BEHAVIOR INTERVENTION IMPLEMENTATION PLAN Review Date _________________ Person By Impl. Rating: Evaluation Decision Tasks Responsible When 2 = Yes - 90%+ Monitor, Modify, or 1 50-90% Discontinue 0 = No - <50% Make problem behavior Prevent & Prompt: irrelevant (antecedent intervention) 2 1 0 2 1 0 Teaching: Teach Replacement Behavior & skills to engage in Desired Behavior 2 1 0 2 1 0 Reinforcement: Make Replacement & Desired behavior more rewarding than problem behavior 2 1 0 2 1 0 Redirect to Replacement Behavior: Prompt replacement behavior at earliest signs of problem. 2 1 0 Minimize Reinforcement of Problem Behavior: Make problem behavior ineffective 2 1 0 Safety: Is safety a concern? Y N Impl Score % If yes, attach crisis plan to Behavior Support Plan Total Implementation Possible Implementation Supports (w/ Who & How) Person When Responsible (circle) (circle preferred method(s) below or ID another method below) Provide Training to the Implementers: Demonstration / with Practice / with Feedback (circle) 2 1 0 Other: Provide Implementation Feedback: Complete the Daily Implementation Checklist Daily Enter Daily Implementation Data into Graph 3 x /wk 2 1 0 Share Graphed Data with implementers weekly Personal check-in / Email / Rating Scale (circle) Other:
BEHAVIOR INTERVENTION IMPLEMENTATION PLAN Tasks Person Responsible By When Review Date _________________ Impl. Rating: 2 = Yes - 90%+ 1 50-90% 0 = No - <50% Evaluation Decision Monitor, Modify, or Discontinue Prevent & Prompt: Make problem behavior irrelevant (antecedent intervention) 2 1 0 2 1 0 Teaching: Teach Replacement Behavior & skills to engage in Desired Behavior 2 1 0 2 1 0 Reinforcement: Make Replacement & Desired behavior more rewarding than problem behavior 2 1 0 2 1 0 Redirect to Replacement Behavior: Prompt replacement behavior at earliest signs of problem. 2 1 0 Minimize Reinforcement of Problem Behavior: Make problem behavior ineffective 2 1 0 Safety: Is safety a concern? Y N If yes, attach crisis plan to Behavior Support Plan Impl Score Total Possible % Implementation Implementation Supports (w/ Who & How) (circle preferred method(s) below or ID another method below) Person Responsible When (circle) Provide Training to the Implementers: Demonstration / with Practice / with Feedback (circle) Other: Provide Implementation Feedback: Complete the Daily Implementation Checklist Enter Daily Implementation Data into Graph Share Graphed Data with implementers Personal check-in / Email / Rating Scale (circle) Other: Daily 3 x /wk weekly 2 1 0 2 1 0