FUNCTIONAL BEHAVIOR ASSESSMENT REPORT

An FBA is an analytical process based on observations, review of records, interviews, and data analysis to determine the
function the behavior serves for the student, how that function can be met more appropriately and how the environment can
be altered to better support general positive behaviors.
Date of Report: 1/29/17
Date(s) of FBA Data Collection: 1/23/17-2/3/17

SECTION 1: Student Information

Student Name: Rodriguez Tatiana Male

Female
Last (legal) First (no nicknames) M.I.
Birthdate: 2001 Grade: 8th
Resident District: Hope School District School of Hope High School
attendance:

SECTION 2: Parent/Guardian Contact Information

Parent Name: Lousia Rodriguez Home (616)555-5555

Phone:
Foster Address: 3028 Hope College Lane Work (616)777-7777
Parent Phone:
Guardian City/State: Holland, MI Cell Phone: (616)599-4804
Surrogate Zip: 49423 E-mail: tatianasmom@gmail.com
Student

SECTION 3: Behavior Analysis

1. Behavior(s) of concern (State a clear, measurable, and observable description of the behavior or behaviors of concern)
Tatiana displays off task behavior such as; putting her head down, making inappropriate comments , or complaining about
the work load.

2. Frequency, Intensity, and/or Duration of current behavior:

From the time period of January 23, 2017 to February 3, 2017 student displayed off task behavior such as refusing to
complete assigned work, putting her head down on the desk for ong than 5 minues, closing her eyes, and making
inappropriate comments from between 10:00 to 10:55 49% of the time and from 11:30-12:25 44% of the time.

Looking at the scatterplot data, there were no days where the student did not display this behavior. From January 23-
February 3 the student missed 3 days of school on the 26th, 31st, and 2nd. The behavior was most prevalent during science
and alegbra, with civics coming in a close third.

The student's behavior does not seem to be affecting the other students work at the time. It is causing the teachers to
become frustrated. Transition from instruction to independent worktime

3. Analysis of this behavior was based on:

Interviews with

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 Student observation(s) on event recording at 10:00-10:50 and 11:30-12:25 from 1/23 to 2/3 using a scatterplot dara
sheet, duration recording, and ABC data collection sheet.
Review of records, consisting of: health discipline other:
Environmental analysis for supportive and unsupportive variables on
Summary of Interview, Observation, Record Review, and Environmental Analysis:

4. Is the behavior impeding learning of the student or peers? Yes No

If yes, please describe:
The student puts her head down and refuses to work independently when asked to do so. Occasionaly the student will get
sent out of the classroom to the office. The student also murmers to herself which is distracting to her and impeding on
her learning.

5. Have Tier II Strategies or other Interventions been tried? (e.g., school/home notes, behavior contracts, self-monitoring)
Yes No
Describe previously selected intervention:
Tatiana has a self-monitoring strategy in place to help her stay alert and on task.

6. Result of selected Tier II or other Positive Behavior Interventions and Strategies:

The student has a self-monitoring strategy in Ms. Mason's classroom but it is not in place in her other classes. This
strategy has not been implemented in her other classes.

7. Is a behavior intervention plan recommended? Yes No Rationale: The student is believed to need a
behavior intervention plan. Tatiana is having troubles keeping on task and learning due to her inapproriate behaviors. The
student makes inappropriate comments, puts her head down, and complains about the work which is lead to believer this
is affecting her learning.

8. Environmental Factors:
What are the reported and observed predictors for the current behavior(s)? (Antecedent events that trigger
problem behavior)
Some predictors that were observed are the need to escape and avoid the work that the student finds underdisable.
When the student is asked to work independently she shuts down as well.

What supports the student using the current problem behavior(s): summary based on the environmental
assessment portion of this assessment: (e.g., what is in the environment that should be eliminated or reduced?
What is not in the environment that should be added?)
One factor that could be altered would be for the students teachers to build better rapport with Tatiana. The self-
monitoring strategy that is in Ms. Mason's classroom should be implemented in all of her other classes. There will
also be a check-in and check-out system with Ms. Mason to hold her accountable for her acting appropriately in the
classroom. This will act as positive reinforcement. There will be more group work implemented in the classroom to
take the place of some of the independent work time.

9. Functional Factors:
Hypothesis of function (purpose) of this behavior for this student based on data collected in Section 3. above
Looking at the data collected, it is believed that the student is behaving in an inappropriate behavior to escape the
work load. This is a form of avoidance so the student does not have to participate in undesired work.

Suggested functionally equivalent replacement behavior:

When the student is given independent work that appears too hard, the student is responsible to communicate with
the teacher and ask for help or modified work. The student will also maintain her self-implemented strategy and

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 develop a reinforcement place with her teachers to reward the student for consistent appropriate behavior and
efficient use of classtime.

SECTION 4: Conclusion/Recommendation
1. Conclusions: (Recommendations for IEP, 504, or school team consideration)

2. Estimate of need for behavior intervention:

Extreme
Serious
Moderate
Needs attention, early stage intervention
Monitor behavior only; no formal behavior intervention plan is recommended at this time

3. If a Behavior Intervention Plan is NOT now recommended:

Behavior goals to be developed by: and contained in:
Consider Tier II interventions, or other interventions, such as
Consider assistance to students teacher to enhance environmental/student
Consider other Tier III interventions, such as district provided Cognitive Behavioral Therapy such as a Related Service
to address emotionally driven behavior
Consider WrapAround or Multiagency teaming

Rationale for selection of an alternate approach:

4. This team has determined that if a behavior plan is NOT to be developed as a result of this assessment, a
functional behavioaral assessment will be considered again if:
data demonstrates the problem behavior intensity, duration or frequency escalates or continues at current rate or
data demonstrates non-responsiveness to selected other approaches

Describe:

5. This student has: a current IEP a current 504 Plan neither

6. Goals to monitor future behavior will be added to:

a new or amended IEP
a new or amended 504 Plan
a school teams plan (no IEP or 504 Plan)

SECTION 5: Evaluation Personnel

Individuals contributing to this evaluation:
Name Position Name Position
Tatiana Rodriguez Student Mr. Acenedo Math Teacher
Ms. Mason English Teacher
Ms. Harris Counselor

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 Mr. Gerard Science Teacher

Contact person for this report: Ms. Mason

Phone: (616)748-9273
E-mail: masonrocks@hopeschool.com

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