Professional Documents
Culture Documents
Behavior Survey
Behavior Survey
Student:
Hour: _________
Target Behavior #1: Blurting out during lessons
1) About how often in an average class period does student blurt out during inappropriate
times?
2) How distracting is this behavior to you and to the students? (Please circle one and add
any comments)
Not distracting
somewhat distracting
very distracting
3) What, if anything, has been successful in helping the studdent with this behavior in your
class?
2) When do these comments usually occur? For example, do they occur during lessons,
unstructured times, at the beginning of class, etc.
4) What, if anything, has been successful in helping the student with this behavior in your
class?