Name of student…………………………… Date of Birth Year Group ………… ……….... Individual Behaviour Plan date: From To …………. ………….. Behaviours Causing Concern (please indicate frequency of identified behaviours) Environmental Desired Outcomes New skills Provision Success criteria Factors influencing (What new (What behaviours strategies, organisational/staffing/ e.g. movement attitudes curricular between and skills arrangements/external activities/rooms, need to be agencies will be social groupings, taught for necessary to support the space, noise, the student desired changes?) curricular structure to achieve the desired De-escalation Parental Review date Action to be strategies Involvement taken as a result of review Physical Intervention needed? Type of restraint needed?* (By staff trained in Teamteach) *If physical restraint is used, this should be recorded separately in line with Teamteach guidelines Signed: Headteacher ……………………………………….. Signed: Parent ………………………………………..
Name of student…………………………… Date of Birth ………… Year Group ……….... Individual Behaviour Plan date: From …………. To ………….. Behaviours Causing Concern (please indicate frequency of identified behaviours) Environmental Factors influencing behaviours e.g. movement between activities/rooms, social groupings, space, noise, curricular structure Desired Outcomes New skills (What new strategies, attitudes and skills need to be taught for the student to achieve the desired Provision (What organisational/staffing/ curricular arrangements/external agencies will be necessary to support the desired changes?) Success criteria De-escalation strategies Parental Involvement Review date Action to be taken as a result of review Physical Intervention needed? (By staff trained in Teamteach) Type of restraint needed?* *If physical restraint is used, this should be recorded separately in line with Teamteach guidelines Signed: ……………………………………….. Headteacher Signed: ……………………………………….. Parent
Behaviour-Policy-2017.docx