Student
Student #
Date of Birth
*What is the behavior of concern? (physical, verbal, fleeing, self-harm
etc)
*What are the student’s observable actions when in distress? (leaving,
pushing furniture, hitting, kicking etc)
*Frequency: How often does the behavior occur/happen? (2 x per hour,
3 x a day, 2 x per hour, 2 x a week, 1 x a month)
*Intensity: How intense is the behavior while it is happening? (mild,
moderate, severe)
*Duration: How long does the behavior last? (seconds, minutes, hours)
OR because of when/where they occur
*Place: Where does the behavior occur? (hallway, playground,
particular classroom)
*Time: When does the behavior occur? (before school, after lunch,
transitions, unstructured times in a.m. or p.m. etc)
Internal and external factors and/or events that occur prior to a student
demonstrating a problem behavior. Antecedents may increase the
likelihood of the problem behavior occurring.
What do you notice/observe prior to the problem behavior occurring?
EXTERNAL: People nearby (SEA, teachers, SEA etc), sensory input
(temperature, noise, smell, crowds), Are the demands of the
environment or expectations (academic and non-academic)
mismatched with the student’s coping abilities? (Frustration tolerance,
delayed gratification, language processing demands).
INTERNAL: Unmet basic needs (safety, hunger, lack of sleep, housing),
Executive functions (working memory, planning and organization,
behavioral regulation, emotional control, ability to switch tasks),
emotions (sadness, worry, fear, disappointment, shame etc),
psychological state (anxiety, depression, mood regulation problems),
Trauma (internal self-talk, sensory triggers), life stressors (fight in
neighborhood, social media), beliefs the student has about themselves
or the world.
Gender
Description of Problem
Behavior or Cluster of
Problem Behaviors in
Observable and
Measurable terms
(Frequency, intensity,
duration):
Antecedents:
Grade
School of Attendance
Often times a student struggles in one or more of these areas, which
can increase the probability of the problem behavior(s) occurring:
*Academic Skills: decoding, written expression, math computation.
*Social Skills: reading social cues, turn taking, initiating interactions,
navigating relationships.
*Emotional skills: coping with emotions
*Physical skills: Gross motor (running, kicking, jumping etc), Fine motor
(writing, zipping a jacket)
*Personal coping skills: Frustration tolerance, delayed gratification,
patience, waiting, and self-regulation, self-soothing behaviors,
successful transitioning.
*Communication skills: Self-advocacy skills, comprehending, and
expressing language.
*Executive functions: Starting, stopping, switching, shifting, sustaining,
planning and organizing.
Hypotheses about why the problem behavior occurs (based on
observation and data collection)
*To get something, To get away from something, To maintain or alter
one’s regulation (leaving class to walk when overwhelmed or bored,
head butting to gain sensory input)
*What purpose is the behavior serving? (To obtain status or social
recognition to escape embarrassment or anxiety)
*What is the meaning of the behavior? (To be noticed, to go unnoticed)
*What is the behavior trying to communicate? (to express emotions,
confusion, wanting to be done)
Behavior(s) the student can substitute to meet the same need or
purpose (“honor the function”) as the problem behavior.
*What are some acceptable behaviors (for the specific environment the
student is in) that can meet the same needs for the student?
Examples: Good one: Taps person on the shoulder instead of hitting
Bad one: sit quietly and wait…hitting works much better
EXAMPLES: Raising hand instead of blurting out, go to a quiet area
when recognizing escalation of feeling, use a break card instead of
getting up and walking out without permission, use appropriate words
to communicate feelings instead of hitting or yelling, assigning student
as a helper if they are doing attention seeking behaviors, if feeling the
need to spit take a drink or water or spit into a napkin or trash.
Student’s underlying skills
deficits causing the
behavior:
Function of the Problem
Behavior:
REPLACEMENT BEHAVIOR
(Replacement behavior
should meet the same
need(s) as the problem
behavior:
Proactive Strategies
Accommodations and interventions that can be used to reduce the
likelihood a student’s “problem behaviors” will occur. These strategies
support the likelihood of preferred or replacement behaviors occurring.
EXTERNAL: Natural lighting, fragrance-free environment, alternative
seating, reduced-noise, alternate transition times/ arrival times, hall
passing, departure, etc.
INTERNAL: Fidgets, check-in with trusted adult, food, rest, time,
personal space.
Skills to be taught to the student that he/she needs to be successful in
settings, activities, and/or events in which the “problem behavior” is
occurring.
*Communication Skills: Indicate when a break is needed (break pass,
verbal request, etc)
*Social Skills: Ask a peer to play, join a group activity, ask questions,
share attention, conflict resolution, etc.
*Emotional Skills: Managing frustration, anger etc, delaying
gratification, anxiety reduction, moderating mood, expressing emotions
in a preferred way etc.
*Coping Skills: Relaxation techniques, self-talk, taking a break, meeting
regulation needs etc.
*Self-Advocacy Skills: Requesting assistance, communicating individual
accommodation needs, relationship repair etc.
Antecedent Strategies:
The consequences (what happens after the replacement behaviors
occur) and strategies used to reinforce the replacement behaviors that
are meaningful to the student.
These may be: Tangible (stickers), Verbal (recognition), Token (Points),
Symbolic (Student of the month)
Strategies to reinforce
replacement behavior:
Skill Teaching Strategies:
Reactive Strategies
What would be helpful in addressing the problem after it occurs?
(Interventions to prevent problem behaviors from occurring and
support occurrence of replacement behaviors)
Strategies to address
problem behavior after it
occurs:
(Interventions implemented immediately following a student
demonstrating the problem behavior)