Did the behavior intervention plan include at least one strategy that YES NO prevented the behavior from occurring by addressing the antecedent in the hypothesis? Was the prevention strategy written in sufficient detail so that another YES NO adult who was not at the meeting could implement the strategy? Did the behavior intervention plan include at least one strategy that taught YES NO the student a new, appropriate behavior that would replace the problem behavior? Was the replacement behavior strategy written in sufficient detail so that YES NO another adult who was not at the meeting could implement the strategy? Did the behavior intervention plan include at least one strategy that YES NO reinforced the replacement behavior and no longer reinforced the problem behavior, linking back to the consequences/function in the hypothesis? Was the reinforcement strategy written in sufficient detail so that another YES NO adult who was not at the meeting could implement the strategy? Did the teacher and the student (if applicable) come to consensus on the YES NO plan strategies? Did another school-based consultant/team member train the teacher and YES NO the student to do the plan? Was in-class support provided to the teacher after the plan began to be YES NO implemented? Was there a plan for collecting behavior plan implementation fidelity? YES NO Was there a follow-up meeting to review the fidelity and the YES NO data to determine whether the behavior plan was effective?
Did the behavior intervention plan include at least one strategy that prevented the behavior from occurring by addressing the antecedent in the hypothesis? YES NO Was the prevention strategy written in sufficient detail so that another adult who was not at the meeting could implement the strategy? YES NO Did the behavior intervention plan include at least one strategy that taught the student a new, appropriate behavior that would replace the problem behavior? YES NO Was the replacement behavior strategy written in sufficient detail so that another adult who was not at the meeting could implement the strategy? YES NO Did the behavior intervention plan include at least one strategy that reinforced the replacement behavior and no longer reinforced the problem behavior, linking back to the consequences/function in the hypothesis? YES NO Was the reinforcement strategy written in sufficient detail so that another adult who was not at the meeting could implement the strategy? YES NO Did the teacher and the student (if applicable) come to consensus on the plan strategies? YES NO Did another school-based consultant/team member train the teacher and the student to do the plan? YES NO Was in-class support provided to the teacher after the plan began to be implemented? YES NO Was there a plan for collecting behavior plan implementation fidelity? YES NO Was there a follow-up meeting to review the fidelity and the data to determine whether the behavior plan was effective? YES NO
PTRHandoutpacketcompleteblankformsrevisedJune2016.docx