Pro-Social Behaviors to Increase (prioritize what behaviors you want to increase) Problem Behaviors to Decrease (prioritize what behavior to focus on in FBA) Stage 3: Assessment Functional Behavioral Assessment Behavior Support Plan (F-BSP) Protocol Functional Behavioral Assessment Interview –Teachers/Staff Student Name ____________________________________ Age:____ Grade:____ Date:__________________ Person (s) interviewed:____________________________________________________________________________ Interviewer: ____________________________________________________________________________ Student Profile: What is the student good at or what are some strengths that the student brings to school? ________________________________________________________________________________________________ STEP 1: INTERVIEW TEACHER/STAFF/PARENT Behavior Description of the What does the problem behavior(s) look like? How often does the problem behavior(s) occur? How long does the problem behavior(s) last when it does occur? How disruptive or dangerous is the problem behavior(s)? Antecedent Description of the When, where, and with whom are problem behaviors most likely? Schedule Activity Specific Problem Likelihood of With Whom does (Times) Behavior Problem Behavior Problem Occur Low High
Pro-Social Behaviors to Increase (prioritize what behaviors you want to increase) Problem Behaviors to Decrease (prioritize what behavior to focus on in FBA) Stage 3: Assessment Functional Behavioral Assessment Behavior Support Plan (F-BSP) Protocol Functional Behavioral Assessment Interview –Teachers/Staff Student Name ____________________________________ Age:____ Grade:____ Date:__________________ Person (s) interviewed:____________________________________________________________________________ Interviewer: ____________________________________________________________________________ Student Profile: What is the student good at or what are some strengths that the student brings to school? ________________________________________________________________________________________________ STEP 1: INTERVIEW TEACHER/STAFF/PARENT Description of the Behavior What does the problem behavior(s) look like? How often does the problem behavior(s) occur? How long does the problem behavior(s) last when it does occur? How disruptive or dangerous is the problem behavior(s)? Description of the Antecedent When, where, and with whom are problem behaviors most likely? Schedule (Times) Activity Specific Problem Behavior Likelihood of Problem Behavior With Whom does Problem Occur Low High
VTPBiSBehaviorSupportPlan.docx