional behavior assessment (FBA). A functional behavior assessment is the process of

  • Identifying problematic behavior(s)
  • Identifying environmental events which impact problematic behavior(s)
  • Determining the cause/function of the problematic behavior(s)
  • Outlining the necessary changes needed to be made by the school, teacher, student, and parent/guardian in order to allow the student to successfully access the general curriculum.

An FBA may include, but is not limited to, the following components:

  • Interviews completed by the student (if applicable), teacher(s), and parent(s)/guardian(s) regarding the student’s behavior
  • Information gathering tools (e.g., cumulative file review, Motivation Assessment Scale, teacher rating scale and student self-assessment)
  • Observations of student behavior in school settings
  • Data collection on student behavior
  • Interventions to address student behavior, which focus on decreasing negative behavior and teaching new, appropriate replacement behaviors
  • Ongoing data collection to evaluate intervention effectiveness
  • Safety or crisis plan, if necessary

We greatly appreciate your involvement in this plan during each step in the process. The assessments should be completed and shared with you within 40 school days. If you have any questions regarding this process please call ______at ______.

Please sign below to indicate whether or not you give consent for MNPS to conduct a functional behavior assessment (FBA).

I give consent for my child, ______, to participate in a functional behavior assessment.

I do not give consent for my child, ______, to participate in a functional behavior assessment.

______

Parent/Guardian Signature Date

1

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