5. Is the exhibited in order to a non-preferred (difficult, boring, repetitive) task or activity? problem behavior avoid or escape Yes No If yes, specify: 6. Is the exhibited in order to a non-preferred classmate or adult? problem behavior avoid or escape (e.g., teacher, instructional assistant, coach) Please remember not to specify names. Yes No If yes, specify: 7. Is the exhibited in order to sensory stimulation? problem behavior obtain or gain Yes No If yes, specify: 8. Is the exhibited in order to sensory stimulation? problem behavior avoid or escape ___ Yes ___ No If yes, specify: Hypothesis Antecedent: Summarize items marked in Antecedent section 1-7. Problem Behavior: Copy and paste from Problem Behavior section 1. Consequence: Summarize items marked in Consequences section 8. Replacement Behavior: The replacement behavior developed must allow the student to achieve the same function as the problem behavior (e.g. escape, gain attention, etc.) 1. Antecedent 2. Problem behavior 3. Consequence 4. Replacement Behavior When… The student will… In order to… Instead, the student will … Ex: Obtain preferred object from adult Ex. Johnny will verbally express his Ex: When Johnny is denied Ex: Johnny will repeatedly bang his head or peer or needs for an item. access to a preferred item… on the floor and scratch his face leaving red marks Behavior Intervention Plan Demographics Student name: ID#: School: DOB: Plan date: Implementation date: Revision date: Discontinued date: Yes No Does the student’s problem behavior require implementation of a Crisis Plan? If the team indicates a Crisis Plan is needed, develop a plan on the Crisis Plan form. Intervention Data Collection 1. What could the student learn in order to reduce the probability of the occurring in the future? social skills(s) problem behavior Accepting a compliment Joint or shared attention Play skills Adult interaction skills Listening Skills Sharing attention Conversation skills Losing gracefully Sharing objects Gaining attention appropriately Making pro-social statements Taking turns Giving a compliment Peer interaction Other: 2. What could the student learn in order to reduce the probability of the problem behavior occurring in the problem-solving skill(s) future? Accepting consequences Ignoring peers Self-control / management Asking for help Goal setting Conflict resolution Making Choices Organizational skills Working independently Perspective-taking Staying engaged Working with a peer Cause & effect
5. Is the problem behavior exhibited in order to avoid or escape a non-preferred (difficult, boring, repetitive) task or activity? Yes No If yes, specify: 6. Is the problem behavior exhibited in order to avoid or escape a non-preferred classmate or adult? (e.g., teacher, instructional assistant, coach) Please remember not to specify names. Yes No If yes, specify: 7. Is the problem behavior exhibited in order to obtain or gain sensory stimulation? Yes No If yes, specify: 8. Is the problem behavior exhibited in order to avoid or escape sensory stimulation? ___ Yes ___ No If yes, specify: Hypothesis Antecedent: Summarize items marked in Antecedent section 1-7. Problem Behavior: Copy and paste from Problem Behavior section 1. Consequence: Summarize items marked in Consequences section 8. Replacement Behavior: The replacement behavior developed must allow the student to achieve the same function as the problem behavior (e.g. escape, gain attention, etc.) 1. Antecedent 2. Problem behavior 3. Consequence 4. Replacement Behavior When… Ex: When Johnny is denied access to a preferred item… The student will… Ex: Johnny will repeatedly bang his head on the floor and scratch his face leaving red marks In order to… Ex: Obtain preferred object from adult or peer Instead, the student will … Ex. Johnny will verbally express his or needs for an item. Behavior Intervention Plan Demographics Student name: ID#: School: DOB: Plan date: Implementation date: Revision date: Discontinued date: Does the student’s problem behavior require implementation of a Crisis Plan? Yes No If the team indicates a Crisis Plan is needed, develop a plan on the Crisis Plan form. Intervention Data Collection 1. What social skills(s) could the student learn in order to reduce the probability of the problem behavior occurring in the future? Accepting a compliment Joint or shared attention Play skills Adult interaction skills Listening Skills Sharing attention Conversation skills Losing gracefully Sharing objects Gaining attention appropriately Making pro-social statements Taking turns Giving a compliment Peer interaction Other: 2. What problem-solving skill(s) could the student learn in order to reduce the probability of the problem behavior occurring in the future? Accepting consequences Ignoring peers Self-control / management Asking for help Goal setting Conflict resolution Making Choices Organizational skills Working independently Perspective-taking Staying engaged Working with a peer Cause & effect
comp_fba_bip.docx