FUNCTIONAL ASSESSMENT/BEHAVIOR INTERVENTION PLAN
SUMMARY FORM
Student: Joshua (JJ) Floyd Larson II
Date: March 29, 2014
School: (Homebound Instruction (Hale Intermediate –previously)
Grade: 4th
Person Completing Report:
Participants in Developing Plan:
Sources of Information Employed for this Functional Assessment:
Record Review including the following: Joshua’s Developmental and Social History
completed by Judy Larson (11/24/10), IEP’s (Jonestown 11/15/13, 8/27/13, 3/20/13,
02/15/13 –Move In, 03/28/12, 02/17/11 and Kane Township 01/13/13); FBA’s and BIPs
(1st grade, 02/11/14); Teacher Interviews/Input (Ms. Jennifer Hendricks, 02/11/14; Ms.
Cheryl Cooper 01/31/14) ; Parent Input (01/29/14)Student Discipline
Reports/Summaries11/08/13, 11/07/13, 11/06/13, 11/01/13, 10/31/13, 10/29/13,
09/06/13, 09/04/13, 09/03/13, 08/28/13, 08/27/13, 08/26/13, 08/23/13, 08/21/13,
08/19/13, 09/19/12, 05/18/12, 05/17/12, 05/07/12, 05/3/12, 04/17/20, 03/14/12, 03/08/12,
12/01/11, 11/30/11, 11/15/11, 11/02/11, 11/01/1111/22/10, 11/19/10, 11/12/10, 11/09/10,
11/08/10, 11/01/10, 10/29/10, 10/27/10, 10/26/10, 10/25/10, 10/20/10, 10/18/10,
10/13/10, 10/18/10, 10/07/10, 10/06/10, 10/04/10, 09/30/10, 09/29/13, 09/23/10,
09/21/10, 09/20/10, 09/17/10, 09/16/10, 09/08/10, 09/3/10 ; Power School Log Entries
08/30/10 to 11/11/13Entries for Jay Larson and Judy Larson 2013-2014 School Year
document, Meeting Attendance from 08/15/12 to 06/07/13 and 08/14/13 to 12/20/13;
Letter from Ms. Christine L Jahn, MSW.LSW, therapist at Cummins Behavioral Health
Systems, Inc related to Jay’s behavioral incident and their evaluation of 05/08/2012,
Results of Vision Screening 12/2010; School Based Occupational Therapy Evaluation,
01/25/11; Psychoeducational Evaluation Results, 01/25/11, 02/27/14, Wabash Valley
Alliance Diagnostic Report, 02/11/14.
Naturalistic Observation of Jay’s previous class at Hale Intermediate School,; Interviews
with Ms. Kennedy (principal at Hale Intermediate School), Ms. Jennifer Hendricks
(teacher at Hale Intermediate School), Mr. Rex Raines (principal at Jefferson Elementary
School) Judy Larson (Jay’s mother ) and Joshua (Jay) Larson (03/07/14).
FUNCTIONAL ASSESSMENT
1
Target Behavior(s) (Complete steps 1-14 for each target behavior specified):
1.
Provide a description of the target behavior(s) of concern including data on
intensity, frequency, and duration of the behavior.
Physical Aggression – Jay engages in motor behavior that threatens to harm or
harms himself or others. Physical Aggression does not include verbal threats
unless Jay displays both the intent and the ability to act immediately upon those
threats.
A review of the record suggests that Jay has had difficulty with aggressive
displays of behavior since first enrolling in school. He is reported to display
minor aggressive acts (e.g., pushing others) several times weekly. He displays
more serious aggressive acts (hitting, kicking, etc) at a level resulting in an office
referral several times each month.
Verbal Aggression – Jay engages in vocal or verbal behavior that threatens
himself or others, uses emotionally hurtful comments, and/or engages in behavior
that includes screaming or yelling at others.
Like physical aggression, this behavior has been a long standing problem for JJ.
He engages in this type of behavior 2-7 times a week based upon teacher report
and the existing school record.
Non-Compliance – Jay fails to initiate a requested action or activity within 30
seconds of being asked. Compliance relates to the initiation of an activity – not
the successful completion of that activity – that would be work completion.
The school record repeatedly identifies this as a high frequency problem behavior,
however, no specific baseline data was included in the student record. Baseline
behavior should be collected within the homebound instructional sessions if it
does not exist in the teacher’s existing data for this student.
2.
What is the presumed purpose of this behavior?
Physical Aggression – Based upon the school records (Teacher Input Ms.
Hendricks (02/11/14, 03/07/14; Parental Input (01/29/14), and multiple incident
reports found in the student record, the function of Jay’s aggressive behavior
appears to serve the function of escape and avoidance.
Verbal Aggression - Jay’s verbal aggression also appears to serve the function
of escape and avoidance [Parental input (01/29/14), Teacher Input- Ms. Hendricks
(02/11/14; 03/07/14), Ms. Cooper (01/31/14); and behavioral incident reports in
record.]
2
Non-Compliance – Jay’s non-compliance is hypothesized to serve the primary
function of escape and avoidance based upon Teacher Input – Ms. Hendricks
(02/11/14, 03/07/14), Mr. Ryker (03/07/14), and Ms. Cooper (01/31/14).
As all three behaviors appear to serve the same primary function of escape and
avoidance they can be addressed as a behavioral class; benefiting from similar
intervention strategies. Indeed, these can behaviors are often seen to occur
together when Jay becomes upset.
While escape and avoidance are the functions of the behaviors they are not
directly tied to the need that is not being adequately addressed. Humans do not
have a need to escape or avoid. These behaviors are reactions to a failure to meet
other basic human needs. Typically, escape and avoidance occur when an
individual’s need for safety, competence/success/self-esteem, and/or autonomy
are threatened. When Jay feels fearful, frustrated or that he is being denied his
ability to make a choice he engages in one or more of the target behaviors.
3.
A description of the setting in which the behavior(s) occur (e.g., physical
setting, time of day, persons involved).
The target behaviors occur in all settings and can occur at any time of day. Jay
has demonstrated physical and verbal aggression towards both adults and peers
(and on rare occasions towards himself)..
His mother indicates that he has more difficulty with his sister than with his
brothers. She reports he can become aggressive at home and in the community
when angered. Compliance can be a challenge at home and at school.
Jay reports that he can become upset easily if he is tired.
4.
Described the observed antecedents of the behavior(s).
Jay is sensitive to messages of failure or incompetence – thus he can become
upset if reprimanded too frequently or in what he believes is a harsh tone. When
confronted with work he does not feel comfortable that he will be successful – he
often fails to engage in the assigned task. If pressured to comply he can become
verbally or physically aggressive. Social situations with peers in which he feels
fearful, or feels he is being made fun of or social situations that present social
problems beyond his skill level to address successfully can also lead to verbal or
physical aggression.
Transitions from one task to another can be stressful for Jay. He will likely be
reluctant to exit a task he enjoys and in which he is successful to start a less
desirable task.
3
Any attempt to engage Jay physically is almost guaranteed to trigger a threat to
his safety needs – resulting in a fear reaction. Movement towards JAYat times
when he is fearful will likely result in a fight or flight reaction.
5.
Describe the consequences of the behavior(s).
According to school records [and supported by interview with Ms. Hendricks
(03/07/14)] the following behavior plan was in place at Hale Intermediate School:
“Jay will receive classroom money for the work (both homework and class work)
he has completed, demonstrating good choices and character traits (honesty,
caring, helping others, sharing, etc.). Jay will be charged a fine for inappropriate
behaviors, failure to comply with classroom rules.
Jay is provided three warnings for inappropriate behavior. He may Take Five
(timeout, regrouping opportunity) at his choice or be asked to do so by an adult.
After three warnings Jay will go to the Hot Seat1.
Jay will go immediately to the Hot Seat for making threats, calling names, or
using inappropriate language.
Jay will go immediately to the Quiet Room2 should he become a danger to
himself or to others. Crisis team may be called, holds may be used as warranted
to keep student safe. Parents are notified when Jay goes to the Quiet Room via
email.”
6.
Describe any other environmental conditions that may affect the behavior(s)
(e.g., medication, medical conditions, lack of sleep, diet, temperature,
crowding, social factors).
Jay has multiple co-morbid mental health disorders: Attention Deficit DisorderHyperactive Type (ADHD), Mood Disorder: Not Otherwise Specified, and
Oppositional Defiant Behavior. These mental health disorders are exacerbated by
psychosocial and environmental stressors.
1
Hot seat is a desk located at the back of the classroom. Students use the Hot Seat when a Take Five (time
out, regrouping opportunity) has failed, received three warnings, or has become disruptive and not
responded to redirections. A student in the Hot Seat receives instruction from the teacher or aide and is
provided all the same assignments as the class. The student loses the privileges of being able to get up and
move around the room, turn in their own work, or have their personal possessions in the Hot Seat desk.
Students are allowed to earn their way out of the Hot Seat by completing work according to the
redirections, being quiet and respectful and staying in the seat. [Description provided in Student Record.]
2
The Quiet Room is a resource for students who have become violent or extremely disruptive. Students
will be escorted to the Quiet Room by teacher, aide or crisis team members. Once in the Quiet Room and
student is calm, the teacher and the student will discuss a plan to re-enter the scheduled activities. The
student is monitored at all times while in the Quiet Room. [Description provided in Student Record.]
4
Jay was discharged from Cummins Behavioral Health Systems as of 10/28/13 and
was without medication for an extended period of time (including the time of the
November 8, 2013 incident). He had been on the following medication regimen:
Concerta (36 mg/day)
Risperidone (not specified)
Clonidine (.3 mg/day
Ms. Larson reports Jay has problems sleeping and Jay indicates that he has more
problems at school when he is tired.
The family has moved frequently and at times have been in situations where basic
needs have not been able to be met in the home (e.g., having to provide showers
and the laundering of clothing at the school three times a week for JJ), Breakfast
and lunch were provided for Jay at the school.
Jay’s previous IEP called for called for his placement to be in a ‘special education
resource room all day except for specials and lunch. The ‘multi-categorical
classroom’ at Hale Intermediate School serves 21 students. Thus, the class
resembles a general education classroom in size and serves both 4th and 5th
graders. The class also serves as the school’s in-school suspension center. Thus,
the class likely was simply too crowded and posed too many demands upon the
teacher to adequately provide for Jay’s need for a full-time special education
program.
7.
A description of environmental modifications and behavioral interventions
previously attempted.
[See # 5 above.]
Nicholson Elementary School had employed a ‘clip system’. “Jay will follow a
clip up/clip down system in the classroom. He will start on green and can move
up to blue and then to purple if he is doing a good job. He will be rewarded with
a sticker for every 30 minutes that he is on one of these colors. For every 5
stickers he will be able to pick a small prize (pencil, sticker, eraser, etc.) for every
25 stickers he will be able to select a big prize (game, computer time, lunch in the
classroom, etc).
If he is not following the rules, he will move his clip down: yellow – take a break
(he can use strategies to calm down during this time), orange – take a break (with
Miss Penny or Miss Amber if available), pink – phone call home, red – write up
and/or visit to principal’s office.
The safety team will be called in any situation where Jay is a threat to himself or
others. The safe room will only be used if Jay is hurting himself or others. His
parents will be contacted if this happens.
5
During the short time Jay was at Pleasant Hill Elementary School in the
Montgomery School Corporation, the behavior program consisted of :
“Jay will use an independent behavior system on a clipboard, tailored to his target
behaviors. Jay’s day will be broken down into timed segments with built in
rewards four times daily. Jay will earn the privilege to attend specials, lunch, and
recess with his third grade peers. His behavior will be safe, compliant and
respectful towards his peers, self, and staff.
If Jay’s behavior becomes non-compliant, refuses to complete class work or he
demonstrates behaviors which do not comply with classroom or school rules, then
Jay will call his mother and speak with her to assist with his transition back to
class work and following procedures. ….Additional coping strategies: If Jay
becomes upset within the classroom, he will be offered the following coping
strategies: listening to music, drawing/writing for a specific amount of time or
using his Beanie Baby.
If Jay is offered his coping strategies but his behavior becomes unsafe to self,
staff, and students, then the safety team will be called and the team will follow
their safety procedures to keep JJ, peers, and staff safe. A report will be
completed by staff and parents will be contacted.
8.
What strengths does the student have that could be used to help with
this(these) behavior(s)?
Jay is generally a very likable student. He can be very pleasant and typically
wants to please. He is very responsive to praise and messages of success. He has
average or above average ability and has a history of doing well academically.
He has a number of interests including video games and computer. He enjoys
successfully solving challenging math problems and values success following a
challenge.
9.
What non-restrictive interventions should be planned?
Given the combination of mental health concerns, Jay will require coordinated
services that would likely include medication, behavioral and cognitive behavioral
intervention within the school and the community, and strong family support
(again calling for coordinated school and community services).
Employing coercive and punitive consequences for behaviors linked to ADHD
have been identified as adding to the risk for students to display Oppositional
Defiant Disorder. Jay has been diagnosed as co-morbid for both of these
disorders. Additionally, Jay has a mood disorder. The use of punishment in
hopes of ‘teaching’ a student like Jay is contraindicated. You will not punish Jay
out of his undesired behavior; rather you will cause him to become more
dysfunctional, angry, and aggressive. That is not to say there will not be
consequences for the display of undesired behaviors – only that these will not be
6
particularly helpful in making any real change. Overall, the ratio of praise to
reprimand must be heavily weighted towards praise.
Any effective effort to promote improved self-regulation and display of pro-social
behavior will require direct instruction of desired behavior and frequent positive
feedback and reinforcement in an effort to ‘trap’ Jay into doing well. To this end,
Jay’s behavior intervention plan will involve the following:
A. There is a need to intensify the positive reinforcement of desired behavior.
Jay will be provided a This involves a laminated sheet (or multiple paper
copies) that lists two or three key behaviors that you want to increase and/or
strengthen (see Figure 1). These behaviors are written in language that
resembles the inner speech you would like Jay to use to self-regulate his own
behavior. You then simply provide positive feedback/reinforcement
frequently during instruction (initially every 3-5 minutes). If the student is
displaying the desired behavior, you make a check or star on the paper. If not,
leave the area blank. Only comment on what he is doing correctly. Try to
have one of the behaviors one that the student is likely to be displaying so you
will always have a strong likelihood of providing some level of reinforcement.
Figure 1 – Sample Check Sheet – could be laminated or new sheet each day – task or
period can be delineated if desired
Math Class
I stayed in my seat.
I am doing my work.
I am following directions.
I am using kind words and
actions
Bonus Points
Moved to ‘safe place ‘
When he became upset
Used his emotion chart
and took a break when
upset.
The number of stars earned for each behavior can then be graphed with Jay
once or twice a day as a means to help him see how his behavior is improving.
Use a cumulative graph (see Figure 2) as this will always depict improvement
(or at least no drop in performance). The goal is to encourage growth.
7
Figure 2. Sample Cumulative Graph
200
175
150
In Seat
125
Doing My Work
100
Following Directions
75
Kind Words and Actions
50
25
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
It will be determined by the team if back-up reinforcers are needed and what
these reinforcers would involve to support behavior change and Jay’s desire to
gain points. Whenever possible, having him earn activities with staff or peers
should be considered as this provides a way to teach, practice, and provide
feedback and reinforcement for social behavior and helps to build
relationships with others. Jay could select a reinforcer from a menu provided
whenever he earns a set number of points.
B. Use care in the ‘strategic use of self’ when working with Jay. Your level of
enthusiasm, frustration and anger will likely trigger responses in Jay. Try to
minimize attention and emotional responses to undesired behavior – react in a
planned, predictable businesslike manner. Be very enthusiastic when
presenting material and reinforcing desired responses.
C. Time out as a consequence for an undesirable behavior makes the assumption
the student has the knowledge and skill to respond to a conflictual situation
and is simple selecting not to do so. Thus, presenting a punitive response
may make him think twice about selecting the undesired response. I am not
at all confident that Jay has the knowledge, skill or the ability to self-regulate
his behavior when he becomes upset. He needs to be directly taught social
problem solving skills, and anger management strategies to deal more
effectively with his emotions. This is a process of instruction with the need
for considerable practice and positive feedback as he begins to display
improved behavior.
a. Jay will be provided direct instruction in social skills, social problem
solving, and anger management (e.g., Skill Streaming, Coping Cats,
Second Step, etc).
b. Emotion Recognition – Provide Jay with a laminated chart depicting
him displaying a series of emotions moving being calm to be very
upset. Next to each image is a label for the emotional state and a set
of possible strategies that he could select to employ to address his
8
emotional state. Across the day, he will be asked to identify where he
is emotionally. When he begins to become upset, he will be
prompted to identify where he is emotionally and prompted to employ
one of the strategies listed. See Figure 3.
Figure 3. Emotion Management Chart
Strategies
Go see ___________
Go to my ‘safe place’
Ask to call home
Take a break – cool down area
Ask to talk with ___________
Use Peace Path with peer
Ask to take a break
Take 7 deep breaths
Tell myself I can deal with _____
Smile and keep going
Tell myself –“Good job!”
Be rally proud of myself.
Do something I really like to reward
myself for good work
This could actually
employ photographs
of Jay displaying
different emotions.
The team will identify meaningful strategies for each level.
 Develop a ‘break card’ that Jay can use to signal his need
for a break and identify what actions Jay can engage in
while on break. For example, he can go to the back of the
class and look at a book, listen to music with earphones, get
a drink of water from his water bottle, etc. Breaks should be
for a specified period of time (e.g., 3-5 minutes. The team
can select if he can extend a break by 1-2 minutes. No
points are earned while on a break. [Note: Initially, you
may want to provide bonus points for his selecting to take a
break when needed rather than getting upset – also for
returning to work immediately when the break was over.]
 Consider the identification of a ‘safe place’ both within and
outside near the classroom that Jay can move to if upset that
will allow him to feel safe and not pose a problem for
others. This area should be accessible to him when upset
without gaining permission to go there. During those times
he is in the ‘safe place’ he is left alone to cool down. He
does not get any significant attention and he does not earn
points while in either of these areas. [Note: Initially, he main
gain bonus points for using the safe place rather than acting
out.]
9



Identify a counselor or mentor – someone he can go to talk
if he becomes angry. Again, he does not earn points when
engaged in talking with this person – but he has access when
needed.
Provide a mentor for Jay– someone who he can visit with
for 10-15 minutes each day at school who can provide him
unconditional support and acceptance. Typically, that
should be someone who is not currently assigned to act as
his teacher or who currently provides any services that
require Jay to complete work, etc.
If a time out procedure is deemed necessary, it should be a
different location than the cool down area or ‘safe place’ if
possible. The length of the time out should be short (the
amount of time he needs to sit there once he has stopped the
undesired behavior). A log will be kept to identify the
nature of the activity when the behavior became
problematic, the specific nature of the behavior displayed,
efforts to redirect positively, and the duration of the timeout.
c. The classroom could adopt a structured program to provide cognitive
behavioral instruction and practice related to social problem solving.
For example, some schools employ a Peace Path system. When two
students become engaged in a conflict or one student aggresses
against another – both students are directed to move through the steps
of the Peace Path (see Figure 4.) Whenever a social problem arises
between two students, they each go to the path and stand facing one
another moving down the path as they examine their actions and
resulting feelings and then brainstorm solutions to their problem.
Students can do this on their own or as a consequence for problem
behavior.
Figure 4. Peace Path Diagram
10
D. A differential reinforcement for low rate behaviors (DRL) procedure will be
used to address talk outs. This can be set up as a class-wide program or as a
Hero-system. In the Class-wide program you would take baseline data on the
average number of times any student talks-out during a specified period (e.g.
30 minute interval).. In the Hero-system you determine how many times Jay
talks out on average in a specified interval.





Divide your school day into reasonable intervals (e.g., 30 minute
intervals). Take a couple of day’s worth of baseline data to determine on
average how many times the students (as a group) display each target
behavior in 30 minutes.
Place a number of marks slightly larger than the average determined
during baseline on the board (I think Class Dojo can be configured to do
this).
Any time any student displays the target behavior a point is removed if
using the Class-wide system. If using the Hero-system, you remove a
mark when Jay talk outs..
If any points (even 1) remains at the end of the interval, the class as a
whole is reinforced. For example, have had classes earn letters to spell
‘game’ or perhaps a vocabulary word for the week. When they have
earned all the necessary letters – the group gets to select an academic
game from a menu you provide.
As behavior begins to improve (more marks left at the end of intervals, the
interval can be lengthened or the number of marks provided at the start
reduced. Always keep the number somewhat larger than the current
average of display of the behavior(s) targeted for change.
Figure 5. Sample DRL chart
E. Efforts should be made to ‘trap’ JAYinto school success. Fortunately, his
ability level academically allows him to do well in most subjects. He does not
like to write and his fluency level in reading and math are somewhat below
11
expectations. Care should be taken to ensure the work assigned will result in
at least an 80% level of correct responding.
Perhaps Jay could be provided the opportunity to serve as a tutor for younger
students allowing him to assist in reading to them or helping them with their
math facts drill. This will provide him with leadership opportunities and
increased drill and practice to improve his own fluency in these areas.
10.
What restrictive or highly restrictive interventions should be planned?
If Jay engages in behavior that threatens immediate serious harm to self or others
efforts will be made to engage him in strategies to promote self-regulation from
his behavior intervention plan (e.g., recognize his emotional state, select an
socially appropriate calming strategy, etc), staff will employ assertive crisis
communication (using a calm voice indicate their desire to promote his success
and to offer two meaningful and positive alternative behaviors/actions for him to
take (e.g., Jay, I want you to be successful in this writing assignment. We can sit
and work on this together or we can walk down the Hendricks get a drink and
then come back and do something similar to what we did yesterday for journal”)
Note: you are looking for a win/win – he gets the chance to demonstrate some
autonomy – choice and you get him to write – what you wanted to start with. You
also reduce the threat and frustration in the situation by remaining calm and not
resulting to threats of consequences (curriculum of control). Physical restraint
may be used. If so, individuals involved will be properly trained in both verbal
de-escalation strategies and physical restraint. Staff must possess up to date
certification. Remember restraint is an option not a requirement and its use
should be carefully weighed against risk of injury within the restraint.
The U.S. Department of Education has established guidelines for the use of
seclusion and restraint that clearly indicate seclusion and restraint can not be
used as punishment or as a consequence for an undesired behavior. Rather these
procedures can only be used when that student’s behavior becomes presents an
immediate risk of serious injury to the student or others.
Schools have found it useful to use the following charts to help teachers and staff
identify appropriate levels of intervention when a student’s behavior begins to
escalate
12
Figure 6. Level of Dangerousness for Student Behavior
The injury is or would likely
NOT be serious (require
immediate medical attention)
Student behavior involves a
threat.
Student behavior involves a
physical attempt or actually
makes contact.
The injury is or would likely
be SERIOUS and require
immediate medical attention
Simple Assault
Aggravated Assault
Assault & Battery
The level of restrictiveness employed in our response to student behavior should
be guided by nature of danger posed to the student and others. Options for
response expand as the student’s behavior becomes more dangerous. Staff should
never use more force than is necessary to promote safety. The chart below can
serve as a guide to identify those intervention options that meet the level of threat
presented by the student (See Figure 7).
A crisis team should be identified and a crisis plan developed that will provide
staff who are certified in the verbal de-escalation of the crisis situation and to
employ evasion and/or manual restraint as warranted by the level of danger
displayed by Jay in the moment. There also needs to be a plan to evacuate other
students when needed, providing a place (e.g. the learning center) and level of
supervision to maintain their safety if the classroom would need to be evacuated.
13
Figure 7. Restrictiveness of Intervention Matched to Level of Danger
Challenging
Behavior
Simple
Assault
Assault &
Battery
Aggravated
Assault
11.
Student
Behavior
Intervention
Plan /BackUp Plans
Student
Behavior
Intervention
Plan /BackUp Plans
Student
Behavior
Intervention
Plan /BackUp Plans
Student
Behavior
Intervention
Plan /BackUp Plans
Crisis
Communication
Crisis
Communication
Evasion
Crisis
Communication
Evasion
and possibly
Manual
Restraint
Who will be responsible for implementing this plan?
This will be completed at the case conference.
12.
Who is responsible for monitoring this plan?
This will be completed at the case conference.
13.
Who will receive a copy of this plan?
This will be completed at the case conference
14.
Monitoring:
The team will monitor both the integrity of the implementation of the behavior
intervention plan as well as the effectiveness of the plan to have the desired
impact upon Jay’s behavior and self-regulation. A 30 minute probe data
collection session should be conducted at least once a week to identify
implementation integrity and Jay’s use of program components.
14
Expected Behavior Changes
Given a situation in which Jay
begins to display anger or
distress, he will with prompting
identify his emotional state and
select a pro-social strategy (e.g.,
ask for a break, move to cool
down or his safe place, etc)
without becoming verbally or
physically aggressive 9 out of 10
trials for 4 consecutive weeks.
Given a request by a teacher or
responsible adult, Jay will initiate
the requested action or task
within 30 seconds of the request
a minimum of 8 out of 10 trials
for 4 consecutive weeks
15.
Methods/Criteria for Outcome
Measurement
Data related to verbal and/or
physical aggression will be
collected on an event basis every
time either behavior is displayed.
Probe data (e.g., 30 minute probe)
will be collected at least once a
week related to Jay’s use of the
emotion management chart and
selection of appropriate strategies
to address his emotional state.
Data on compliance will be
collected using probe data
collection for a minimum of 30
minutes per week.
Schedule of Outcome Review
The team will explore the
effectiveness of the intervention
approximately 6 weeks after
implementation and will monitor
results at least weekly.
The team will explore the
effectiveness of the intervention
approximately 6 weeks after
implementation and will monitor
results at least weekly.
Sample Data Collection Materials:
The Behavioral Check Sheets identified in the behavior plan will serve as on
critical source of data. Over time we should see a significant increase in the
display of desired behavior. Since aggression can be a dangerous and/or
destructive behavior, data will be collected on a continuous basis each day. These
data will identify the following:
Student: Jay Larson
Date: _______________
Antecedents
Identify task or activity and the events that
led up to the aggressive act.
Behavior
Hit
Kick
Throw
Other
Describe
Consequence
Verbal
Aggression
Each episode of aggression should be identified on a single line. Thus, he could display
hitting, kicking, and verbal aggression in one episode.
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Probe Data Sheet
Date_______________ Time: _________ Task: ______________________________
Person Collecting the Data: ________________________________________________
Program Implementation
Check if observed
The assigned task is one for which Jay appears to have the knowledge and
skill to complete with at least 80% correct responding?
Jay is provided social skill, social problem solving and/or anger
management instruction (direct instruction)?
The emotion management chart is present and Jay is being prompted to
use it across the day to identify his emotional state?
There are opportunities provided for Jay to engage in social problem
solving strategies to promote self-regulation (e.g., Peace Path)?
Ratio of Praise to Reprimand (Provide a mark for each of the following delivered to Jay during the probe data
collection session.)
Verbal Praise for Behavior
Verbal Praise for Academics
Verbal Reprimand for Behavior
Academic Correction
Teacher and staff provided correction (reprimand, etc) in a calm and
respectful manner?
Academic Participation (These data explore Jay’s academic engagement and involvement within the lesson.)
Opportunity to Respond
Jay Volunteers
Jay Called Upon
Jay Calls out Response
Jay Provides Correct Response
Teacher Response
1 = No Response, 2 = Verbal Praise, 3 = Verbal Reprimand, 4 = Provided support to answer correctly, 5 = Other _______________
Compliance: (Check each box that applies related to each request made of Jay during the probe observation.)
Jay is provided a request or mand
Jay Complies
Jay ignores the request
Jay actively resists
Consequence
1 = No Response, 2 = Verbal Praise, 3 = Verbal Reprimand, 4 = Other _______________________________________
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16.
Who/how will this plan be coordinated with the student’s parent(s)?
To be completed at the case conference.
17.
The Behavior Intervention Plan and a copy of procedural safeguards and
behavior intervention policy has been given ____ sent ____ to the parents by
______________________________________ on ___/____/____.
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Direct Behavior Intervention Plan
Current Undesired Behavior:
Physical Aggression and/or Verbal Aggression
Expected Behavior:
Jay will identify his emotional state and select an appropriate prosocial response to address his needs from a list of strategies he and
the team have developed.
Student Displays the Desired Behavior
Yes
Response:
 The staff will provide feedback in the form of
verbal praise and the delivery of stars on his
behavior chart frequently across each period
for the display of desired social behavior
(e.g., use of kind words and actions).
 If Jay engages in a pro-social strategy when
upset, he will be provided bonus points
(initially) for displaying a good choice.
Promotion of Success: (This includes efforts to
bring level of instruction and opportunities to
respond to the student’s level)
 Care to match instruction to Jay’s knowledge
and skills to promote success.
 The direct instruction of social skills, social
problem solving, and/or anger management
curricula.
 Implementation of a behavior check system
to reinforce desired behavior frequently
throughout the day.
 Develop an emotion recognition chart with
strategies identified to address emotional
state. Teach Jay how to use it.
 Peace Path or other CBI system for social
problem solving
No
Response:
 Jay will be prompted to identify his emotional state using
emotion management chart and to select an appropriate
calming strategy.
 Jay will be allowed to move to his ‘safe place’ or to seek a
designated person with whom he can speak to when upset.
 Jay will be prompted to employ his cool down area or
‘safe place’.
 Jay will be asked to take a short time out.
 If Jay escalates to aggressive behavior crisis
communication and evasion will be implemented.
 If serious injury is immediately threatened manual
restraint may be an option
Prevention Efforts: (This includes efforts to alter the
environment, change in teacher behavior, etc.)
 Efforts to employ instructional consequences versus the
use of punishment to alter Jay’s behavior.
 Approach Jay in a calm and respectful manner when
addressing behavioral errors and undesired behavior.
 Embed numerous opportunities for Jay to practice the
social skills and social problem solving skills being
taught.
 Provide Jay the opportunity to serve as a tutor for younger
students to help boost his self-esteem and to help develop
math and reading fluency.
 Structure reinforcers to capitalize on interactive activities
that include staff and peers interacting with Jay.
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