FORM 2.

Functional Behavioral Assessment Competency Scale (FBACS)

Name:
Date of Self-Assessment:

Part One: Ethical Responsibilities

Ethical Responsibilities Rating Rubric:
0= My behavior is inconsistent with this standard
1= My behavior is partially consistent with this standard
2= My behavior is consistent with this standard
NA = I have no experience conducting FBAs

Instructions: Using the Ethical Responsibilities Rating Rubric, self-evaluate your adherence to each
ethical standard.

Standard Rating Comments

3.0 Assessing Behavior

Evaluators use behavior-analytic assessment 0 1 2 NA

techniques based on current research

3.1 Behavior-Analytic Assessment

Evaluators conduct current assessments prior to 0 1 2 NA

making recommendations

Evaluators conduct FBAs prior to developing a 0 1 2 NA

behavior-reduction program

FBA procedures are determined by each 0 1 2 NA

student’s needs, consent, environmental
parameters, and other contextual variables

Evaluators collect and graphically display FBA 0 1 2 NA

data in a manner that allows for decisions and
recommendations about the development of
behavior plans

(continued)

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Functional Behavioral Assessment Competency Scale (FBACS) (page 2 of 5)

Standard Rating Comments

3.02 Medical Consultation
Evaluators seek medical consultation when 0 1 2 NA
there is a reasonable possibility that a referred
behavior is influenced by medical or biological
variables
3.03 Informed Consent
Prior to conducting an FBA, evaluators explain 0 1 2 NA
to guardians (and students, as appropriate) the
procedures, who will participate, and how the
resulting information will be used
Prior to conducting an FBA, evaluators explain 0 1 2 NA
to guardians (and students, as appropriate) the
risks and benefits of the assessment procedures

Prior to conducting an FBA, evaluators 0 1 2 NA

obtain written approval of the assessment
procedures from the guardians (and students, as
appropriate)
3.04 Explaining Assessment Results
Evaluators explain FBA results using language 0 1 2 NA
and graphic displays of data that are reasonably
understandable

Evaluators provide written reports describing 0 1 2 NA

the assessment procedures, the results, and
function-based recommendations

4.0 Behavior Change Recommendations

Behavior-change recommendations are 0 1 2 NA
conceptually consistent with behavior-analytic
principles

Evaluators use FBA results to identify individually 0 1 2 NA

tailored intervention recommendations that are
matched to the function(s) of each interfering
behavior
Standards are adapted from the BACB’s Professional and Ethical Compliance Code for Behavior Analysts (2014).

(continued)
 Functional Behavioral Assessment Competency Scale (FBACS) (page 3 of 5)

Part Two: Knowledge of Conceptual Foundations

Conceptual Knowledge Rating Rubric:
0 = I am unfamiliar with this principle/concept
1 = I can describe some of the components of this principle/concept
2 = I can define this principle/concept
3 = I can define this principle/concept and provide one to two clear examples
4 = I use this term in my daily vocabulary and can explain this principle/concept to laypersons

Instructions: Using the Knowledge Rating Rubric, self-evaluate your knowledge of each behavior-
analytic principle or concept.

Principles/Concepts Rating Comments

Interfering Behavior 0 1 2 3 4

Response Class 0 1 2 3 4

Response Class Hierarchy 0 1 2 3 4

Socially Mediated Positive Reinforcement 0 1 2 3 4

Socially Mediated Negative Reinforcement 0 1 2 3 4

Individually Mediated Positive Reinforcement 0 1 2 3 4

Individually Mediated Negative Reinforcement 0 1 2 3 4

Automatic Positive Reinforcement 0 1 2 3 4

Automatic Negative Reinforcement 0 1 2 3 4

Matching Law 0 1 2 3 4

Parameters of Reinforcement
• Schedule 0 1 2 3 4
• Quality 0 1 2 3 4

• Magnitude 0 1 2 3 4
• Timing 0 1 2 3 4

Discriminative Stimulus 0 1 2 3 4

Motivating Operation 0 1 2 3 4

(continued)
 Functional Behavioral Assessment Competency Scale (FBACS) (page 4 of 5)

Part Three: Knowledge and Experience in Conducting FBAs

Knowledge Rating Rubric:
0 = I am unfamiliar with this procedure
1 = I can describe some of the components of this procedure
2 = I can describe this procedure
3 = I can describe this procedure and provide one to two clear examples
4 = I can explain this procedure to laypersons

Experience Rating Rubric:

0 = I have no applied experience with this procedure
1 = I have received only didactic training on this procedure
2 = I have observed but not directly implemented this procedure
3 = I have implemented the procedure, received performance feedback, and been judged to be
competent by a supervisor
4 = I have considerable experience implementing this procedure with a range of students,
across multiple settings, and with multiple interfering behaviors

Instructions: Using the Knowledge and Experience Rating Rubrics, self-evaluate your knowledge of
and experience with each FBA procedure.

Procedures Knowledge Experience Comments

Assessment Methods

Semistructured Behavior-Analytic Interviews 0 1 2 3 4 0 1 2 3 4

Behavioral Stream Interviews 0 1 2 3 4 0 1 2 3 4
Anecdotal Observation 0 1 2 3 4 0 1 2 3 4

A-B-C Recording 0 1 2 3 4 0 1 2 3 4
Incident-Based Functional Assessment 0 1 2 3 4 0 1 2 3 4

Interval Recording Procedure 0 1 2 3 4 0 1 2 3 4

Structural Analysis 0 1 2 3 4 0 1 2 3 4
Extended Functional Analysis 0 1 2 3 4 0 1 2 3 4
Brief Functional Analysis 0 1 2 3 4 0 1 2 3 4

Trial-Based Functional Analysis 0 1 2 3 4 0 1 2 3 4

Synthesized Functional Analysis 0 1 2 3 4 0 1 2 3 4

Treatment Analysis 0 1 2 3 4 0 1 2 3 4
Preference Assessment 0 1 2 3 4 0 1 2 3 4
Reinforcer Assessment 0 1 2 3 4 0 1 2 3 4

(continued)
 Functional Behavioral Assessment Competency Scale (FBACS) (page 5 of 5)

Procedures Knowledge Experience Comments

Data Recording Procedures
Frequency Recording 0 1 2 3 4 0 1 2 3 4
Duration Recording 0 1 2 3 4 0 1 2 3 4
Latency Recording 0 1 2 3 4 0 1 2 3 4
Intensity Recording 0 1 2 3 4 0 1 2 3 4
Partial-Interval Recording 0 1 2 3 4 0 1 2 3 4
Whole-Interval Recording 0 1 2 3 4 0 1 2 3 4
Momentary Time Sampling 0 1 2 3 4 0 1 2 3 4
Performance-Based Recording 0 1 2 3 4 0 1 2 3 4
Permanent Product Recording 0 1 2 3 4 0 1 2 3 4
Task Analysis Recording Procedure 0 1 2 3 4 0 1 2 3 4
Experimental and Data Analysis Methods
Graphing Data 0 1 2 3 4 0 1 2 3 4
Visual Inspection of Data 0 1 2 3 4 0 1 2 3 4
Case Study Design (AB) 0 1 2 3 4 0 1 2 3 4
Reversal Design (ABAB) 0 1 2 3 4 0 1 2 3 4
Alternating Treatments Design 0 1 2 3 4 0 1 2 3 4
Multiple Baseline Design 0 1 2 3 4 0 1 2 3 4
Interpreting and Reporting FBA Results
Identification and Description of Target 0 1 2 3 4 0 1 2 3 4
Behavior(s)
Identification and Description of Contextual 0 1 2 3 4 0 1 2 3 4
Variables, Personal Characteristics, and Skill
Deficits
Identification and Description of Environmental 0 1 2 3 4 0 1 2 3 4
Antecedents: Discriminative Stimuli
Identification and Description of Environmental 0 1 2 3 4 0 1 2 3 4
Antecedents: Motivating Operations
Identification and Description of Reinforcing 0 1 2 3 4 0 1 2 3 4
Consequences
Identification and Description of Parameters of 0 1 2 3 4 0 1 2 3 4
Reinforcement
Identification and Description of Evidence- 0 1 2 3 4 0 1 2 3 4
Based and Function-Based Recommendations
 FORM 2.2

Functional Behavioral Assessment Procedural Checklist (FBAPC)

1. Informed Consent
FBA procedures have been fully described to parents/guardians
Written consent to conduct the FBA has been obtained from parents/guardians

2. Identification and Description of Interfering Behaviors and Levels of Occurrence

Interfering behaviors are operationally defined in clear, unambiguous terms
Data recording procedures are identified and described
Present levels of occurrence of interfering behaviors are summarized

3. Identification and Description of Variables Associated with Interfering Behaviors

Contexts associated with interfering behaviors are identified and described
Personal characteristics associated with interfering behaviors are identified and described
Medical, biological, and mental health concerns related to interfering behaviors are identified
and described
Skill deficits/delays contributing to interfering behaviors are identified and described

4. Identification and Description of Functional Antecedent Variables

Motivating operations that “trigger” interfering behaviors are identified and described
Sources of reinforcement (discriminative stimuli) are identified and described

5. Identification and Description of Reinforcing Consequences

Reinforcing consequences for interfering behaviors are identified and described
Socially mediated, individually mediated, and automatic positive reinforcers for interfering
behaviors are considered
Socially mediated, individually mediated, and automatic negative reinforcers for interfering
behaviors are considered
Parameters of reinforcement (i.e., the schedule, quality, magnitude, and timing of functional
consequences) are identified and described
Response effort to obtain reinforcement is identified and described

6. Functional Hypotheses
Hypotheses about the function(s) of interfering behaviors are developed
Hypothesis statements identify the antecedent and consequence variables that evoke and
maintain interfering behaviors

7. FBA Results and Recommendations

FBA results are presented in a written report, using understandable language and graphics
Intervention recommendations are evidence-based
Intervention recommendations are function-based
Intervention recommendations are individually tailored to account for unique characteristics of
the student and setting

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 2.3

Functional Behavioral Assessment Informed Consent Form

WHAT IS A FUNCTIONAL BEHAVIORAL ASSESSMENT?

A functional behavioral assessment (FBA) is conducted to answer two questions:

1. Why does the student have problem behaviors?
2. What strategies would decrease problem behaviors and increase appropriate behaviors?

In other words, the purposes of an FBA are to:

• Identify and describe the variables that contribute to behaviors that interfere with a student’s
learning, and
• Develop individually tailored interventions to address those behaviors.

In contrast to traditional assessments (e.g., intellectual and academic assessment) where standard
testing materials and scoring systems are used, FBAs are individualized to address the unique needs
and characteristics of the student. School-based FBAs may involve any combination of the following
assessment procedures:

• Indirect FBA Procedures

|Interviews with family members
|Interviews with school staff
|Interviews with the student
|Review of records, including previous evaluation reports and behavioral data

• Descriptive FBA Procedures

|Observation of the student in the school setting by the evaluator and/or school staff
|Recording of the student’s behavior across varied school settings by the evaluator and/or school
staff
|Recording of the events that occur before and after the student shows problem behaviors

• Functional Analysis Procedures

|Setting up and repeating scenarios that typically lead to problem behaviors in the school setting
to understand the effect of antecedents (triggers) and consequences on the student’s behavior
|Observation and recording of the student’s behavior during these assessment scenarios

• Treatment Analysis
|Briefly “test-driving” interventions to see if the strategies are effective in reducing problem
behavior and increasing appropriate behavior
• Assessment of Reinforcement
|Preference Assessment
„Having the student sample a variety of items or activities that students often find rewarding
„Asking the student to choose items or activities that are most preferred
|Reinforcer Assessment
„Giving the student preferred items or activities after appropriate behaviors
„Observing and recording appropriate behaviors to see if they increase when followed by
preferred items or activities
(continued)

Used with permission from the Margaret Murphy Centers for Children.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Functional Behavioral Assessment Informed Consent Form (page 2 of 3)

• Medical Consultation
|Communicating with medical professionals (after obtaining a release to share information) if the
student’s behaviors seem to be related to medical issues

BENEFITS OF CONDUCTING A FUNCTIONAL BEHAVIORAL ASSESSMENT

Interventions based on the results of the FBA are referred to as “function based.” Research shows
that:
• Problem behaviors may serve multiple purposes or “functions” for students. For example, problem
behaviors may produce access to attention, preferred items, or preferred activities; let the student
avoid difficult tasks or unpleasant situations; create pleasant sensory stimulation; or help the student
self-regulate.
• Behavioral interventions based on the “functions” of problem behaviors are more effective than
interventions based on team preference or professional judgment.
• FBAs lead to the development of individually tailored interventions that address the unique
characteristics of the student and the “functions” of his or her behaviors. These interventions may
lead to reductions in problem behaviors and increases in appropriate behaviors.

POTENTIAL RISKS ASSOCIATED WITH CONDUCTING

A FUNCTIONAL BEHAVIORAL ASSESSMENT

It is important to understand that FBAs are conducted because the student is showing problem
behaviors in the school setting. When conducting the FBA, one or more of the assessment procedures
(especially functional analysis methods) may “trigger” problem behaviors. However, the level and
intensity of problem behaviors during the FBA process is not expected to be significantly different from
what typically happens in the natural school setting. If problem behaviors escalate to the point that
significant harm to the student or others may occur, the assessment will be immediately terminated.

WHAT CAN I EXPECT AFTER THE FUNCTIONAL BEHAVIORAL ASSESSMENT?

• FBA Report: A formal report describing the assessment procedures, results, and recommendations
will be provided to parents/guardians and other members of the school team.
• FBA Review Session: A private meeting with parents/guardians to review the report and discuss the
results and recommendations will be offered. Results and recommendations also will be reviewed
during a formal meeting with parents/guardians and members of the school team.

ACKNOWLEDGMENT OF UNDERSTANDING

The FBA procedures to be used with my child were verbally explained to me. I understand the purpose
of the FBA and the assessment methods that will be used. I understand the risks and benefits of the
FBA process.

Parent/Guardian Signature

(continued)
 Functional Behavioral Assessment Informed Consent Form (page 3 of 3)

CONSENT

I give permission for completion of an FBA with my child. I understand that I will receive a written
report within school days. I also understand that I will have an opportunity to meet with the
school team to review the FBA results and recommendations.

Student Name

Parent/Guardian Name

Parent/Guardian Signature and Date

School Psychologist/BCBA Signature and Date

 FORM 5.1

Executive Skills Questionnaire for Parents/Teachers

Big problem 1
Moderate problem 2
Mild problem 3
Slight problem 4
No problem 5
Item Score
1. Acts on impulse
2. Gets in trouble for talking too much in class
3. Says things without thinking
TOTAL SCORE:

4. Says, “I’ll do it later” and then forgets about it

5. Forgets homework assignments or forgets to bring home
needed materials
6. Loses or misplaces belongings such as coats, mittens, sports
equipment, etc.
TOTAL SCORE:
7. Gets annoyed when homework is too hard or confusing or takes
too long to finish
8. Has a short fuse; easily frustrated
9. Easily upset when things don’t go as planned
TOTAL SCORE:

10. Difficulty paying attention; easily distracted

11. Runs out of steam before finishing homework or other tasks
12. Problems sticking with schoolwork or chores until they are done
TOTAL SCORE:

13. Puts off homework or chores until the last minute

14. Difficulty setting aside fun activities in order to start homework
15. Needs many reminders to start chores
TOTAL SCORE:

16. Trouble planning for big assignments (knowing what to do first, second, etc.)
17. Difficulty setting priorities when has a lot of things to do
18. Becomes overwhelmed by long-term projects or big assignments
TOTAL SCORE:

(continued)
From Dawson and Guare (2018). Copyright © The Guilford Press. Reprinted by permission.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Executive Skills Questionnaire for Parents/Teachers (page 2 of 2)

Item Score
19. Backpack and notebooks are disorganized
20. Desk or workspace at home or school is a mess
21. Trouble keeping bedroom or locker tidy
TOTAL SCORE:

22. Has a hard time estimating how long it takes to do something

(such as homework)
23. Often doesn’t finish homework at night; rushes to get it done in school
before class
24. Slow getting ready for things (e.g., appointments, school,
changing classes)
TOTAL SCORE:

25. If the first solution to a problem doesn’t work, has trouble thinking
of a different one
26. Resists changes in plans or routines
27. Has problems with open-ended homework assignments (e.g., doesn’t
know what to write about when given a creative writing assignment)
TOTAL SCORE:

High School Students Only

28. Lacks effective study strategies
29. Doesn’t check work for mistakes even when the stakes are high
30. Doesn’t evaluate performance and change tactics in order to
increase success
TOTAL SCORE:

31. Can’t seem to save up money for a desired object; problems

delaying gratification
32. Doesn’t see the value in earning good grades to achieve
a long-term goal
33. Seems to live in the present
TOTAL SCORE:
KEY
Items Executive Skill Items Executive Skill
1–3 Response inhibition 4–6 Working memory
7–9 Emotional control 10–12 Sustained attention
13–15 Task initiation 16–18 Planning/prioritization
19–21 Organization 22–24 Time management
25–27 Flexibility 28–30 Metacognition
31–33 Goal-directed persistence

Child’s Executive Skills Strengths Child’s Executive Skills Weaknesses

 FORM 5.2

Executive Skills Questionnaire for Students

Directions: Read each item and decide how often it’s a problem for you. Then add up the three scores
in each set and write that number on the Total score line. Use the Key on page 69 to determine your
executive skills strengths (two to three highest scores) and weaknesses (two to three lowest scores).

1. I act on impulse.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

2. I get in trouble for talking too much in class.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

3. I say things without thinking.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 1–3:

4. I say “I’ll do it later” and then forget about it.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

5. I forget homework assignments or forget to bring home needed materials.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

6. I lose or misplace belongings such as coats, notebooks, sports equipment, etc.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 4–6:

7. I get annoyed when homework is too hard or confusing or takes too long to finish.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

8. I have a short fuse, am easily frustrated.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

9. I get upset easily when things don’t go as planned.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 7–9:

(continued)

Reprinted from Dawson and Guare (2017). Copyright © 2017 The Guilford Press.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Executive Skills Questionnaire for Students (page 2 of 4)

10. I have difficulty paying attention, am easily distracted.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

11. I run out of steam before finishing my homework.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

12. I have problems sticking with chores until they are done.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 10–12:

13. I put off homework or chores until the last minute.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

14. It’s hard for me to put aside fun activities to start homework.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

15. I need many reminders to start chores.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 13–15:

16. I have trouble planning for big assignments (knowing what to do first,
second, etc.).
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

17. It’s hard for me to set priorities when I have a lot of things to do.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

18. I become overwhelmed by long-term projects or big assignments.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 16–18:

(continued)
 Executive Skills Questionnaire for Students (page 3 of 4)

19. My backpack and notebooks are disorganized.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

20. My desk or workspace at home is a mess.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

21. I have trouble keeping my room tidy.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 19–21:

22. I have a hard time estimating how long it takes to do something

(such as homework).
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

23. I often don’t finish homework at night and rush to get it done in school
before class.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

24. I’m slow getting ready for things (e.g., school or appointments).
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 22–24:

25. If the first solution to a problem doesn’t work, I have trouble thinking
of a different one.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

26. It’s hard for me to deal with changes in plans or routines.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

27. I have problems with open-ended homework assignments (e.g., knowing

what to write about for a creative writing assignment or coming up with topics
for a long-term project).
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 25–27:

(continued)
 Executive Skills Questionnaire for Students (page 4 of 4)

28. I don’t have effective study strategies.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

29. I don’t check my work for mistakes even when the stakes are high.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

30. I don’t evaluate my performance and change tactics to increase my success.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 28–30:

31. I can’t seem to save up money for something I want.

Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

32. I don’t see the value in earning good grades to achieve a long-term goal.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5

33. If something fun comes up when I should be studying, it’s hard for me
to make myself study.
Most of the time Frequently Sometimes Very rarely Never
1 2 3 4 5
Total score, items 31–33:

KEY
Items Executive Skill Items Executive Skill
1–3 Response inhibition 4–6 Working memory
7–9 Emotional control 10–12 Sustained attention
13–15 Task initiation 16–18 Planning/prioritization
19–21 Organization 22–24 Time management
25–27 Flexibility 28–30 Metacognition
31–33 Goal-directed persistence

Your Executive Skills Strengths Your Executive Skills Weaknesses

 FORM 5.3

Executive Skills Problem Checklist, Elementary Version—Teacher

Directions:
1. Read each item and decide whether the student in question exhibits this problem to a significantly
greater degree than other children in the same grade level.
2. Look over all the items you checked and choose THREE that you think cause the greatest
problems. Place a star (‘) next to those.

Response Inhibition
Blurts out inappropriate comments
In a teacher-directed activity, does not wait until the person talking finishes and he/she is
acknowledged by the teacher before offering a response
Can’t wait turn in games
Does not use acceptable language to handle conflict situations
Does not remain at his/her seat or assigned area during seatwork time and classroom lessons
Does not complete seatwork or assignments accurately

Working Memory
Doesn’t write down all homework in assignment books or other designated location
Doesn’t bring all necessary materials to and from school every day (e.g., homework, notebooks/
binders, permission slips, gym clothes, lunch money, coats/hats/mittens, etc.)
Doesn’t hand in assignments on the dates they are due
Doesn’t remember where to find all necessary materials to get through the school day and to
complete homework
Doesn’t follow all instructions accurately for multistep tasks by using checklists or rubrics if
necessary

Emotional Control
Leaves class or becomes visibly upset rather than asking for help when he/she doesn’t
understand an assignment
Engages in verbal or physical aggression or unsafe behavior when playing with other students at
recess
Doesn’t use coping strategies to recover when he/she begins to get upset (or angry, frustrated,
anxious)
Anxiety interferes with test performance
Anxiety interferes with classroom presentations
Becomes very upset or responds with verbal or physical aggression when teased or taunted by
other students
(continued)

From Dawson and Guare (2018). Copyright © The Guilford Press. Reprinted by permission.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Executive Skills Problem Checklist, Elementary Version—Teacher (page 2 of 2)

Flexibility
Becomes very upset when confronted with the unexpected (e.g., changes in plans or routines,
disappointment, being told “no”)
Has difficulty managing transitions between activities or settings
Is unable to come up with one or more alternative plans or solutions when the first strategy
doesn’t work (no Plan B)
Is unable to complete open-ended tasks successfully according to the rubric assigned

Sustained Attention
Doesn’t complete classwork and homework within the time allotted or within suggested time
frames
Loses focus on class lessons (as demonstrated by not being able to answer questions related to
the content of the lesson or by not understanding assignments associated with the lesson)

Task Initiation
Has difficulty starting class assignments within 3 minutes of the prompt to begin working
Stretches out breaks and fails to return to work promptly with longer or less preferred work tasks

Planning/Prioritization
Has difficulty setting priorities (in what order to do tasks, how much time to spend on any given
task)
Doesn’t know what to focus on when studying for tests
Writing does not follow a logical sequence; paragraphs don’t contain main ideas and supporting
details

Organization
Does not place materials in a specified place in notebooks, backpacks, desks, and study areas
Does not follow an organizational system with consistency (e.g., throwing out unnecessary
papers, not placing homework assignments in assigned spot, organizing papers for each subject
separately)
Does not have a tidy study area

Time Management
Does not complete assignments within the time allotted or by the due date
Can’t adjust work speed to fit the time available

Goal-Directed Persistence
Does not persist with effortful tasks
Gives up in the face of an obstacle
Has a “good-enough” mentality that gets in the way of producing quality work

Metacognition
Cannot judge the quality of his/her own work
Does not know how to improve work
Has difficulty making inferences, drawing conclusions, grasping the main idea, reading between
the lines
Fails to check work/proofread/use spell-check
 FORM 5.4

Executive Skills Problem Checklist, Middle/High School Version

Directions:
1. Check (9) problem areas that significantly interfere with effective studying.
2. Look over all the items you checked and choose THREE that you think cause the greatest
problems. Place a star (‘) next to those.

Response Inhibition
Rushing through work just to get it done
Not having the patience to produce quality work
Giving up on a homework assignment when I encounter an obstacle
Having trouble doing homework when there are more fun things to do

Working Memory
Writing assignment instructions without enough detail to understand later
Forgetting to take home necessary materials or take materials to class
Forgetting to hand in homework
Forgetting long-term projects or upcoming tests
Not paying attention to classroom instructions/task directions
Trouble remembering multiple directions or multiple problem steps
Losing materials
Forgetting to complete assignments
Forgetting to check agenda/assignment book
Not recording when an assignment is due

Emotional Control
Getting really irritated when a homework assignment is hard or confusing
Finding it hard to get started on assignments because of perfectionism or fear of failure
Freezing when taking tests and doing poorly despite studying long and hard
Not seeing the point of an assignment and finding it hard to motivate myself to do it

Task Initiation
Procrastinating/avoiding tasks due to:
not knowing how to get started
believing the task will “take forever”
(continued)

From Dawson and Guare (2018). Copyright © The Guilford Press. Reprinted by permission.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Executive Skills Problem Checklist, Middle/High School Version (page 2 of 4)

believing my performance won’t meet expectations

seeing the task as tedious, boring, or irrelevant
Finding other things to do rather than starting homework
Difficulty getting back to work after breaks

Sustained Attention
Taking frequent breaks when working
Taking breaks that are too long
Internally distracted—thoughts, states, moods, daydreams (please specify):

Externally distracted—sights, sounds, technology such as phone, computer, TV, video games
(please specify):
Rushing through work—sloppy/mistakes
Not knowing limits (e.g., how long I can sustain attention) or when the best study time is
Not recognizing when I’m off task

Planning/Prioritization
Not making a study plan (may not know how)
Can’t break down long-term projects into smaller tasks and timelines
Having difficulty taking notes or studying for test because I can’t distinguish important from
nonimportant
Not using or not knowing how to use agenda/assignment book
Spending too much time on less important elements—can’t put the most important parts or
most important assignments first
Planning unrealistically (e.g., fail to take into account obstacles to the plan)

Flexibility
Struggling with assignments that require creativity or are open-ended
Getting stuck on one solution or one way of looking at a problem
Having trouble coming up with topics or ideas of things to write about
Having difficulty coming up with “Plan B” if the first attempt didn’t work

Organization
Not using an organizational system or knowing how to design one
Not being able to find things in notebooks or backpacks
Losing assignments or important papers
Not having a neat study area
Losing electronic data—forgetting where work is stored or what name it’s filed under
(continued)
 Executive Skills Problem Checklist, Middle/High School Version (page 3 of 4)

Time Management
Can’t estimate how long a task will take, due to:
overestimating how long it will take to do a task (therefore never getting started)
underestimating how long it will take to do a task (therefore running out of time)
Chronically late (for school, tutoring, other appointments, and obligations)
Difficulty juggling multiple assignments and responsibilities because I can’t judge time involved
Overcommitted—juggling too many obligations (and I think I can pull it off!)
Lacking a sense of time urgency (doesn’t appreciate that deadlines are important)
Relying on deadline as activator or motivator

Goal-Directed Persistence
Not having a long-term goal
Having a long-term goal but lacking a realistic plan to achieve the goal
Not seeing how daily actions impact goal attainment
Not seeing studying as important and making minimal effort as a result
Giving up in the face of an obstacle
Having a “good-enough” mentality that gets in the way of producing quality work
“Not on the radar”—seeing work as not relevant or not important enough to do

Metacognition
Can’t accurately evaluate skills (e.g., expect to do well on tests in spite of poor past
performance; expect to go to a college or get a job without requisite skills or academic record)
Can’t identify appropriate study strategies
Can’t plan or organize a writing assignment
Can memorize facts but missing the larger context (I do better on multiple-choice tests than
essay questions)
Having a hard time understanding more abstract concepts (math as well as content-area
subjects)
Having difficulty making inferences, drawing conclusions, grasping the main idea, reading
between the lines
Failing to check work/proofread

Other

(continued)
 Executive Skills Problem Checklist, Middle/High School Version (page 4 of 4)

WHAT ARE MY TARGETS?

Executive skill Specific problem

What are some ways that I could use my executive skill strengths to help me be successful?
 FORM 5.5

Executive Skills Problem Checklist, Elementary Version—Parents

Directions:
1. Read each item and decide whether your child exhibits this problem to a significant degree such
that it interferes with daily life at home. Keep in mind that some of the items may not be age
appropriate for your child.
2. Look over all the items you checked and choose THREE that you think cause the greatest
problems. Place a star (‘) next to those.

Response Inhibition
Interrupts when others are talking
Blurts out inappropriate comments
Can’t wait turn in games or conversations
Doesn’t use acceptable language to handle conflict situations
Doesn’t consider consequences before acting
Rushes through homework or chores without regard to quality of work

Working Memory
Can’t remember short instructions even right after they’re given
Does not bring all necessary materials to and from school every day (e.g., homework,
notebooks/binders, permission slips, gym clothes, lunch money, coats/hats/mittens)
Has trouble keeping track of schedule when it changes from day to day
Doesn’t remember things necessary for activities outside the home (e.g., sports equipment)
Doesn’t remember to do chores, even when they follow a consistent schedule

Emotional Control
Becomes easily upset over small things that would not bother others
Engages in verbal or physical aggression when angry
Fails to use coping strategies to recover when he/she begins to get upset (or angry, frustrated,
anxious)
Overreacts when provoked by things people say or do to him/her
Gets “revved up” in some situations (e.g., social gatherings) and has trouble calming down
Has trouble dealing with disappointment, such as losing at a game or not getting what he/she
wants

(continued)

From Dawson and Guare (2018). Copyright © The Guilford Press. Reprinted by permission.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Executive Skills Problem Checklist, Elementary Version—Parents (page 2 of 3)

Flexibility
Doesn’t use coping strategies to recover when he/she begins to get upset (or angry, frustrated,
anxious)
Difficulty managing transitions between activities or settings
Can’t do open-ended homework assignments (e.g., using each spelling word in a sentence or
doing a creative writing assignment)
Unable to come up with one or more alternative plans or solutions when the first strategy
doesn’t work (no Plan B)
Gets stuck or fixated on certain thoughts or ideas

Sustained Attention
Doesn’t complete homework or chores within the time allotted or within suggested time frames
Up and down during homework—difficulty sticking with it long enough to get it done
Doesn’t listen when parents or other adults are talking to him/her
Shifts quickly from one play activity to another
Doesn’t stay focused when engaged in organized activities (e.g., sports)

Task Initiation
Doesn’t perform daily routines at scheduled times unless prompted
Leaves homework or chores until the last minute unless prompted by an adult
Finds other things to do rather than chores, homework, daily routines
Stretches out breaks and fails to return to work promptly with longer work tasks
Dawdles when asked to do a chore, perform a boring daily routine, or switch from a preferred to
a nonpreferred activity.

Planning/Prioritization
Has difficulty setting priorities (in what order to do tasks, how much time to spend on any given task)
Can’t make a plan to accomplish a task (even when it’s something the child wants to do)
Gets sidetracked when following a plan and doesn’t get back to it
Doesn’t know what to focus on when studying for tests
Can’t break down a task into individual steps (what to do first, second, etc.)

Organization
Doesn’t hang up coats/put belongings away in designated place
Doesn’t place materials in a specified place in notebooks, backpacks, desks, and study areas
Doesn’t follow an organizational system with consistency (e.g., throwing out unnecessary
papers, placing homework assignments in assigned spot, organizing school papers)
Doesn’t have a tidy study area to work in
Bedroom and play spaces are a mess, and this doesn’t bother him/her
(continued)
 Executive Skills Problem Checklist, Elementary Version—Parents (page 3 of 3)

Time Management
Does not arrive places on time (e.g., coming home from friend’s house at agreed-upon time)
Can’t complete daily routines within time limits
Does not complete assignments by the due date
Can’t adjust work speed to fit the time available
Can’t juggle multiple time demands (e.g., starting homework early on days when child has
evening Scout meetings)

Goal-Directed Persistence
Does not persist with effortful tasks
Gives up in the face of an obstacle
Starts projects but doesn’t finish them (including preferred activities)
Wants to quit rather than do the work to get better at something
Has a “good-enough” mentality that gets in the way of producing quality work
Can’t save up money to make a desired purchase

Metacognition
Can’t judge the quality of his/her own work
Does not know how to improve work
Can’t solve everyday problems
Has difficulty making inferences, drawing conclusions, grasping the main idea, reading between
the lines
Can’t read or misinterprets the emotions or reactions of others
Fails to check work/proofread
 FORM 6.1

Behavior-Analytic Problem Solving: Assessment Results

Name: Date:

Personal Characteristics: Context: Skill Delays/Deficits:

Traits, sensitivities, beliefs, Probable contexts Communication, academic, executive, adaptive
and/or values contributing to in which interfering living, social, and/or self-management skill
interfering behavior behavior occurs delays/deficits contributing to interfering behavior

Motivational “Triggers” (Motivating Operations):

Deprivation of physical or social wants and needs, which increases the value of reinforcers and the probability of interfering behavior
Presentation of aversive biological/medical conditions, emotional states, thoughts, academic tasks, or social situations,
which increases the value of reinforcers and the probability of interfering behavior

Sources of Reinforcement (Discriminative Stimuli):

Persons, items, or locations that signal the availability of reinforcing consequences (i.e., source of reinforcement),
thereby occasioning interfering behavior

Interfering Behavior(s):

Reinforcing Consequence(s): Parameters of Reinforcement:

Consequence(s) that strengthen the future probability Describe the power (robustness) of reinforcing consequences
of the interfering behavior
Schedule:

Quality:

Magnitude:

Timing:

Used with permission from the Margaret Murphy Centers for Children.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 7.1

Behavior-Analytic Problem-Solving Interview (BAPS-I)

Student’s Name: DOB:
School: Date:
Evaluator:

The purpose of this semistructured interview is to identify and describe (1) student-specific interfering
behavior(s) and (2) the individual and environmental variables that contribute to, evoke, occasion, and
maintain interfering behavior(s). The interview is based on the eight-term behavior-analytic problem-
solving model (Chapter 6). Each section of this form includes questions and prompts to guide the
interviewer in gathering relevant information from caregivers, teachers, or others familiar with the
student.

IDENTIFY AND DESCRIBE PERSONAL STRENGTHS

1. What are [the student’s] most significant strengths?

a. Prompt: Identify communication, academic, executive, adaptive living, social, and/or self-
management skills in the student’s current repertoire.

Personal Strength Description

(continued)

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Behavior-Analytic Problem-Solving Interview (BAPS-I) (page 2 of 6)

IDENTIFY AND DESCRIBE THE INTERFERING BEHAVIOR

Note: After identifying the interfering behavior, focus all interview questions on this target. Conduct
separate interviews, using separate forms, for each target response class.

1. What behavior interferes most with [the student’s] day-to-day functioning? What behavior is
most concerning or problematic?
a. Prompt: Identify the behavior(s) that led to the referral.
b. Prompt: If multiple behaviors, prioritize one target at a time for assessment.
2. Describe the interfering behavior. What does it look like?
a. Prompt: Ask for specific examples or demonstrations.
3. How does an “episode” of the interfering behavior typically unfold? Are there early signs or
predictable sequences of behavior during an episode?
a. Prompt: If applicable, identify the response class hierarchy.

Interfering Behavior Definition and Examples

Response Class Hierarchy Examples

IDENTIFY AND DESCRIBE THE CONTEXT

Note: Focus on the context relevant to occurrences of the target interfering behavior.

1. When is the interfering behavior most likely to occur? Are there particular locations, settings, or
activities when the interfering behavior is most probable?
a. Prompt: Identify specific physical locations, social circumstances, or types of activities that are
challenging for the student.
2. What behaviors are expected of students in that context?

Description of Context Description of Expected Behaviors

(continued)
 Behavior-Analytic Problem-Solving Interview (BAPS-I) (page 3 of 6)

IDENTIFY AND DESCRIBE MOTIVATIONAL “TRIGGERS” (MOs)

Note: Focus on the MOs relevant to occurrences of the target interfering behavior.

1. What seems to trigger the interfering behavior? What could I do right now to make the
interfering behavior happen?
a. Prompt: Identify relevant conditions of deprivation or restricted access. Consider deprivation
of sleep, food, or other basic needs; divided/diverted attention; and restricted access to
reinforcers.
b. Prompt: Identify aversive stimuli/events that evoke interfering behavior. Consider physical pain
and discomfort, unpleasant social interactions, nonpreferred task demands, and unpleasant
thoughts and emotions.

Potential MO Description
†Deprivation of physical wants/needs

†Divided or diverted attention

†Restricted/denied access to reinforcers

†Physical pain/discomfort

†Unpleasant thoughts/emotions

†Nonpreferred tasks/activities

†Aversive social situations

IDENTIFY AND DESCRIBE SOURCES OF REINFORCEMENT (SDs)

Note: Focus on the SDs relevant to occurrences of the target interfering behavior.

1. Who is typically present when the interfering behavior occurs? Is the interfering behavior more
or less likely to occur when certain people are present?
a. Prompt: Does the interfering behavior occur more often in the presence of specific peers,
teachers, or other school staff? If so, whom?
2. Are there specific items or places that seem to “trigger” the interfering behavior?
a. Prompt: Does the interfering behavior occur reliably when certain objects are present or in
specific physical locations/settings?

Potential SD Description
†Persons

†Items/Locations

(continued)
 Behavior-Analytic Problem-Solving Interview (BAPS-I) (page 4 of 6)

IDENTIFY AND DESCRIBE REINFORCING CONSEQUENCES AND PARAMETERS

OF REINFORCEMENT

Note: Focus on the consequences relevant to occurrences of the target interfering behavior.

Assess for Socially Mediated Reinforcement

1. How do you and others typically respond to the interfering behavior?
2. What seems to work to distract or deescalate [the student] when the interfering behavior
occurs?
a. Prompt: Consider access to peer and adult attention (visual, vocal, and physical). What do
adults say and do when the interfering behavior occurs? What do peers say and do when the
interfering behavior occurs?
b. Prompt: Consider access to edibles, tangibles, and activities. Does the student ever get access
to things or activities he/she wants by engaging in the interfering behavior?
c. Prompt: Consider avoidance or escape from aversive tasks/activities/situations. Does the
interfering behavior allow the student to get out of task expectations? Is the interfering behavior
followed by changes in task expectations (e.g., modifications or alternative tasks)? Does the
interfering behavior lead to the student’s removal from the setting? Do people “back off” when
the interfering behavior occurs?

Potential Socially Mediated Reinforcing

Consequence Description

†Access to social attention

†Access to edibles, tangibles, activities

†Escape from tasks/activities

†Escape from other aversive situations

Assess for Individually Mediated Reinforcement

1. Does [the student] ever gain access to desired items, activities, or locations by engaging in the
interfering behavior?
a. Prompt: Determine if the interfering behavior results in direct access to preferred edibles,
tangibles, activities, or locations without help or mediation from others.
2. Does [the student] ever escape from items, activities, or locations he/she does not like by
engaging in the interfering behavior?
a. Prompt: Determine if the interfering behavior results in direct escape from aversive edibles,
tangibles, activities, or locations without help or mediation from others.

Potential Individually Mediated

Reinforcing Consequence Description
†Access to edibles, tangibles, activities,
or locations
†Escape from activities, locations, or
other aversive stimuli
(continued)
 Behavior-Analytic Problem-Solving Interview (BAPS-I) (page 5 of 6)

Assess for Automatic Reinforcement

1. Does the interfering behavior ever occur when [the student] is alone?
2. Does the interfering behavior appear to result in sensory consequences that [the student] enjoys?
a. Prompt: Assess for “self-stimulating” functions: visual, auditory, olfactory, or tactile. Does
the interfering behavior occur more frequently when [the student] is “bored” or not directly
engaged with people and preferred items/activities?
3. Does the interfering behavior seem to provide a “release” or sense of relief for [the student]?
a. Prompt: Assess for arousal reduction. Does the interfering behavior typically occur when [the
student] is tense, anxious, frustrated, or angry? Does the interfering behavior occur when [the
student] is in pain?

Potential Automatic Reinforcing

Consequence Description
†Sensory stimulation

†Arousal reduction

Assess for Parameters of Reinforcement

Note: List each identified reinforcing consequence in the table below and describe the associated
parameters of reinforcement to estimate the strength/robustness of consequences relevant to the
interfering behavior.

1. Tell me more about situations when the interfering behavior results in [reinforcing consequence].
What exactly does that look like?
a. Prompt: Estimate schedule. How often does the interfering behavior “work”?
b. Prompt: Estimate quality. How valuable is the reinforcing consequence for [the student]?
c. Prompt: Estimate magnitude. How long does [the student] get the reinforcing consequence?
How much of the reinforcing consequence does [the student] get?
d. Prompt: Estimate timing. Is the consequence immediate or delayed?

Possible Reinforcing Consequence Parameters: Schedule, Quality, Magnitude, Timing

IDENTIFY AND DESCRIBE PERSONAL CHARACTERISTICS

Note: Focus on personal characteristics relevant to occurrences of the target interfering behavior.

1. What personal characteristics make it difficult for [the student] to be successful in [the specific
context(s) associated with interfering behaviors]?
a. Prompt: Identify relevant patterns of feeling or thinking.
b. Prompt: Identify relevant biological/medical conditions.
(continued)
 Behavior-Analytic Problem-Solving Interview (BAPS-I) (page 6 of 6)

c. Prompt: Identify relevant diagnoses.

d. Prompt: Identify relevant cultural factors.

Traits
Sensitivities
Beliefs

Values
Other

IDENTIFY AND DESCRIBE SKILL DELAYS/DEFICITS

Note: Focus on the delays/deficits relevant to occurrences of the target interfering behavior.

1. What skills does [the student] need to learn to be more successful in [specific context
associated with interfering behavior]?
a. Prompt: Consider communication, academic, executive, adaptive living, social, and self-
management skills.
2. Are there particular skill deficits that contribute to the interfering behavior?
a. Prompt: If the identified deficit was a strength, would the interfering behavior be less likely to
occur?

Communication Skills
Academic Skills

Executive Skills
Adaptive Living Skills
Social Skills

Self-Management Skills

ADDITIONAL RELEVANT INFORMATION

 FORM 8.1

Functional Behavioral Assessment Observation Form (FBAOF)

Student’s name:

Date/Time Context Antecedent Behavior Consequence Effect Staff

Used with permission from the Margaret Murphy Centers for Children.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 8.2

Incident-Based Functional Assessment Form (IBFAF)

Context

Motivating Operations

Discriminative Stimuli Interfering Behaviors Reinforcing Consequences

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 8.3

Conditional Probability Record (CPR)

Student
Date of observation Observer
Setting Time of day
Behavior 1 Behavior 2

Antecedents Target Behaviors Consequences

Academic Task Teacher Behavior 1 Behavior 2 Teacher Peers Academic

0:15
0:30
0:45
1:00
1:15
1:30
1:45
2:00
2:15
2:30
2:45
3:00
3:15
3:30
3:45
4:00
4:15
4:30
4:45
5:00

Any of the categories may be coded according to the observer’s preferences or the data that currently exist but must remain
consistent across observations. Indicate coding scheme here for each of the categories.

Codes:
Academic: Teacher :
Task: Peers:

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 8.4

Interval Recording Procedure (IRP)

Date Name

Target Behaviors
Recording Procedures
Time Setting and/or Activity Staff

Add each column

Convert to percent or rate

Used with permission from the Margaret Murphy Centers for Children.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt, Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright
© 2019 The Guilford Press. Permission to photocopy this material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 9.1

Task Difficulty Antecedent Analysis Form

Student’s name School/grade
Setting Date
Observer Time
Target behavior

Task description

10-SECOND INTERVALS

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Easy
(90%)
Medium
(70–80%)
Difficult
(<70%)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Easy
(90%)
Medium
(70–80%)
Difficult
(<70%)

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 11.1

Behavior-Analytic Problem Solving:

Function-Focused Intervention
Name: Date:

Personal Characteristics: Context: Skill Delays/Deficits:

Identify strategies to address traits, Identify strategies for modifying Identify strategies to mitigate communication,
sensitivities, beliefs, and/or values contexts and/or participation in academic, executive, adaptive living, social,
contributing to interfering behavior contexts in which interfering and/or self-management skill delays/deficits
behavior occurs contributing to interfering behavior

Motivational “Triggers” (Motivating Operations):

Identify strategies to weaken (abolish) motivation for interfering behaviors by preventing conditions of deprivation
and/or altering the environment to make motivational “triggers” less aversive

Sources of Reinforcement (Discriminative Stimuli):

Identify strategies to modify or eliminate persons, items, and/or locations that signal the availability
of reinforcing consequences for interfering behaviors

Interfering Behavior(s): Replacement Behavior(s):

Identify the behavior(s) that interfere Identify logical, socially appropriate
with functioning replacement behavior(s)

Reinforcing Consequence(s): Reinforcing Consequence(s):

Identify strategies for minimizing reinforcement Identify strategies for maximizing reinforcement
of the interfering behavior of the replacement behavior

Used with permission from the Margaret Murphy Centers for Children.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 FORM 13.1

Behavioral Assessment Report

Identifying Information

Student:
Date of Birth: Age: Grade:
Home School/District:

Evaluation Dates

Date of Informed Consent:

Evaluation Dates:
Report Date:
Date Report Provided and Reviewed with Parent(s)/Guardian(s):

Reason for Referral

Insert student name was referred for a Functional Behavioral Assessment (FBA) of interfering
behaviors* by Name of referring party
Insert individualized details about the referral concern/question.

*Interfering behaviors: Behaviors that are disruptive to the learning of the student or others; behaviors that interfere with
the student’s progress or performance of skills.

Purposes of the Functional Behavioral Assessment (FBA)

The FBA was conducted to answer two basic questions:
1. Why does Insert student name engage in interfering behaviors?
2. What can we do to reduce interfering behaviors and increase appropriate behaviors?

Foundations of Functional Behavioral Assessment (FBA)

1. Human behavior (both appropriate and interfering) is learned and can be changed.
2. No two individuals are the same. Each student’s learning history is unique.
3. Students with very similar interfering behaviors may have very different learning histories.
This means that their behaviors may have very different causes (i.e., functions). Treatment is
most effective when behavior support plans directly address the causes (i.e., functions) of
behavior.

(continued)
Used with permission from the Margaret Murphy Centers for Children.

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Behavioral Assessment Report (page 2 of 6)
FBA identifies and describes the relevant aspects of the student’s unique learning history. FBAs
investigate the following factors that contribute to interfering behavior: (a) context, (b) personal
characteristics, (c) skill delays/deficits, (d) motivational triggers, (e) sources of reinforcement of
interfering behavior, and (f) history of reinforcement of interfering behavior.

Information collected during the FBA is used to design individually tailored and evidence-based
interventions that directly address the variables that contribute to interfering behavior.

Description of Assessment Procedures

List and briefly describe all assessment procedures, including record reviews, behavior-analytic
interviews, descriptive assessments, experimental analyses, preference/reinforcer assessments,
and/or treatment analysis.

Relevant Background Information

Summarize background information directly relevant to understanding the interfering behavior,
gleaned from record reviews, interviews, and/or other indirect sources.

Results: Identification and Description of Interfering Behavior(s)

Behavior Definition
Insert behavior label Insert operational definition of the behavior

(continued)
 Behavioral Assessment Report (page 3 of 6)

Results: Documentation of Current Levels of Interfering Behavior*

Occurrence
Behavior Measurement Procedure [Insert dates of data collection]
Insert behavior label Describe the behavior recording Summarize levels of occurrence in
procedure terms of averages, ranges, etc.

*Data obtained from (Insert information about the source of the data).

Results: Graphic Display of Interfering Behaviors

Insert a graphic display of current levels of interfering behavior.

Results: Behavior-Analytic Interviews

Briefly summarize relevant information gathered during interviews. Consider including a visual
diagram to illustrate “behavioral streams.”

(continued)
 Behavioral Assessment Report (page 4 of 6)

Results: Behavior-Analytic Observations

List each descriptive FBA procedure used, along with a brief rationale and explanation of the results.
Include supplementary figures and graphs as appendices.

Results: Experimental Analyses

If applicable, list and describe each experimental FBA procedure used, along with a brief rationale
and explanation of the results. Include supplementary figures and graphs as appendices.

Synthesis of Results
Provide a brief narrative summary of FBA results by describing the influence of context, personal
characteristics, skill delays/deficits, MOs, SDs, reinforcing consequences, and parameters of
reinforcement on the interfering behavior. Include the Behavior-Analytic Problem Solving:
Assessment Results form as an Appendix.

(continued)
 Behavioral Assessment Report (page 5 of 6)

Results: Behavior-Analytic Treatment Assessments

If applicable, list and describe each treatment or reinforcer analysis conducted, along with a brief
rationale and explanation of the results. Include supplementary figures and graphs as appendices.

Summary
Conclude with a functional hypothesis statement(s) to summarize (a) the context in which interfering
behaviors occur and (b) the variables that evoke and reinforce interfering behaviors. Summarize
additional variables that contribute to occurrences of the interfering behavior, and explain the
strategies determined to be effective for reducing occurrences of the interfering behavior.

Interpretive Session with Parent(s)/Guardian(s)

Identify when FBA results were reviewed with the parent(s)/guardian(s), who was present, and what
was discussed.

(continued)
 Behavioral Assessment Report (page 6 of 6)

Recommendations for the Team’s Consideration

1. A collaborative problem-solving process involving team members in the design of an individually
tailored Behavior Support Plan is recommended. The use of the Behavior-Analytic Problem
Solving: Function-Focused Intervention form is recommended as a tool to develop function-
based strategies based on [student]’s individualized FBA results.

2. It is recommended that [student]’s Behavior Support Plan include strategies for

addressing/minimizing those variables that contribute to [interfering behavior] and strategies for
increasing appropriate replacement behaviors. Comprehensive Behavior Support Plans include
(a) proactive strategies to minimize the likelihood of interfering behaviors, (b) teaching and
reinforcement-based procedures to remediate skill deficits and strengthen appropriate behaviors,
and (c) responsive strategies to ensure safety while minimizing reinforcement of interfering
behaviors. Given [student]’s FBA results, specific Behavior Support Plan strategies for
consideration include the following:
a. Use . . .
b. Implement . . .

3. Ongoing behavioral consultation by a professional with experience and training in applied

behavior analysis is recommended to support the design, implementation, and evaluation of an
individually tailored Behavior Support Plan. Use of a behavioral skills training model of
consultation also is recommended to increase the likelihood that interventions will be
implemented accurately.

Name

Credentials

Insert additional pages for appendices that display results in figures, tables, and/or graphs.
 APPENDIX

Functional Behavioral Assessment Rating Scale (FuBARS)

Description: The FuBARS task analyzes the behavior-analytic problem-solving (BAPS) model by listing
the tasks associated with each phase of a seven-step problem-solving process. The FuBARS serves
both as (1) a formative tool to guide the comprehensive FBA process and (2) a summative tool to
evaluate the quality of the behavior-analytic assessment–intervention continuum.

PHASE 1: IDENTIFICATION AND DESCRIPTION OF INTERFERING BEHAVIOR

Informed Consent

0 1 2
Parent/guardian consent not Parent/guardian consent Parent/guardian consent
obtained obtained; specific assessment obtained; specific assessment
procedures and risks/benefits procedures and risks/benefits
not identified and described identified and described in
understandable format

Identification and Description of Interfering Behavior(s)

0 1 2
General area of concern Target/priority interfering Target/priority interfering
identified, but target/priority behavior(s) identified, but behavior(s) identified and
interfering behavior(s) not described in nonbehavioral described in clear and
identified terms measurable terms

PHASE 2: RECORDING CURRENT LEVELS OF INTERFERING BEHAVIORS

Identification and Description of Behavior Recording Procedures

0 1 2 3
Behavior recording Behavior recording Behavior recording Behavior recording
procedures not procedures identified, procedures identified procedures identified,
identified but not described and described described, and
matched to the
dimensions of the
interfering behavior(s)

(continued)

From Conducting School-Based Functional Behavioral Assessments, Third Edition, by Mark W. Steege, Jamie L. Pratt,
Garry Wickerd, Richard Guare, and T. Steuart Watson. Copyright © 2019 The Guilford Press. Permission to photocopy this
material is granted to purchasers of this book for personal use or use with students (see copyright page for details).
 Functional Behavioral Assessment Rating Scale (FuBARS) (page 2 of 6)

Current Levels of Occurrence (CLO) of Interfering Behavior(s)

0 1 2 3
CLO not reported CLO estimated CLO reported, but CLO reported
based on limited data and based on
(e.g., one observation) representative sample
of data (i.e., multiple
observations)

PHASE 3: IDENTIFYING AND DESCRIBING ANTECEDENT, CONSEQUENCE,

AND ASSOCIATED VARIABLES
Identification and Description of Context

0 1
Contexts in which interfering behavior occurs not Contexts in which interfering behavior occurs
identified identified and described

Identification and Description of Personal Characteristics

0 1
Personal characteristics contributing to Personal characteristics contributing to
interfering behavior not identified interfering behavior identified and described

Identification and Description of Skill Delays/Deficits

0 1
Skill delays/deficits contributing to interfering Skill delays/deficits contributing to interfering
behavior not identified behavior identified and described

Identification and Description of Motivational Triggers (Motivating Operations): Deprivation

0 1

Deprivation of/restricted access to wants and Deprivation of/restricted access to wants and
needs that increase the value of reinforcing needs that increase the value of reinforcing
consequences not assessed consequences assessed, identified, and
described (as applicable)

(continued)
 Functional Behavioral Assessment Rating Scale (FuBARS) (page 3 of 6)

Identification and Description of Motivational Triggers (Motivating Operations): Presentation

0 1
Presentation of personally aversive stimuli that Presentation of personally aversive stimuli that
increase the value of reinforcing consequences increase the value of reinforcing consequences
not assessed assessed, identified, and described (as
applicable)

Identification and Description of Sources of Reinforcement (Discriminative Stimuli)

0 1
Discriminative stimuli that signal availability of Discriminative stimuli that signal availability of
reinforcement not identified reinforcement identified and described

Identification and Description of Reinforcing Consequence(s)

0 1 2
Consequence variables that Consequence variables that Consequence variables that
reinforce the occurrence reinforce the occurrence of reinforce the occurrence of
of interfering behavior not interfering behavior identified interfering behavior identified
identified and described

Identification and Description of Parameters of Reinforcement

0 1
Schedule, quality, magnitude, and timing of Schedule, quality, magnitude, and timing of
reinforcement not considered reinforcement considered, estimated, and
described

PHASE 4: CONCEPTUAL SYNTHESIS

Behavior-Analytic Problem Solving: Assessment Results Form

0 1 2
Form not completed Form partially completed Form completed with all
relevant assessment data
reported and correctly
categorized

(continued)
 Functional Behavioral Assessment Rating Scale (FuBARS) (page 4 of 6)

Hypothesis Statement(s)

0 1 2
Hypothesis statement not Hypothesis statement Hypothesis statement
formulated formulated, but written in formulated using accurate
ambiguous, nonbehavioral behavior-analytic terms (e.g.,
terms socially mediated negative
reinforcement, automatic
negative reinforcement)

Completion of Written Report

0 1 2
Comprehensive written report Comprehensive written report Comprehensive written report
of FBA procedures, results, of FBA procedures, results, and of FBA procedures, results, and
and recommendations not recommendations completed, recommendations completed
completed but not reviewed with team and reviewed with team

Quality of Written Report

0 1
Written report uses highly technical language Written report includes language
not understandable and graphic displays of data that are
reasonably understandable

PHASE 5: LINKING ASSESSMENT DATA TO INTERVENTIONS

Function-Based Intervention

0 1 2
BAPS: Function-Focused BAPS: Function-Focused BAPS: Function-Focused
Intervention form not used to Intervention form used by Intervention form used by
inform selection of interventions evaluator to inform selection evaluator in collaboration
of interventions that partially with the multidisciplinary
address relevant individual, team to inform selection of
antecedent, and consequence comprehensive interventions
variables that address all relevant
individual, antecedent, and
consequence variables

(continued)
 Functional Behavioral Assessment Rating Scale (FuBARS) (page 5 of 6)

Evidence-Based Intervention

0 1 2
Intervention strategies selected Intervention strategies selected Intervention strategies selected
on the basis of theory or on the basis of limited empirical on the basis of strong empirical
personal preference evidence evidence

Consideration of Generalization Strategies

0 1
Strategies promoting generalization of Strategies promoting generalization of
replacement behavior not identified and replacement behavior identified and described
described

PHASE 6: IMPLEMENTATION
Behavior Skills Training

0 1 2
Training on implementation of Training on implementation of Training on implementation of
interventions not delivered interventions delivered using interventions delivered using
only initial components of the the complete behavioral skills
behavioral skills training model training model

Intervention Acceptability

0 1 2
Intervention acceptability not Intervention acceptability Intervention acceptability
assessed assessed informally evaluated using structured
interviews or rating scales

Reliability of Data: Interobserver Agreement

0 1 2
Interobserver agreement not Interobserver agreement Interobserver agreement
assessed assessed, but data insufficient assessed sufficiently and
to demonstrate reliability reliability of data verified
of data (e.g., only 1–2
independent observations or
agreement less than 80%)

(continued)
 Functional Behavioral Assessment Rating Scale (FuBARS) (page 6 of 6)

Treatment Integrity/Intervention Adherence

0 1 2
Treatment integrity not Treatment integrity assessed Treatment integrity assessed
assessed indirectly (e.g., interventionist directly (e.g., direct observation
self-report using procedural of adherence to procedural
checklists) and/or data show checklists) and high adherence
poor adherence achieved

PHASE 7: PROGRESS MONITORING

Single-Case Experimental Design

0 1 2 3
No progress- Progress monitoring Progress monitoring Progress monitoring
monitoring systems implemented with no implemented using implemented using
implemented baseline data case study (A-B) case study (A-B)
design with unstable design with stable
baseline data and/or baseline data and
insufficient data sufficient data to
determine efficacy

Data Analysis/Graphing of Data

0 1
Progress-monitoring data not graphed Progress-monitoring data graphed accurately

Data-Based Decision Making

0 1 2 3
Progress-monitoring Progress-monitoring Progress-monitoring Progress-monitoring
data not reviewed; data reviewed data reviewed data reviewed regularly
modifications to periodically to inform periodically and and informal interviews
intervention based only modifications to informal interviews and direct observations
on informal interviews intervention conducted to inform conducted to inform
modifications to modifications to
intervention intervention