FRA (Mid Ferm) Dratr ! Sample Record of Functional Behavioral Assessment and Intervention ‘rida Department of Eco Divo of Pub Seon and Comme daca Dara f tena Sopot ad Comma Serve Name: ee savor Lyons Ore Middle Swhool ‘Team Members: Who is involved in the nvinteryenti Sherri Wilton, ese Teacher Britnay Gendreau Intervention Settings: in what settings will the assessmenv/intervention be conducted? SVE Classiomn Student Information Grade: "7 Birthdate: |2.[ 0) [2OO4 Inplenenaion duc MYCN 21,2018 Rationale/Goals of Intervention Rationale: For what reason(s) was the functional behavioral assessment initiated? ‘Student is engaging in behavior that places the student or others at risk of harm and/or results in substantial property damage Behavioral concems are resulting in exclusion from participation in activities or settings with peers ‘Educational team is considering a more restrictive placement due to behavioral concerns ‘Current intervention involves excessively intrusive procedures (¢.g. restraint, isolation) Student's behavioral difficulties persist despite consistently implemented behavior management strategies based on a less comprehensive or systematic assessment o gaookR & Other: ‘Target Behaviors: What ae the specific behaviors identified fo increase or decrease? Description of behavior Baseline Estimate (what student says or does) (how often, how long) waspitring, Every Few minuits, constant i S utc + Screaming random times for Several min . Broad Goals: What are the social and educational goals forthe student {Go increased pareipaion in inclusive setings, development of fiendshis, improved academic performance? “RR pea aael, enEBaAEe: SMS: “Sample Record of Functional Behavioral Assessment and Intervention ord Depart of Eden action Divina of Publ Shokan Cammunity ncalon Bares ofinerectonalSaport and Conmany Serves pee ie ‘Assessment Methods m What records wers reviewed? ‘curriculum/EP ‘What relevant information Conducted by: psi nt was obained? Britmay Cerarcuw dpcinntevaime | 1 was gbie fe daermne GFanecdoaivtomenies | YBehower pattras bacect on psychological evaluation | ys qusaioilin, and Qoother: Thome Schedule - Interviews: a a Wha incr iews were conduced? Qe Wa ea iaoraton Tools used: [ESE teacher srudent preference s Snacor suey erent sitemeter | eeachier {00'S Loe pos nore Gets poi scnool reccanendasors an \ Gendirtam other we) para peolessana? cao = sve “tassreawn ‘What relevant information Wha ect observations oe é was obained? “Cercannng ErSOIERS Cfreane |! wos bie, ST. ‘Tools used: 10 hours borren ne student m0 en Gala colechar Srwis J arassroom, ewwd by norcs 218lisan ana peor aren ange Eos alan Sag eee nae Mater SBnimnay Gendray Anges 7 Other Assesements: What, if any, other assessments were conducted (ea, ecological or clastoom management inventories, curcular assessments? no assessmenls were canducicol,, \ was able to see_sludenrs educanana® deity s dunng arr and purze live. ‘Summary (Hypothesis) Statements Patterns: What pattems were identified in the data collected CASC\Y SCX CAMS , somes, Kicks (ie, erciumslances in which behavior is mos likely east likely; possible function of tne behavior) When this ears» he tndeat ues feos Ue cumstances) (Gesetibe behav) aalpanaln PERSE s sue Arcane, eae oases ingle) to compre a yasy. __ycl\S_____ requesrta ask 5 Coc ‘Setting Events: Are there other ‘Variables that appear to be affecting the student's ‘behavior HOYT (-g.medical problems, cuticular issues)? . ™ © VADINESS Guhs + pcee influenceSntnnaaninaeeee en Tu Sample Record of Functional Behavioral Assessment and Intervention ‘lord Departeat of Edoatin + inna of Pui eho ad CommanlyEénctn + aren of lnc ppt ed Comm Behavioral Support Plan Intervention Components: What strategies willbe used (based on the hypotheses)? Proactive: What environmental adjustments will be used to make the studs problem behavior unnecessary? Studerk wit) wor one on one unin parapinsionat yo avoid asnacnons and ers. Ne necds fo be Womtord fp void wnyvrious leche « Educative: ‘What skills will be taught to replace (meet the same function as) the student's problem behavior and improve his/her ability to function more effectively? Casey. ot ve. wesnqucreel he “prom, cuss nd vistas toot RED ommancats M5 vyecas, oL- goats integrated with TEP Functional: How will consequences be managed to ingure the student receives reinforcers {or positive, and not problem, behavior? ‘When the student does... Adults will .. casey will be gen positive remforemenr ond Hears Tar ne ory: Crisis Management: Are criss management procedures needed fo insure safety and de-ecaation of the student's behavior inemergency situations? yes Lno If so, describe strategies NIA Generalization and Maintenance: What stegies wll bused o insure that behavior changes transfer across envion- ‘ments (e.g., natural cues and contingencies)? Help with transinon from acnury posinre remrorcement tears Implementation, Monitoring, and Evaluation sures: Wt ning an ou ae needed to implement the plan? Tralning Reson CmVag (Casey Space, nO Quiet area of The classtaav, way Fron prers or Teacper cparas. GE Hamed hts as SO\ AS Rechm Us. es mn hor eve reacner 04 ‘How frequently will monitoring take place? ve daily _ weekly — monthly other 4ne amounr of outoursrs wi implementation and outcomes be east? Se mer ciassroom = ASTupran. anes of Team Member M/S. Wi\to0 sly bead {Botioay —Gncdreat — SOs Stas Becher Qatena aviFea (Mid term) I ‘Sample Record of Functional Behavioral Assessment and Intervention Pe Depart Ect Dro Pb eon nd Cammy Edcan Dar Inari Sppr ad Comma Sven . Student Information ‘me: CaSCY ruse: 7 Binhdwte: 121012004 Setoot| LYONS Cree nddier Implementation Dues MAC 21,201% “eam Member: Whos involvedin tbe asesmenvintenion? MS. Wilton, Sve Teaoner Suitrnay Genaredu Imerventon Seiings In wha seting wl he ssessmenvimervenion be conducted? SVE Classroom) Rationale/Goals of Intervention Rationale: For what reason(s) was the functional behavior assessment intaed? qa ‘Student is engaging in behavior hat places the sudent or ethers at risk of harm anor resus in substantia property damage ‘Behavioral coucers are resulting in exclusion from participation in activities or stings with peers Educational team is considering a more restrictive placement due to behavioral concerns Current intervention involves excessively intrusive procedures (cg. retain isolation) a a 0 g Ad sauets behavior iticaies pers dept consistently implemented behavior management segs based on a less comprehensive or systemalic assessment Other “Target Behaviors: What are the specific behaviors identified for Increase or decrease? Descriptio fear Baie ie (ea stent ys 602) (ov oie, tow on) “soins deen feo minutes, Constant scream ahem hmes foe Strerad mmulty eee Tred Gon: Win ee il con eb Fr cat cepted paripaton in incsive etn, development fends, improved rae ; smereasea paitiuparon in, educarenat Sem 40 improve academic performan®- _ increased wring caPabilites “Tanne Sample Record of Functional Behavioral Assessment and Intervention re Depart of Eaton Dino Pee Sch and Commas Bénin + Bare lero! Soper nd Comme Sri Functional Assessment Methods Records: What records were reviewed? | Gfcunicslum/lEP ‘What relevant information aera rs obaied? Conducted by: vuimenenieas | * OME wie, and Brittnay Gendreau CHanccdoutsttome nos | Aves | aistiveS 1 psychological evalution | * behavior patterns Gates sumipations | we uo Wis" disability. Interviews: O student ‘What relevant information ‘What interviews were conducted? parent ‘was obtained? a = *shudent preferences "Shident survey Cperentsiuesonteter | tooo used by ME Snaunee school administrator teacher conde by Bierce: | Ty ppmkesion! iter. + School }profes Brittnay Gondreay Paragressnal | “veceomenaatons Otmervations ease ‘What evant infomation ‘Wha, regoteraons occured? Classraom. wesobuie!? “spiin a Lyons creek mide. aniecedents Lay No Kiours betwen | * triggers Data catechen| notes mn S vaaseoom behanor and Conducted by ell mmicractions Wit peers) Brittnay,_Gondreau shatt. Cer Assessments: What any, ter ssessments wee conducted (egrets magne mente corel cms? 1 was N jor Informa) asscssmen were conducted! No formal Creve caseys educational abilines trough Injocachon _ar__puzi and am tec. ‘Summary (Hypothesis) Statements Patterns: What patterns were denied inthe das called ranean in which behaviors mos ices ikl; posi function of te beavi) ‘Whe this occurs the stadentdesar tot or aol. crib creomsanes) ecb boar ci conequgcs) WER ERR Raced “CHE URex soreams, SEs ANT “Lomoreny fp compicte 0 task, __and_yeél required tase Ree tore ote varies tht spent be feting he dens bekavor (ane es ai sy? peer influence -Mmited specon -laziness. isSample Record of Functional Behavioral Assessment and Intervention Behavioral Support Plan Intervention Components: What strategies wll be used (based onthe hypotheses)? Proactive: Rdveatve: Fenctionl: What environmental adjustments will What sil wll Be taught to replace How will consequence be managed to be used to make the student's problem (meet the same function as) the insure the student receives reinforces behave unnecessary? student's problem behavior and for postive, andnot problem behavior? ISHS OWN SPACE improve isher ability to function When the student dos... Adus wil awa From peers And. sneppemreetectvly? eo i woods COS V1 (Casey wil) wt a’ Easey will be 9 ¥e powition spraproesscral to cos Famseif with ust 2 pos inst, remtorcowrent 4 as Should always be PEM OO) oho cardsHe tor eaprevent ser-mpiniss ERE ger why a) cue Sys speual frets a er wares The tavher us Se YIgn- Aires” _rerioal praise. Cie Managemen: Ar css anagent procedures nde tons sly and eescalnof the dent's eave tnemcuen hans? yes Yoo Io, deere sates NIA Generalization and Maintenance: What srateyes willbe used to insure that behavior changes transfer across environ ‘ments (eg, nara cues and contingencies)? a Hele with +ransinon ater each acnuty. sposinve reinforcoment + Treats | rewards Implementation, Monitoring, and Evaluation ‘Tralning/Resources: What training andlor resources are needed to implement the plan? Feacwer wil) owe casey space tm a quiet Corner of Mme cussroom “awe fron cadet ae ers. Tre oc: reatner Tene, Ketek le case S00 Tiny Cehing WY - Te How frequently wil monitoring ke piace?” aL daily __weekly monthly _other tatnatmantnamcetent BY ne ampints and Arahan ane oF tare’: “ollhburchs: Ms. Wilton Ureacner)__ BrittnayGendréay