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Functional Behavior Assessment

This document outlines the purpose and components of a Functional Behavioral Assessment (FBA). An FBA is used to gather information about a student's behavior to determine the need for and provide a foundation for a Behavioral Intervention Plan (BIP). It is required if a student's violation of a code of conduct that results in a change of placement is determined to be a manifestation of their disability. The FBA document collects information on the student's strengths and description of the problem behavior, the settings and antecedents of the behavior, the consequences and impact, other potential variables, prior interventions attempted, and the team's hypothesis of the behavioral function and recommendations.

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Crystal Lopez
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288 views

Functional Behavior Assessment

This document outlines the purpose and components of a Functional Behavioral Assessment (FBA). An FBA is used to gather information about a student's behavior to determine the need for and provide a foundation for a Behavioral Intervention Plan (BIP). It is required if a student's violation of a code of conduct that results in a change of placement is determined to be a manifestation of their disability. The FBA document collects information on the student's strengths and description of the problem behavior, the settings and antecedents of the behavior, the consequences and impact, other potential variables, prior interventions attempted, and the team's hypothesis of the behavioral function and recommendations.

Uploaded by

Crystal Lopez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PURPOSE: A Functional Behavioral Assessment (FBA) is used to gather information about a student’s behavior to determine the need for,

and provide the foundation for, a Behavioral Intervention Plan (BIP). An FBA is required to be conducted if the student’s violation of a
code of conduct (resulting in a change of placement) is determined to be a manifestation of the student’s disability.

FUNCTIONAL BEHAVIORAL ASSESSMENT

Student name: Meeting Date:


Student ID #: Disability: Grade:
Home School: Case Manager:

Team Members Present at Meeting:

Name/Title Name/Title

Name/Title Name/Title

Name/Title Name/Title

Student’s Strengths (include a description of the student’s behavioral strengths, such as positive interactions with staff,
ignoring the inappropriate behavior of peers, accepts responsibility, etc.):

Description of Behavior(include a description of the frequency, duration, and intensity of the behavior(s)):

Setting(s) (include a description of the setting(s) in which the behavior occurs, i.e. – physical setting, time of day, persons
involved):

Antecedent(s) (include a description of the relevant events that preceded the behavior):

Form 7a - Functional Behavioral Assessment Page 1 August 2008 (Rev. 8/2018)


Consequences and Educational Impact (include a description of the result of the behavior (i.e. – removed from class,
not able to complete assignments/tests, etc.), and the impact on the student, peers, and the instructional environment):

Other Potential Variables (include a description of any other factors/variables that may affect the behavior, such as
medication, weather, diet, sleep, substance abuse, attendance, social factors, etc.):

Prior Interventions (include a description of the behavioral interventions that have been implemented in the past,
including the date(s) of implementation, length of intervention, the impact of the intervention on the student’s behavior, etc.
Attach data summary, if appropriate):

Hypothesis of Behavioral Function (describe the team’s hypothesis of the relationship between the behavior and the
environment in which it occurs – what function is this behavior serving for the student? What is the student trying to get? What
is he/she trying to avoid?):

Summary/Recommendations (Provide recommendations for prevention of the target behavior, replacement


skills/behavior(s) to be taught, reinforcements for positive behaviors, etc.):

Functional Behavioral Assessment (FBA) by Office of Superintendent of Public Instruction is licensed under a
Creative Commons Attribution 4.0 International License.

Form 7a - Functional Behavioral Assessment Page 2 August 2008 (Rev. 8/2018)

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