FUNCTIONAL BEHAVIOR ASSESSMENT PLAN TEMPLATE

STUDENT FIRST NAME:

DATE: 9/5/15

DATE OF BIRTH: 8/15/2008

AGE: 7

MALE/FEMALE: Male

GRADE: 2nd grade

STAFF PARTICIPATING IN ASSESSMENT: RSP teacher, Behaviorist, Mother, 2nd grade teacher, 1st grade
teacher

I.
REASON FOR FBA
Explain the target behavior in specific, observable terms, describing what the behavior looks like and the
reason for this referral. (If there is more than one behavior, complete additional forms.)

AR is a sweet and kind boy who is very artistic. He shows interest and likes to engage in conversation
with adults and peers. While AR likes to be in the school community, AR has difficulty maintaining
attention and following routines and direction. He is often off task in classroom taking off his shoes and
has his hands in his mouth and feet off the floor 75% of the time, as observed in data collection. It has
been recorded that on average he his disengaged/distracted and/or demonstrating inappropriate
behavior approximately 70% of the time. In addition, he has difficulty with classroom routines and
teacher directions. He is able to follow the morning routine without prompting only 20% of the time. He
obeys line rules 50% of the time and often disturbs the class line process by arriving late, turning to talk to
his peers, dragging his coat and often spilling the content of his lunch because he does not zip the
lunchbox. Despite having a reward system and visual schedule for routines in place, AR has shown little
progress and some regression on his IEP behavior goals. The current behavior systems in place on the IEP
do not appear to be effective.

II.

STUDENT PROFILE

Gather background information in order to assess the behavior in each of the following categories:
IEP
Medical
Family consultation (family interviews)
Previous interventions
Defining and prioritizing behavior

Assessing student environment

BACKGROUND
AR is a 7-year-old boy attending school at Miwok Valley Elementary. He lives in Santa Rosa with his
mother and siblings: a sister who is 8 years old and a brother who is 4 years old. While pregnant with AR
the mother reports having Diabetes and took diabetic medication. The mother reports that birth and
developmental histories were normal without complications. Current vision and hearing tests at school
show he is within normal range. AR attended preschool for 2 years and has attended Miwok Valley
Elementary since kindergarten. English is spoken in the home and is ARs primary language. French and
Arabic are also spoken in the home.
During ARs Kindergarten year, the teacher recommended AR to be evaluated by a Student Student team
based upon his lack of progress in the classroom. During the SST process, AR was given interventions
which included accommodations and modified work in the classroom, small group and individualized
assistance from classroom aides and RTI personnel, screenings by school speech therapist and Resource
Specialist and informal intervention by occupational therapist. In addition, he was pulled out by the PIP
program (Primary Intervention Program) of the general classroom for personal/social support.
Through the parent questionnaire, it is noted that the parent is concerned about ARs emotional
problems, not paying attention and not completing work. The following behaviors are also noted:
hyperactive/restless, easily distracted, upset by change in routine, destructive especially of others work,
demands attention, uncooperative behavior, cannot seem to self-control, difficulty with peers and/or
adults over trivial things, impulsive and extreme reactions. During kindergarten it is noted that AR went
to a psychologist once a month and takes medicine (melatonin) to sleep at night. During the IEP the
mother noted that AR no longer takes the medication. In the IEP meeting, the mother also mentioned that
AR like to play with Barbie dolls and girls stuff. Note: The psychologist said not to worry about that type
of behavior.)
The referral for testing created by the Student Study Team at the end of ARs kindergarten year notes that
AR pushes others, pulls others hair, has harmed animals, steps on other kids finger and has choked his
mother. The referral also notes that there is concerns about ARs difficulty with focusing. The mother
reported to the team that AR argues with her a lot and with his siblings. He is high energy at home and
demands much attention. He can be very uncooperative, impulsive, is easily distracted and has extreme
reactions.
Speech & Language assessment observations and report (date of report 12/3/2014) indicated that AR was
friendly and polite and readily engaged with Clinician. He had difficulties with attending to assessment
tasks and needed verbal prompts to pay attention frequently. AR was easily redirected with prompts. His
attention span ranged between 10-15 minutes. The evaluation found that AR was within average range for
his age in expressive and articulation skills. AR receptive language skills which include determining word
relationships, understanding grammar rules and following complex directions are below the average
range. As a result, AR qualifies for DIS in the areas of receptive language
At the end of kindergarten, ARs Student Study Team recommended that he get evaluated for a learning

disability. During the first quarter of first grade, AR was diagnosed with a learning disability. The
Psycho-Educational assessment noted in student observations that AR was in general non-responsive to
the instruction and seemed only to respond when called on. In testing AR was cooperative, friendly and
somewhat shy. He dressed appropriately except for having no socks on a cold day. He generally appeared
to understand directions, but often lost focus, seemed distractible and needed occasional redirections. His
psychological result was as follows: AR demonstrated a level of cognitive abilities within the average
range of intelligence. Despite varied levels of academic interventions within the general Education setting
AR exhibits academic delays that are associated with a specific learning disability with processing delays
in auditory perception and visual perception and visual/motor integration. Note in particular, in memory
and auditory reasoning. In addition, AR demonstrates difficulties sustaining attention. Due to ARs
difficulty with fine motor difficulties and self-help skills. the psychologist recommended occupational
therapy testing to get services as part of the IEP.
Special education assessment report for initial IEP reported in similar findings with the psychoeducational evaluation that ARs academic development was a year below his grade level. AR has a
relative strength in mathematics. AR has relative weakness in language arts. Based upon the assessment
finding he had 6 measureable goals developed for his IEP. Three of which where for academics: one for
decoding one-syllable words, one for reading comprehension, one for mathematics addition &
subtraction. Four were for behavior: one for sitting and facing the teacher during instruction, one for
appropriate peer interaction and one for independently doing the morning classroom routine and one
was for receptive language skill (Speech & Language) - following 2-step directions. The examiner noted
that AR had trouble following the directions of the test. On addition ARs penmanship was large and
awkward the test. It was noted that he held the pencil in a tripod grip. AR used math strategies
counting on fingers and using touch point math. He talked aloud to solve problems. He at a point in the
testing had is hands, fingers and fist in his mouth. The IEP gave him accommodations to read to student,
breaks and extra time, sensory tools, modified assignments to ability level, math manipulatives, check for
understanding, rephrase directions, partner work, option to dictate to student, provide sentence frames,
spelling help, word banks for writing and reward charts for behavior goals. AR special education time
was designated to be 450 minutes weekly in special education/resource room, plus 50 minutes weekly in
Speech & Language.
First grade teacher reported concerns about ARs behavior. Noting that he is one of the most disorganized
students she has taught. He has not yet learned the procedures of starting the day and it is 4 months into
the school year. He needs coached support to finish his daily morning routine 90% of the time. He is
often late to school. He craves attention from his peers but often gets negative attention due to his
approach to hos peers. He often blows in their ears, kisses them and cuts them off in line. AR personal
hygiene skills are lacking. His clothes are often dirty because he spills food on himself. He often has food
on his hands and face. The items in his backpack also have food on them because the bottom of his
backpack has old food in it. AR shoes are on the wrong fee 95% of the time and he often takes them off
during class. According to observation notes, AR only sits facing the front of the class 50% of the time
when instruction is commencing. 75% of the time AR is not able to start his work because he has not been
actively listening to the lesson and instructions. He often draws on his work. The teacher often must
remove objects from his desk in order to encourage him to focus. He usually prefers to play with the girls.
At beginning of the year AR had trouble staying out of the girls bathroom, but he has improved. He often

makes his peers angry because he violates their personal space, poking them, bumping into them,
blowing on them putting his mouth close to their ears and talking to them.
Through first grade AR attending the RSP room with little progress on behavior. It was reported that AR
was responsive to 1 on 1 intervention work but in a small group or general classroom setting he had little
success in maintaining focus and keeping up with the classroom/group content and activities. Despite
having a reward system and visual schedule for routines in place, AR has shown little progress and some
regression on his IEP behavior goals. At the end of AR first grade year, he was evaluated by the special
Day educator for possible inclusion in SDC class, during the assessment period he remained focused and
on task at which point it was decided he did not qualify for further specialized serves. The current
behavior systems in place on the IEP do not appear to be effective. AR is currently in the beginning of his
second grade year, he continues to be off-task most of the time. Currently there is an aide in the class and
she spends 75% of her time, refocusing AR on classroom tasks.

III.
ASSESSING THE BEHAVIOR
Describe briefly (include data collection forms):
Interviews (student, teacher, paraprofessional, support staff, school psychologist, counselor. . . )
Observation (ABC Chart, scatter-plots, interval/duration/frequency recording, incident log, etc.)
Checklists
Questionnaires
Progress monitoring results from end of last year:
Behavior Goals and observations:
Goal: AR will sit properly in his chair (feet on the floor and body sitting up) and face the teacher during
instruction 90% of the time.
Observations:
First observation: In classroom AR was on task 12% of the time, disengaged/distracted 68% of the time
and demonstrated inappropriate behavior 17% of the time.
Second observation: At an assembly, AS was on task 42% of the time, distracted 28% and demonstrating
inappropriate behavior 30% of time. He was observed kicking the student in front of him.
Goal: AR will demonstrate appropriate peer interactions in a classroom line (respect others personal
space) 100% of the time over a two-week period.
Observations:
AR general education teacher notes that AR has demonstrated improvement in his ability to demonstrate
appropriate peer interactions in a classroom line. He is able to respect others space 70% of the time.
Goal: Without teacher prompting, AR will independently do his classrooms morning routine 80% of the
time as measured by teacher charted data.
Observations: AR has a visual schedule and receives reward points for doing the steps of his morning
routine. AR continues to need prompting to follow the visual schedule/tasks required. He is able to
follow the morning routine without teacher prompting 20% of the time.

Goal: AR will restate and follow 2-step directions containing ordinal (i.e.: first, last) and temporal (i.e.:
before/after) concepts to 80% accuracy 4 out of 5 trails
Observations: AR displays significant difficulty attending to therapy tasks and requires multiple
repetition of directions to complete 1 step directions. He displays significant difficulty following the
group routine. He has been observed to crawl under the table and take his socks and shoes off.
Academic Goals and assessments:
Goal: AR will decode grade level spelled one-syllable words as measured with 70% accuracy in 2 trials.
Progress: in 2 out of 4 trials AR was able to exceed the 70%. In the 2 others he was within 60-67%. He has
progressed/ met this goal.
Goal: After listening to a grade level text, AR will identify the main topic and retell key details of the text
as measured with 75% accuracy in 2 trials.
Progress: In one on one testing situations for 2 assessments, AR listened to and answered assessment
questions with 60% accuracy. He was able to identify the main idea for both passages, but he
demonstrated difficulty answering why and inferences questions.
In three quizzes ARs had 50% accuracy. His ability to understand what he reads or listens to varies
greatly depending on his ability to focus. He is often able to identify the main who/what but struggles
with his ability to provide a main idea. He tells a detail from the story but not the over-arching main idea.
AR is able to provide three details after listening to text but the details are not always in order and are
typically from the end of the passage. In summary, AR is not able to independently identify the main idea
completely and needs to continue working of recalling key events in sequence. He currently requires a lot
of teacher-led discussion regarding each sentence he reads/listens to before he is able to retell a story.
Goal: With the use of manipulatives AR will solve 10 addition and subtraction word problems with 75%
accuracy in 2 out of 2 trials.
Progress: AR has made progress on this goal. His nest step will be to work on consistency in drawing and
representing problems.
Trial 1: with manipulatives AR was able to solve addition and subtraction word problems with 90%
accuracy. However, when asked to draw the picture to represent the problem with the manipulatives, he
had 0% accuracy. When drawing AR put random amounts and did not count one to one.
Trail 2: AR was able to solve word problems with 70% accuracy. He demonstrated difficulty choosing the
correct operation for problems. AR was able to draw a picture to represent the problem in 1 out of 10
problems.
Trail 3: AR had 80% accuracy. AR was able to show an accurate drawing 1 out of 10 problems.

Behavior Progress monitoring beginning 2015-16:

Meeting with RSP teacher, second grade teacher, Behaviorist and parent: Unfortunately, the parent did
not show up to meeting. The meeting was then switched to interviews of teachers on ARs behavior and
systems in place.
Teachers interviews and observations: AR is a friendly sweet boy. He is artistic and loves color. Likes to

build patterns with blocks. He loves technology and computers. He enjoys playing. He tends to like
more traditional girl oriented activities including playing with dolls. He has poor dine and gross motor
skills. The RSP teacher has referred him to get evaluated from the occupational therapist. Regarding
ARs behavior, he has trouble attending in class. He is very impulsive and will get out of his chair
frequently. He seems to be on his own agenda. He pouts when he does not get his way. He displays
immature behavior. He has difficulty following classroom routines. He gets distracted frequently and
does not make eye contact. He tends to avoid physical contact. He does like sensory activities such as
using had soap and putting his hands in his mouth. He takes off his shoes frequently during class. His
mother no longer has him wear socks because he takes them off. AR is not an independent worker. He is
unable to start and complete tasks without assistance. It has been noted that he will bring snacks to school
that are not healthy drinkable yogurt, cookies, sugary things. He is often late to school, so he misses the
school breakfast. The cafeteria lady now brings his breakfast to him during class so he will have
something solid to eat before school. He does not have friends. On the playground it has been observed
that he will parallel play with other students but not engage in interactive play. He does like having adult
attention and will engage in conversation and activities when in one on one situations.

Observation Data: The observed behavior occurring running away, hiding under tables and out of seat
behavior. These behaviors occur when students wants to eat something/put something in his mouth.
During instructional class time. When student does not get his way or does not want to do something
that is instructed. When conflicts occur with other classmates he reacts aggressively to other students by
pushing or running up to them in an aggressive manner.

IV.

ANALYZING THE BEHAVIOR RESULTS

Describe and synthesize the following from the multiple sources of data (Provide data collection or record review):
Predictors/triggers:
Setting events
Antecedents
Consequences: What happens after the behavior occurs?
Consequences that maintain the behavior
What other consistent consequences were found?
Frequency, Intensity, and duration of behavior:
When does the behavior occur?
How long does the behavior continue?
How often does the behavior occur?
Other:

What setting events or antecedents identified are associated with low rates of target behavior?

Predictors: Settings in his environment that create situations for behavior are school
classroom and playground settings.
Triggers: school content work, negative playground interactions with students, noisy
classroom, needing something in mouth, in class conflicts with other students and transitions
during class time.
Consequences: vary depending on behavior:
Behaviors:
Distracted or disengaged - Redirection. Sent back to his seat. no points/prizes
Inappropriate: no points/prizes, redirection, He has been talked to numerous times about his
behavior. Filled out student reflection sheets and sent to the principals office. When he runs
out of class, adults follow him outside and follow him to monitor and redirect him to the
classroom. He is directed to take a break in a chair. His parents are notified.
Note: When he gets up for food in his lunch box he is allowed to eat it because of his mouth
sensory issues.
Frequency: events primarily occur between 9am 12:30pm. Recorded incidences are as
follows: From August 18th until August 31, he had 8 incidences and from September 1 until
September 25t, he had 29 incidences. In behavior observations based on 15minute intervals,
AR averages appropriate behavior 45% of time, inappropriate behavior 20% of time and is
disengaged/distracted 35% of time

V.

HYPOTHESIS OF THE FUNCTION OF BEHAVIOR

Identify function of behavior: obtain, avoid/protest, or self stimulation

Within the context of the hypothesis, describe the following:
Setting events
Antecedents
Consequences

Function of ARs behavior is believed to be avoidance/protest and self stimulation.

Setting: The function of the behavior occurs during class setting between 9-12:30 when
instruction on academic curriculum is taking place. It also takes place in free time on
playground and during transition times from free-time to academic setting.
Antecedents:
Avoidance/ protest behavior: This behavior seems to most often during academic time when
he is asked to do something he does not want to do. It also occurs if the student is told to stop
doing something he currently would like to do (transition times). In addition, he is also
evident when he does not get something such as a prize etc. In these events, he will run out of
the environment or hide under furniture. Furthermore, conflicts with peers also generate this
behavior. He has been noted to run up to other kids scaring them or pushing other kids
during conflicts.

Overstimulation: happens when student hears too much noise as noted when the classroom
gets noisy he holds his ears and hums. In addition, he has sensory issues with mouth, feet
and hands. He demonstrates behavior of putting hands in mouth, needing to eat/put things
in mouth, taking off shoes and socks and putting hand soap on hands without washing it off.
These sensory issues contribute to his behavior to be disengaged and increase his
inappropriate behavior.
Consequences: The consequences of his behavior range depending on the severity of the
incident. No points for prizes/rewards is a motivator since he loves prizes. He is often
warned with less severe behavior that he will not earn points if he does not get back on task.
This type of redirection has been successful; however, more consistency in delivery and
warning levels might be advisable. Consistency across all educators would help the student
to know that there are clear boundaries and for the educators provide consistent approaches
on behavior standards with the student.
Breaks to refocus student would also be beneficial to student, since he is having difficulty
maintain attention for long periods of time. Providing him shorter times to focus and more
breaks to reward him immediately will provide him incentive to focus on his academic work.
He should get a visual schedule to help him with routines and transitions.
In regard to his escape behavior: since behavior has escalated he has been receiving
consequences of reflections sheets, going to the principal and notifying parents. This team
approach could be very beneficial for the student to understand that this type of behavior is
inappropriate and can not be tolerated.
For his oral sensory and other sensory stimulation, he should be provided tools to use to help
him calm his sensory issues to the greatest extent possible.

VI.

FBA SUMMARY AND RECOMMENDATIONS

Describe:
What alterations in the environment, instruction or interactions could prevent the behavior from
recurring?
Identify functionally equivalent replacement behaviors.
Describe current methods of reinforcement and recommend any changes of reinforcement.
What goals, services, etc. are you recommending?

Official physician assessment will be requested from the parent for possible Autism Spectrum Disorder.
After assessment Student team should discuss if student might benefit from smaller class size.
In the meantime, student is not progressing on goals with current reward system. Student is motivated
by rewards but as a result of his short attention span the rewards need to immediately follow the positive
behavior he exhibits. Therefore, by implementing a simplified system of rewards, he will better
understand that the positive behavior he exhibits is socially preferred. The reward system will be as
follows:
10 minutes of work gets 10 minutes of time for either drawing or computer time.
Staying on routine AR will get an immediate reward of a sticker. The classroom routine will be
given to him with a simplified 3- step visual check list.
By giving the student an immediate reward system the hope is that he will begin to acclimate to the
general and resource classroom. Once he gets measureable gains the goal will be increased by 5 minutes.
Fifteen minutes of work to 10 minutes of reward time.
In addition to refocus the student there should be a warning implication standard in place for all
educators involved, so that consistency in delivery is across all environments. This will provide the
student with a more consistent view of behavior boundaries.
In addition to help his oral sensory perception, we will provide a necklace he can use for oral perception,
instead of using his hand. He will be reward immediately with a sticker when he uses the necklace for
oral sensory relief.
Also the use of noise cancelling headphones could help with his overstimulation with noisy
environments.
In addition, the student might benefit from weighted seat pets or weighted blanket to help him clam his
body.
The shoe issue should be tolerated at the moment. It does not pose a threat to the student as log as he
wears his shoes outside and when he is walking around. He will be allowed to take his shoes off at his
desk, provided it does not interfere will his fellow students or his well fair.
Coach him on speech to help him express his feelings and needs in words

Social stories for routines and social interactions.

10