Muskegon Area ISD Functional Assessment/Behavior Intervention Form

General Information
Student: School: Kim Birthdate: Medication: Previous Funct Assess? Eligibility Status: Yes No When: Date:

Caseload Teacher:

I. Student Strengths, Skills, and Difficulties

List Student Strengths and Skills: K demonstrates leadership skills, is helpful, has a big personality, is strong-willed, has a good sense of pride, and loves herself. List Student Difficulties: Physical agression towards others

II. Behavior(s) of Concern

Description - Observable/Measurable
Physical agression towards adults or peers (i.e. shoving, slapping hands of staff, pushing past adults) will be the main focus of this IEP. 1. Yelling at adults using negative words, tone and volume happens daily and can last from 1 to 50 minutes. 2. Crying uncontrollably happens daily and can last from 1 to 50 minutes. 3. Refusal to comply with adult direction, happens daily. 4. Physical agression towards adults and peers--pushing past adults, shoving, slaping at hands of adults--4 times towards staff during the '11-'12 school year, 3 of those times were during the second semester of '11-'12 school year. 5. Negative verbal outburst with adults and peers occur throughout the day. Data indicated that K's verbal outbusts occur more frequently during sturctured and unstructured times, such as, transitions in the hallway, Art, PE, Math, Science/Social Studies and dismissal. 6. Refusal to comply occur throughout the school day. Data indicates that K's noncompliance occur most often during Morning announcements. 7. Physical agression occurs when K is agitated and when she appears calm. She has had 3 incidents of physical agression toward staff during 2nd semester of the 2011-2012 school year. Phsyica agression toward peers occur more frequently during unstructured times, such as lunch/recess, transitions in the hallway, Art and P.E. How Often 4 times during the 11-12 school year, 3 of those times were during 2n d semester of 2011-2012 school year Duration Varies Intensity Hgh Intensity Problem has E x i s t e d (l e n g t h o f ti m e ) Through the 2 0 1 1 2 0 1 2 S c h o o l Y e a r

Is this behavior addressed in the School Handbook? Y

III. Environmental Issues and Situational Variables

What triggers or causes the behavior? What happens before the behavior?
Physical agression occurs when K is aggitated and when she appears calm. Antecedents: Verbal demands/requests, group instruction, unstructured activity/setting, being sent to the office, after receiving a warning, not getting her way, getting something incorrect in class, losing points, when behavior is ignored

What happens immediately after the problem behavior occurs?

(student reactions, staff reactions, environmental changes) K is given verbal verbal prompts, is removed from class to take a break,/ is sent to the principal's office, or gets a call home.

In what settings/situations is the behavior of concern most and least likely to occur? Settings/Situations Most Likely Least Likely Adults? Peers?
(personality characteristics, teaching style, gender, disciplinary style, etc., no names) (personality characteristics, gender, etc., no names) Adults who have authority over K or teachers with an authoritative teaching style Peers who are mean or are unfair to K An adult K feels comfortable with and has a good relationship with Peers who she feels the most comfortable around or who do what K wants

Certain Activities?

Structured activities (lecture, or when she is given explicit instructions, etc.i In the general education classroom during Settings? (playground, math, science, lunch, On the playground, in the cafeteria, walking in structured activities with limited distractions and the hallway, during specials) school bus, unstructured time) chaos During direct instruction in the general education Time of Day or Class (morning, end of Morning, transition times. and dismissals classroom class, afternoon) When given the adequate amount of sleep, is Other? (home issues, bus, medication, health, Lack of sleep, change in routine, unexpected given a schedule of activities, and when changes that aren't incorporated into BIP sleep, etc.) activities are kept routine IV. Childs Exposure to Rules Governing This Behavior Check One or More and List How Often Class Discussions 1-1 Discussions Behavior Plan (independent work, lecture, writing activities, small group) Assemblies Check Sheet Social Work Support Behavioral Support Contracts Other Handbooks Other Conflict Resolution Anger Management Check One or More and Indicate Frequency Peer Mediation Staff/Student Awareness Regarding BIP Posted Classroom Rules

Unstructures activities (independent work, large groups, P.E., Art, recess, lunch, etc.)

V. Previous Interventions and Supports

VI. Previous Consequences and Disciplinary Measures

Time Out Loss of Privilege Parental Notification Other Referred to Office In-School Suspension/Suspension Behavior Ignored

Check One or More and Indicate Frequency of Use Detention Work Detail/Restitution Reprimand/Warning *Attached Documentation

VII. Needs Being Met Through This Behavior

Escape/Avoidance Sensory Stimulation Relief of Fear/Anxiety Attention Power/Control Other

Check One or More and Explain Expression of Anger/Frustration Tangible

VIII. Goal to Appropriately Address Need(s)

Goal: By the end of the 2013 school year, K will use strategies to cope with her frustration towards teachers during unstructured activities and transitions in and out of the general education classroom (i.e. P.E., recess, art, walking in the hallway) in 3 out of 5 situations. By the end of the 2013 school year, K will use strategies to cope with her frustration towards peers during unstructured activities and transitions in and out of the general education classroom (i.e. P.E., recess, art, walking in the hallway) in 3 out of 5 situations.

IX. Preferred Activities and Reinforcers

List preferred activities: -Given a leadership role -Teacher's helper -Line leader -When teacher models an activity -Given direct/explicit instruction -Debating with peers in class -When given projects K can relate to/passionate about List preferred reinforcers: -Stress cushions, stress balls, certificates and stickers for doing well on an assignment or behaving well when frustrated, given a badge when it is her turn to be the line leader or teacher's helper

X. Skills Needed to be Taught to Replace Behavior of Concern

What Behaviors Do You Want the Student to Engage in to Replace the Behavior? Stepping away from the situation will be taught as a full class skill, talking through the problem will be taught in front of the full class, taking out agression on a stress ball or stress cushion will be taught individually with K. If the whole class skills are not understood or effectively used, K will be taught how to step away from the situation and talking through problems individually.

XI. Behavior Plan Preventative Strategies

Classroom Accommodations, Approach Strategies, Seating Arrangements, Instructional Strategies, etc.

Reinforcement Strategies
Methods of Teaching and Reinforcing Appropriate/Replacement Skills

Procedures to Follow When Behavior Occurs

Specific Steps to Take When Behavior Occurs

- Seat K near students she gets along with well - Talk through the situation with K - Use explicit and direct instruction - Give K stress balls to take out her agression - Use apps to monitor behavior such

-Hand gestures taught to K that allow her to leave class using a signal -Close proximity will be used to keep K on task and to monitor undersired behaviors -Give K reassurance by placing a light hand on the shoulder

If K cannot contain her physical agression then the teacher will give K a signal to excuse herself to grab a stress cushion or stress ball. She can also move to the back corner of the room to the cool off zone in order to take some time to herself and regain

as, irewards -Hands on learning -Write up a daily schedule on the whiteboard -Give K a planner already filled out for the day -Have a weekly routine to keep consistency -Keep students moving during the lesson -If a task is difficult, pull K aside and provide one on one instruction -Talk to K at her level -Give K a journal to write down her thoughts and/or feelings to express frustrations before, after, and during school

-Sticky notes/reminders on the desk to keep K on task and remind her of any changes there may be that day -Cue cards to display around the room reminding K of desired behaviors (Desired praise in the form of verbal reminders) -Token economy to reward K for positive behaviors that she can cash in at the end of each week. Tokens can be taken away for poor behavior. -Using facial expression and verbal praise to show K when she demonstrates desired behavior (i.e. smile, 'good job') -Sending a note home to K's parents keeping them informed of her progress and behavior

her composure. If a crisis should occur the teacher will first send one student to the office with a crisis plan card. The teacher will then send the rest of the students to the library where he or she will have just called. While the teacher is waiting for reinforcement to come down from the office, he or she will, if possible, help the student calm down to the best of their abilities. Once reinforcement has either helped the student or escorted them from the classroom and the teacher thinks it is safe enviornment, he or she will phone down to the library to send the students back. As the students are walking back, the teacher will make a phonecall home to inform the parents of the activities that took place during the crisis plan.
Deviation of School Handbook? Yes No

XII. Data Collection

Describe how systematic/measurable data will be collected for Behavior Plan:

Attach Sample Data Sheet will inform the following staff of BIP:

Signatures below indicate the plan has been reviewed and agreed upon for implementation:

Parent/Guardian Social Worker/Psychologist Student Other Date(s) plan reviewed:

*Attachments may include point sheets, contracts, token cards, progress notes, referrals, parent contacts.

Teacher Special Education Teacher Administrator Other Date plan terminated:

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