Help with Homework
FBA Template Candidate Name:
**Please use the “Tips for Writing the FBA” document as a guide for filling out this template. That document will explain in more detail what should go in each section!**
Functional Behavioral Assessment – NAME OF STUDENT
STUDENT’S BEHAVIORAL STRENGTHS
Positive Behaviors and Skills:
Where and when do strengths occur?
Positive behavior is reinforced by:
STUDENT’S BEHAVIORAL CONCERNS
List of behaviors/concerns:
Target (Problem) Behavior:
Prioritize the behavior that will be the focus of the assessment and intervention plan.
Choose the behavior that most interferes with the student’s functioning in the school environment. Be specific and describe the behavior in measurable and observable terms. Also address your reasons for NOT choosing the other behaviors on your list.
Baseline Data:
Indicate the frequency (how often), the intensity (distracting, disruptive, destructive – mild, moderate, severe) and the duration (how long does the behavior last) of the target behavior.
CONDITIONS, TRIGGERS, REINFORCERS:
Contributing Factors:
Include a description of “long term” or “chronic” factors/variables that may affect the behavior.
Setting Events:
Identify any “short term” setting events that make the target behavior more likely to occur.
Antecedent:
Include statement of the event(s) that
most commonly immediately precede the behavior.
Consequence:
Include a description of the result of the behavior (i.e. – removed from class, not able to complete assignments/tests, etc.). What consequence appears from the data
most likely or most commonly present to maintain the problem behavior(s)?
Function:
FUNCTIONAL HYPOTHESIS STATEMENT:
Based on your analysis of data, make a statement that represents your “best guess” about the reason for the behavior(s). Please use appropriate hypothesis statement wording and
make sure all parts of the statement are present (Antecedent, Behavior, and Consequence)
