IEP teams can use this checklist to guide them through the process of conducting a
functional behavioral assessment and writing and implementing a positive behavioral
intervention plan.
Student: _______________________________________ Date: __________________________
Team leader: __________________________________ Grade: __________________________
Behavior(s) of concern: __________________________________________________________
Yes |
No |
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| 1. |
Is the student behavior of concern clearly defined? |
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| 2. |
Have replacement behaviors that serve the same function (or result in the
same outcome) for the student been identified, along with the circumstances under which
they should occur (e.g., when threatened by peer in hallway)? |
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| 3. |
Are multiple sources of information available that have been collected
from various individuals (e.g., teachers, parents, classmates, student)? At least two
separate indirect measures and multiple direct measures (e.g., ABC charts, scatterplots)
that capture multiple occurrences/non-occurrences of the behavior (and its context) should
be in agreement. |
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| 4. |
Has the team produced an acceptable convergent database? |
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| 5. |
Is the hypothesis statement written according to the three-term
contingency (i.e., under x conditions, the student does y, in order to
achieve z) so that an intervention plan can easily be produced? |
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| 6. |
Is the plan aligned with student needs and assessment results? |
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| 7. |
Does the plan address all aspects of the social/environmental contexts in
which the behavior of concern has occurred? |
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| 8. |
Is there a strategy to verify the accuracy of the hypothesis statement
(e.g., analogue assessment)? |
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| 9. |
Does the plan address both short-term and long-term aspects of student
behavior (and its social/environmental context), including procedures to eliminate
reliance on unacceptable behavior? |
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| 10. |
Does the plan include practical ways to monitor both its implementation
(e.g., checklist, treatment scripts) and its effectiveness as a behavioral intervention
plan? |
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| 11. |
Does the plan include ways to promote the maintenance and generalization
of positive behavior changes in student behavior (e.g., self-monitoring)? |
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| 12. |
Is the plan consistent with building-level systems of student behavior
change and support? |
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