New Hampshire Center for Effective Behavioral Interventions and Support (NH CEBIS)
Functional Behavioral Assessment (FBA) and Behavior Support Plan (BSP)
Fidelity of Implementation Evaluation Tool
Muscott, Benjamin, Bradley, Gersten, and Mann (2008)
FBA/BSP Completed by: _______________________
Date: ____________
Code: __________
Evaluation Completed By: ___________________________________________ Date: ____________
Reliability Completed By: ___________________________________________ Date: ____________
0 = The information is not included or there is no evidence of the conceptual framework.
1 = There is evidence of the conceptual framework, however there is no evidence of competency.
2 = There is evidence of the conceptual framework and basic competency.
3 = There is evidence of the conceptual framework and advanced competency.
Feature 1
Develop a
Behavior
Pathway and
Summary
Statement
Feature 2
Developing
Replacement
Behavior Based
on Function
Skill Competencies
1. Define problem behavior in observable
and measurable terms.
2. Describe problem behavior in terms of
frequency or rate and intensity.
3. Identify immediate triggering antecedent
or, if possible, distant setting events.
4. Determine if the problem behavior occurs
in one or more routines.
5. Identify possible function of behavior or
maintaining consequence events for each
problem routine.
Total Score for Feature 1
Skill Competencies
1. Identify student strengths and interests to
inform reinforcement and behavior plan
strategies.
2. Identify short-term replacement
behavior(s) for the problem behavior for
each problem routine.
3. The short-term replacement behavior(s)
are matched to the apparent function of the
problem behavior for each routine.
Total Score for Feature 2
0
Score
1 2
Comments
3
0
1
2
3
0
1
2
3
0
1
2
3
0
1
2
3
/10
0
Score
1 2
3
Comments
0
1
2
3
0
1
2
3
/6
Adapted from Sugai, (2002) and Sugai, G, Lewis-Palmer, T, & Hagan-Burke, S. (1999-2000).
Overview of the functional behavioral assessment process. Exceptionality, 8(3), 149-160.
1
New Hampshire Center for Effective Behavioral Interventions and Support (NH CEBIS)
Functional Behavioral Assessment (FBA) and Behavior Support Plan (BSP)
Fidelity of Implementation Evaluation Tool
Muscott, Benjamin, Bradley, Gersten, and Mann (2008)
Feature 3
Identify
Strategies For
Behavior
Support Plan
(BSP)
Feature 4
Develop a Plan
to Monitor
Progress
Skill Competencies
1. Select antecedent strategies that minimize
impact of setting events or make triggering
antecedents irrelevant or ineffective.
2. Select strategies that teach student skills
that make problem behavior less efficient
and effective including the teaching of
replacement behaviors.
3. Select strategies that make the
maintaining consequences for problem
behavior less effective – minimize the
impact of inadvertently reinforcing the
problem behavior.
4. Select punishment strategies that reduce
the likelihood the problem behavior will
reoccur.
5. Select reinforcement strategies that make
replacement or desired behaviors more
likely.
6. The reinforcement strategies include
student’s strengths and interests or things
the student finds reinforcing.
If necessary, develop emergency procedures
if behavior escalates.
Total Score for Feature 3
Skill Competencies
1. Develop observable and measurable
outcomes.
2. Develop specific criteria for success.
3. Identify how data will be collected to
monitor progress and include form or tool.
4. Develop a schedule for assessing
progress.
Total Score for Feature 4
0
Score
1 2
3
Comments
0
1
2
3
0
1
2
3
0
1
2
3
0
1
2
3
0
1
2
3
Included
Not included
/12
0
Score
1 2
3
Comments
0
0
1
1
2
2
3
3
0
1
2
3
/8
Adapted from Sugai, (2002) and Sugai, G, Lewis-Palmer, T, & Hagan-Burke, S. (1999-2000).
Overview of the functional behavioral assessment process. Exceptionality, 8(3), 149-160.
2
New Hampshire Center for Effective Behavioral Interventions and Support (NH CEBIS)
Functional Behavioral Assessment (FBA) and Behavior Support Plan (BSP)
Fidelity of Implementation Evaluation Tool
Muscott, Benjamin, Bradley, Gersten, and Mann (2008)
Feature 5
Develop a
Detailed Action
Plan to
Implement the
BSP.
Skill Competencies
1. Identify who will do what by when.
2. Identify how the plan will be shared with
other members of the team, staff and family.
Identify any training necessary to support
fidelity of implementation.
Total Score for Feature 5
Total Scores
Feature 1
Feature 2
Feature 3
Feature 4
Feature 5
Total of All Features
Score
/10
/6
/12
/8
/4
/40
0
0
Score
1 2
1 2
Comments
3
3
Included
Not included
/4
Comments
Draft 5 8 08
Adapted from Sugai, (2002) and Sugai, G, Lewis-Palmer, T, & Hagan-Burke, S. (1999-2000).
Overview of the functional behavioral assessment process. Exceptionality, 8(3), 149-160.
3
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New Hampshire Center for Effective Behavioral Interventions and Support (NH... Functional Behavioral Assessment (FBA) and Behavior Support Plan (BSP)

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