Worksheet for using reports from Positive Behavior Support Surveys Website (www.pbsurveys.org) to action plan
based on Effective Behavior Support (EBS) Self Assessment Survey results
1
Introduction
The EBS Survey is used by school staff for initial and annual assessment of effective behavior support systems in their school. The survey examines the status and need
for improvement of three behavior support systems: (a) school-wide discipline, (b) non-classroom management systems, and (c) systems for individuals students engaging in
chronic behaviors. The Self-Assessment Survey examines the current status and need for improvement of four behavior support systems: (a) school-wide discipline systems, (b)
non-classroom management systems (e.g., cafeteria, hallway, playground), (c) classroom management systems, and (d) systems for individual students engaging in chronic
problem behaviors. Each question in the survey relates to one of the four systems. Survey results are summarized and used to develop an action plan for implementing and
sustaining effective behavioral support systems throughout the school.
Who completes the survey?
Initially, the entire staff in a school completes the EBS
Survey. In subsequent years and as an on-going assessment
and planning tool, the EBS Survey can be completed in
several ways: · All staff at a staff meeting. · Individuals from
a representative group. · Team member-led focus group.
When and how often should the survey be completed?
Since survey results are used for decision making and
designing an annual action plan in the area for effective
behavior support, most schools have staff complete the
survey at the end or the beginning of the school year.
Individual Summaries
Analyzing the Survey Results.
There several charts that you can print from the
PBS Surveys website (http://www.pbssurveys.org).
These include Individual Summary Charts and
Analysis of School-Wide Systems.
Sample Individual Summary Charts for School-wide
This report is grouped by survey dates (most recent first), then by
survey. For each self-assessment system (school-wide, nonclassroom,
classroom, and individual), it displays a table with the percentage of
respondents who answered "In Place", "Partially In Place", and "Not In
Place" for current status and "High", "Medium", and "Low" for
improvement priority. Bar charts of these figures can be displayed for
each survey.
Analysis of School-Wide System
Shows a chart with bars for percent In Place, Partially In Place, and Not In Place for
each of the elements below for each year, plus the implementation average for each
year:

Expectations defined (question 1)

Expectations taught (question 2)

Reward system (question 3)

Violations system (question 4-8)

Monitoring (question 10-12)

Management (question 9, 14-16)

District support (question 17-18)
Sample Analysis of School-Wide System Charts
Self Assessment Survey: Summary
School: ________________________________________
Date: ____ / ____ / ____
School: ______________________________________________
2
Date: _________________
Step 1: Review your school’s Individual Summary charts. Use this information to complete the section below…
System
Established?
Priority?
( > 66% respondents Identifying system as "In Place")
( > 50% respondents Identifying system as "High Priority")
Schoolwide
 Established
 Not Established
 High
 Not High
Nonclassroom
 Established
 Not Established
 High
 Not High
Classroom
 Established
 Not Established
 High
 Not High
Individual Student
 Established
 Not Established
 High
 Not High
What system should your school focus on during this year? Circle one of the above four systems. If Schoolwide is not established, your main goal
is to establish the Schoolwide system.
How will you communicate the importance of establishing the identified system to key stakeholders (other school staff, parents, etc.)
Who needs to know this information?
Who will communicate this information?
When will it be done?
Self Assessment Survey: Action Planning
School: ________________________________________
Date: ____ / ____ / ____
3
Step 2: Strengthening the Schoolwide System for Positive Behavior Support.
\
For every feature that is in needs of
improvement, check the item(s) that
needs improvement for that feature
Check features that
need improvement

Expectations
defined

A small number (e.g. 3-5) of positively &
clearly stated student expectations or
rules are defined.

Expectations
taught

Expected student behaviors are taught
directly.

Reward system

Expected student behaviors are rewarded
regularly.

Problem behaviors (failure to meet
expected student behaviors) are defined
clearly.

Consequences for problem behaviors are
defined clearly.

Distinctions between office v. classroom
managed problem behaviors are clear.

Options exist to allow classroom
instruction to continue when problem
behavior occurs.

Procedures are in place to address
emergency/dangerous situations.

Violations
system
How will this be improved?
Who will do it?
When will it
be done?
Self Assessment Survey: Action Planning
For every feature that is in needs of
improvement, check the item(s) that
needs improvement for that feature
Check features that
need improvement




School administrator is an active
participant on the behavior support team.

Data on problem behavior patterns are
collected and summarized within an ongoing system.

Patterns of student problem behavior are
reported to teams and faculty for active
decision-making on a regular basis (e.g.
monthly).

A team exists for behavior support
planning & problem solving.

Booster training activities for students
are developed, modified, & conducted
based on school data.

School-wide behavior support team has a
budget for (a) teaching students, (b) ongoing rewards, and (c) annual staff
planning.

All staff are involved directly and/or
indirectly in school-wide interventions.

The school team has access to on-going
training and support from district
personnel.

The school is required by the district to
report on the social climate, discipline
level or student behavior at least
annually.
Monitoring
Management
District support
School: ________________________________________
How will this be improved?
Date: ____ / ____ / ____
Who will do it?
4
When will it
be done?
Self Assessment Survey: Action Planning
School: ________________________________________
Date: ____ / ____ / ____
5
Step 3: Developing the additional systems to Schoolwide. Only focus resources on these other areas if the Schoolwide system has been
established. If schoolwide is not established- no need to complete this section.
For every feature that is in needs of
improvement, check the item(s) that
needs improvement for that feature
Check features that
need improvement



Non-Classroom

Define/teach routines

Supervisor booster training & feedback
sessions

Data management

Maintain team & communication cycle
with other school teams

Develop implementation plan

Define/teach routines/ link with school
wide rules

Classroom staff boosters & feedback
sessions for creating effective
strategies/materials

Data management

Maintain team & communication cycle
with other school teams

Develop implementation plan

Process for referral & support plan
design, implementation & monitoring

Plan to develop & use Functional
Behavioral Assessment to support skills

Data management

Maintain team & communication cycle
with other school teams
Classroom
Individual
Student

Develop implementation plan
How will this be improved?
Who will do it?
When will it
be done?