Running head: FBA & CONSULTATION REPORT
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Functional Behavioral Assessment & Consultation Project Report
By Student Y
Ball State University
Date
This is a template. You will have to change things like the student name, etc. on the front page.
Instructional comments are provided in the document to help you know what goes there. You
need to delete these comments before submitting it. Rename the file with your last name and
FBA Project.
Planning ahead…(You must submit a consent form that is password protected before beginning
your project).
FBA & CONSULTATION REPORT
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Reflection #1
Reflect on what your past experiences are with FBA’s. Have you been a part of
completing FBA’s or intervention plans? If so what did that look like, what went well, what
have you seen as challenges? What experiences do you have with consultation and working
with parents or teachers? What do you expect to get from this FBA/Intervention Project? If you
do not have experience explain what you think will happen and what you think the process will
look like. (This should be ½ page to 1 page)
Consultee Information
This should include basic information about the consultee like their relationship to the
client, history with the client, etc. Do not include identifying information such as real name. Do
not include password forms here and do not password protect this document.
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Student Description and Context
This should include age, diagnosis, communication mode, injury/illness history,
educational history, delinquency or truancy history, etc., and description of setting where FBA
and intervention will be completed. Includes details about who else is in environment (without
detailing identifying information). This should also include other pertinent information that you
may have found in obtaining the background history.
Consultee Interview 1: Needs Identification Identification
Should include subject description, behavior description, setting, antecedent events,
postcedent events, likely functions, desired alternative behavior, etc., raw interview with script of
questions and answers are turned in, based on appendix a and b in Sheridan book but may
include other questions as well
Student:
School:
Interviewer:
Date:
Grade (or Age):
Respondent:
Teacher:
1.
Question 1?
Answer 1
2.
Question 2?
Answer 2 (include entire transcript)
Consultee Interview 2: Needs Identification Interview (only if you have two consultees)
should include subject description, behavior description, setting, antecedent events,
postcedent events, likely functions, desired alternative behavior, etc., raw interview with script of
questions and answers are turned in, based on appendix a and b in Sheridan bookbut may include
other questions as well (do not include specific identifying information)
FBA & CONSULTATION REPORT
Student:
School:
Interviewer:
4
Date:
Grade (or Age):
Respondent:
Teacher:
1.
Question 1?
Answer 1
2.
Question 2?
Answer 2 (include entire transcript)
ABC Observation Form
Should include setting, context, antecedents, behavior description, consequences. This can be
single spaced. You should have a minimum of 15-20 rows of data over a minimum of 3 days (10
if it is a very low frequency behavior but you may want to discuss this with your instructor.
Student Name
Observer(s):
Activity:
Time / Setting
Observation Date:
Time:
Class:
Antecedent
Behavior Description
Consequence
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Conditional Probability Analysis
This should include the % of target behaviors that were followed by a specific
consequence (out of total possible). Put the exact calculations. See the Sterling article for
information on how to calculate this.
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Scatterplot Observation
This should include behavior description, frequency or duration, setting, clarity, behavior data
summary, and is different data than what was in ABC data
Student:
Grade:
Dates:
Observer:
Behavior:
Setting:
Time:
Include Scatterplot Data Table (include whatever chart makes sense given your target behavior).
The point is to find patterns such as when, with whom, where, what activities etc the problem
behavior is occurring. Look under course resources for links to sample scatterplots and
information about scatterplots. A simple time based tally generally is not enough information.
e.g. Touching another students hair.
Monday
Calendar
1111
Time *Sitting
on floor in
circle with 15
other children
8:00-8:15
Snack Time
(Sitting at
table with 3
other kids)
8:16-8:30
1
Tuesday
Wednesday
11
11111
11
Thursday
111
Friday
Total
1111
18
1
4
FBA & CONSULTATION REPORT
Reading
Instruction (2
students; 1
teacher)
8:31-8:45
Free Play
(Able to play
at any station
in class) 8:469:00
11111
111111
7
111
1111
1
11
8
10
7
111
21
1
2
9
45
Analysis of above data…..
Data Triangulation Chart
This should three sources of data without replication of the same dates and data, interpretation,
precipitating events, maintaining consequences, function. It can be single spaced within the
chart.
STUDENT: Name
DATE:
SOURCE ONE
SOURCE TWO
SOURCE THREE
ABC Observation Chart
Interview with classroom
teacher
Scatterplot
Summary of information
Summary of information
Summary of information
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PERCIPITATING EVENTS:.
MAINTAINING EVENTS:
FUNCTION:
Description of Target Behavior
Should Provide a specific, observable, operational definition. Providing examples and
non-examples is required unless exception approved by instructor. Passes the dead mans test
Conjoint Needs Analysis Interview
raw interview with script of questions and answers are turned in, includes goals set, and
questions about agreement on hypothesis etc) and planning for intervention, clearly based on
Appendix D and E in Sheridan book but may include other questions as well
Student:
School:
Interviewer:
Date:
Grade (or Age):
Respondent:
1.
Question 1?
Answer 1
2.
Question 2?
Answer 2 (include entire transcript)
Teacher:
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Description of Target Behavior
Should Provide a specific, observable, operational definition. Providing examples and
non-examples is required unless exception approved by instructor. Passes the dead mans test
Function of Behavior Hypothesis
Includes three-fold contingency — “when X occurs, the student does Y, in order to achieve Z”;
reflects observations and analysis above. Includes diagnostic code & citation based on the Cipani
systemg
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Problem Behavior Pathway
Can be single spaced. Should be on form, setting events, triggering antecedents, problem
behavior, maintaining consequences
Student:
Date:
Setting:
Time:
Observer:
Setting Events
Triggering
Antecedents
Problem Behavior
Maintaining
Consequences
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COMPETING BEHAVIOR PATHWAY
should include form, setting and with accommodations, antecedents and with accommodations, maintaining consequences reflect
function (can be single spaced) to use form double click on box and type
STUDENT:
SCHOOL:
DATE:
GRADE:
Desired Behavior(s)
TEACHER:
Maintaining Consequence(s)
(Setting Events)
Accommodations
Triggering Antecedents
Accommodations
Problem Behavior(s)
Maintaining Consequence(s)
Setting Events
Triggering Antecedents
Replacement
Behavior(s)
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Baseline Assessment
Primary Observer:
Setting:
Secondary Observer:
Dates:
collect at least 5 days of baseline date; inter-observer reliability with at least 80% agreement;
and a report that describes the setting and subject, behavioral definition, measurement procedure,
and results. Different days and data than what was in scatterplot and ABC data.
Measurement System
You must concisely define the measurement system you are using to assess behavior
change. Points can be taken off if you select an inappropriate measurement system (given the
target behavior and other information you provide). Include sample data collection forms.
Include IOA procedures.
Include table that gives raw data
Baseline Data
Date
Number of _____________
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Intervention Plan
Intervention: Antecedent Strategy
Describe the SD and MO modifications you are implementing and provide a justification
for doing so. Hint: Be sure it reflects the function of the behavior.
Intervention: Replacement Behavior
Describe the replacement behavior you are implementing and provide a justification for
doing so. Hint: Be sure it reflects the same function!
Intervention: Consequences
Describe the alterations of the consequences when the inappropriate behavior occurs.
Hint: Be sure it is a functionally sound and ethically appropriate recommendation that is likely to
implemented with fidelity.
Results (If you right click on a pc or control click on a mac, you can select edit data
and type in your data.
Dependent Variable Title
Chart Title
10
9
8
7
6
5
4
3
2
1
0
Baseline
Intervention
Name of Client
0
2
4
6
8
10
Axis Title (Usually Sessions or Date)
12
14
16
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You will lose points if you have not provided a graph that is consistent with ABA standards. You
need a graph that has both your baseline and intervention data. Then write a description of the
data that includes baseline, intervention, IOA, treatment fidelity, etc. Note: IOA calculation
should be provided (not just the overall IOA level).
Discussion
Overview and analysis (conclusions) of the results. What explanations do you have for the data.
What went well, what were challenges actually related to the data and the intervention? Where
di you get information to back your plan? (citations/references)
Conjoint Plan Evaluation Interview
Includes raw script of questions and answers, discusses results of interventions and changes that
should be made. Clearly based on appendix I & J in Sheridan book.
Student:
School:
Interviewer:
Date:
Grade (or Age):
Respondent:
Teacher:
1.
Question 1?
Answer 1
2.
Question 2?
Answer 2 (include entire transcript)
Final Reflection
Consultation wrapup overview
This is more a reflection of what you learned from the process. What went well, what
were challenges. What would you do differently in the future. What would next steps be?
FBA & CONSULTATION REPORT
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References
Include any references for intervention.