Functional Behavioral Assessment

Participants (may include): Teacher, Parent, Student, Psychologist, Social Worker, Counselor, Community Agency, Related Service Provider, Interpreter, Cultural Liaison, Family Liaison, etc.
Parent: / Counselor:
Parent: / Teacher:
Student: / Other:
Team Leader: / Other:
School Psychologist: / Other:
School Social Worker: / Other:

STEP 1: IDENTIFICATION OF TARGET BEHAVIOR

Interviews Teacher(s)/Student(s)/Guardian(s)

Who was interviewed (name and title)?

Summary (include possible antecedent, behaviors of concerns, current consequences perceived intensity, frequency, and duration, how it effects quality of life and other information as needed)?
Individual Interviewed: / Individual Interviewed: / Individual interviewed:
Summary: / Summary: / Summary:

Based on Interviews and informal observations, Description of the Behavior *Keep in mind cultural influences and how they may effect behavior

Behaviors of greatest concern? / Behavior Selected? Select OneYesNo
Why or Why Not?
Behavior Selected? Select OneYesNo
Why or Why Not?
Behavior Selected? Select OneYesNo
Why or Why Not?

STEP 2: PROPOSE A TESTABLE EXPLANATION

Based on the interviews and observations, what is your working testable explanation for the function of the target
behavior?
Because of the student’s
( setting events i.e. environmental factors, academic difficulties, other contributing factors )
when occurs,
(antecedent/trigger, i.e. a direction to do difficult work, answer difficult question, work with a disliked peer, etc.)
the student
(problem behavior)
which results in
( consequence/outcome/what happens afterwards, i.e. what is the teacher’s and or peers’ response)
serving the purpose of for the student.
( function/purpose, i.e. to get teacher attention, to get peer attention, gets desired object/activity, escapes undesirable activity, escapes demand, escapes particular people, etc.)

STEP 3: CONDUCT OBERVATIONS AND DATA COLLECTION

At least two data collection tools must be used in order to complete an accurate Functional Behavior Assessment, Choose from the following and attach to BIP:

Indirect / Direct
Anecdotal Notes
Functional Analysis Screening Tool
Motivational Assessment Scale
BASC
Office Discipline Referrals
other / Antecedent, Behavior, Consequence
Frequency
Duration
Intensity
Scatter Plot
other
Who will be responsible for collecting data?
Data collection to begin: End
Will data collection occur in the home: Yes  No
Who will be responsible for collecting data in the home?
Data collection in the home will begin: End:
Who will analyze the data?
Next team meeting to discuss results:

STEP 4: IDENTIFY ANTECEDENTS AND MAINTAINING CONTINGENCIES (CONSEQUENCES)

Summarize Antecedent (and Setting Events)

What situations seem to precede the target behavior? (difficult tasks, transitions, structured activities, small group settings,
teacher’s request, particular individuals, etc.)
When is the target behavior most likely to occur? (times of the day and days of the week)
When is the target behavior least likely to occur? (times of the day and days of the week)
Setting Events: Are there specific conditions, events, or activities that make the problem behavior worse?
(missed medication, history of academic failure, conflict at home, missed meals, lack of sleep, history or problems with peers, etc.)

Description of the Behavior

/ What does the target behavior(s) look like?
How often does the target behavior(s) occur?
How long does the target behavior(s) last?
How does this behavior impact students and or other quality of life (danger, skill deficit, disruptive, engagement, stamina etc…)?

Description of the Consequence

/ What usually happens after the target behavior Occurs? (what is the teacher’s reaction, how do other students react, is the student sent to the office, does the student get out of doing work, does the teacher talk to the student (etc.)

What strategies have been implemented to remediate the student’s problem behavior? What were the results of these strategies?

Strategies Implemented: / Results:

STEP 5: CONFIRM/MODIFY TESTABLE EXPLANATION

Function of the Behavior
Based on the two sources of data collected, why is the behavior occurring? (to get teacher attention, to get peer attention, gets desired object/activity, escapes undesirable activity, avoids undesirable activity, escapes demand, avoids demands, escapes particular people, avoids particular people, automatic)

Hypothesis Statement
Based on the data collected, what is your hypothesis for why the problem behavior occurs?
Because of the student’s,
(setting events)
when occurs,
(antecedent)
the student ,
(behavior)
which results in ,
(consequence )
serving the purpose of for the student.

Will a Behavior Intervention Plan be developed? Why or why not?