Lincoln Public Schools
Direct FBA Part 1
Student Name:______Grade:______Date of Meeting:______
List of Team Members Present:
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TEAM INTERVIEW & DISCUSSION~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Identify the student’s strengths:
Academic / Behavioral/Social / Home2. Identify why the team determined a Functional Behavior Assessment was needed:
3. Identify the referring/target behavior(s) (written in observable, measurable terms):
4. Location
Where does the behavior almost always happen? / ____Classroom ____Hallway ____Lunchroom____Playground ____Specific class ___Restroom
Where does the behavior almost never happen? / ____Classroom ____Hallway ____Lunchroom
____Playground ____Specific class ___Restroom
5. Time
What time of day does the behavior almost always happen? / ___Before school ____Class period (____)____After school ____Lunch
What time of day does the behavior almost never happen? / ___Before school ____Class period (____)
____After school ____Lunch
6. Adults & Students
Who is present when the behavior tends to occur? / ____Student(s):____Adult(s):
Who is present when the behavior almost never occurs? / ____Student(s):
____Adult(s):
7. Before and After
What happens just prior to the referring target behavior occurs? / What happens just after the referring target behavior occurs?8. Other relevant factors to referring behavior:
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DETERMINE DATA COLLECTION PLAN~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
13. How will baseline data be collected?
Who / When / Where / How (What data collection tool?)14. Date of data review meeting:______
Lincoln Public Schools
Direct FBA Part 2
Student Name:______Grade:______Date of Meeting:______
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DATA REVIEW MEETING~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
List of Team Members Present:
1. Summarize baseline data:
2. Hypothesize the function or purpose of the behavior?
____Attention ____Power & Control _____Lack of Skills
____Escape/Avoidance ____Sensory
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Summary of FBA Data~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Setting/Event(what makes it worse) / Predictors
(when, where, etc) / Behavior / Function
(what purpose is served?)
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RESULTS OF FBA~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A Behavior Intervention Plan (BIP) will be developed to proactively address behavior analyzed in this functional behavioral assessment. This plan will describe what staff will do to support alternative behavior
The team has determined that a Behavior Intervention Plan (BIP) is not necessary as a result of this assessment. Rationale: ______
______
______
Edupoint Direct FBA