FAIR Behavior Intervention Plan
Name
Date
Targeted Behaviors
(use measurable definitions
only)
Warning Signs
(list behavior clues that
indicate the student’s
behavior may be escalating)
F
Functional Hypothesis
(Document all instances of targeted behaviors using ABC data sheet (minimum of 10 incidents)
What is the functional hypothesis, according to ABC notes (can check more than one)?
◊ Escape
◊ Tangible
◊ Attention
◊ Sensory
A
Accommodations
Environmental
Executive Functioning
I
R
Curriculum
Replacement Behaviors
Underdeveloped Skill Development
Self-regulation and Self-monitoring
Interaction Strategies
Response Strategies
Bonus points assigned for the following strategies/skill practice:
1.
____________________________________________
2. ____________________________________________
3. ____________________________________________
4. ____________________________________________
Data Collection
List the target behaviors on which you will collect, or will continue to collect, data, and list which data sheets you will be
using:
Also list timeline and review dates, including benchmarks and timelines for reviewing the FAIR Intervention Plan.
Implementation Checklist
On a separate worksheet, create a corresponding implementation checklist.
FAIR PLAN COLLABORATION
Please list all involved team members and their roles in implementing the plan:
Staff
Role
Staff
Role
Staff
Role
Staff
Role
Staff
Role
SIGNATURES
__________________________________________
______________________
Staff Signature
Date
__________________________________________
______________________
Parent/Guardian Signature
Date