Behavior Analyst Referral Checklist
Please check that you have completed all of the following items prior to
sending a Behavior Analyst Referral form.
Item 1:
 Identify target behavior(s) that needs to be addressed (e.g., inappropriate
language, aggression, calling out, etc.).
Item 2:
 Collect data for at least 1 week on the behavior (e.g., tally the frequency,
duration measure, etc.)
o If the behavior results in harm to the student or others alert the
Behavior Analyst immediately. If not, follow the remainder of the
checklist.
Item 3:
 Collect ABC data or Scatterplot data for at least 1 week
Item 4:
 Refer the student to the Child Study Team
o The team should develop a behavioral intervention strategy
o The behavior analyst can attend and consult with the Child Study
Team if requested.
Item 5:
 Collect data for at least 1 week using the strategies proposed at Child Study.
If little or no improvement is observed or if the behavior deteriorates further,
complete the Behavior Analyst Referral Form and send to the Special
Education Office.