Superintendent’s Circular #SPE-15, 2010-2011

September 1, 2010

Page 1 of 6

Attachment D

(1 of 2)

Boston Public Schools

FUNCTIONAL BEHAVIORAL ASSESSMENT (FBA)

Student Name: ______Date(s): ______

Age:______Grade:______School:______

Participants in Functional Analysis: ______

Teacher(s) Name(s): ______

______

STEP 1:Identify and define target behavior. How often it occurs, location, intensity, duration: How discrepant is this behavior from peers?

STEP 2:What has been tried previously and for how long?

STEP 3:Collect information across respondents and settings. This is obtained from a variety of settings including student records, input from previous teachers, other staff, parent and student interview, as well as direct observation.

STEP 4:Identify antecedent events and consequences. Identify what triggers the behavior, i.e., transition, lack of attention, difficult tasks, environmental conditions such as medical, diet, etc., concurrent events, i.e., group instruction, seat work, unstructured activity and consequences, i.e., behavior ignored, warning, loss of privilege, etc.

Attachment D

(2 of 2)

FUNCTIONAL BEHAVIORAL ASSESSMENT (FBA)

Student Name:______

STEP 5:Identify the purpose and function of the inappropriate behavior, i.e., obtain or get something, escape or avoid something or someone, or to control.

STEP 6:Develop hypothesis about behavior, i.e., summarize the current problem, e.g., when given a task the student swears at the teacher to avoid complying with direction.

STEP 7:(a)Develop an intervention based on the hypothesis. Remember to consider student strengths: what does the student do well? Consider intervention strategies that will be a positive functional alternative behavior to the inappropriate behavior, e.g., positive behaviors to receive attention. The goals should be measurable and observable.

(b)Identify steps of the intervention, individuals responsible and where and when it will occur.

(c) Monitoring - who will monitor the plan, and how often will it be evaluated?

(d)Date to further discuss how the plan is working.

Attachment E

Boston Public Schools

Behavioral Intervention Plan

Student Name:______Date(s):______Age:______Grade:______School:______

Participants in Determining an Intervention Plan: ______

______

Teacher(s) Name(s): ______

______

  • Identify inappropriate behavior(s)
  • Identify antecedents/triggers to behavior
  • Identify consequences/reinforcers of behavior
  • Identify motivation for behavior - control/power; escape/avoid; attention
  • Identify replacement behavior
  • Identify consequences/reinforcers
  • Identify individual who will implement and/or record data
  • Identify settings
  • Identify follow-up meeting date and person responsible for facilitating meeting

Superintendent’s Circular #SPE-15, 2010-2011

September 1, 2010

Page 1 of 6

GUIDELINES FOR BEHAVIOR SPECIALIST SERVICES

PRE-REFERRAL PROCESS AT SCHOOLS

  1. School staff should identify a child’s target behavior that is interfering with academic learning or is a danger to themselves or others.
  2. Define the behavior.
  3. Collect baseline data for 7 to 10 days.
  4. Data collection should include antecedent, behavior and consequent format including target behavior frequencies and durations.
  5. After ten days, the data is summarized into a functional behavior assessment format using the BPS tool.
  6. Data and the FBA should be presented to AAF or SST for the development of a Behavior Intervention Plan.
  7. The teacher should implement the Behavior Intervention Plan for 15 to 30 days to assess its effectiveness.

REQUEST FOR A BEHAVIOR SPECIALIST

  1. If after 30 days the plan is not working, School staff should fill out a Request For A Behavior Specialist Form.
  2. This form is to be presented to the School based ETF.
  3. The School based ETF will contact the APD and present the case for their review.
  4. APD’s will screen the requests.
  5. APD’s will sent all requests for behavior specialists to Richard Asztalos at BLA or fax at 8033.
  6. Richard Asztalos will review and assign the case to behavior specialists.
  7. Upon receiving this request, the assigned behavior specialist will contact the schools within twenty-four hours and set up an appointment to observe the child and meet with school based staff.

PROTOCOL FOR REQUEST FOR CONSULTATION

OF A BEHAVIORAL SPECIALIST

Date:

School:Cluster: #

Name of Requestor:Position:

Student Name:Grade:Room: #

BirthdayPrototype

Address:Telephone:

Cell/other -

Parent /Guardian Name:

Language of the Student:Parent:

Medications:Recent Trauma:

Presenting Problem(s)

Attempted Interventions by the Teacher:

.

Expected Outcomes:

Approval of building

Administrator:______

Signature

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Observation and recommendations of Behavioral Specialist: