Behavior Intervention Plan

BEHAVIOR INTERVENTION PLAN

Date BIP was developed: / Date(s) BIP was reviewed/revised: / Date BIP was discontinued:

TO BE COMPLETED BY THE TEAM

Using the Behavior Intervention Process and the Functional Behavior Assessment (FBA), determine the appropriate behavior goal and specific strategies for intervention. The Behavior Intervention Plan (BIP) must address the function, or purpose, of the student’s behavior. It is expected that the parents/guardians will participate in the development of the BIP and when appropriate, the student.

Student: / Grade: / School:

SUMMARY STATEMENT/HYPOTHESIS

1.  Summarize documentation from FBA forms and other indirect measure(s).

2.  Summarize the baseline data from the direct measure.

3.  Generate a summary statement that hypothesizes why the student is engaging in the inappropriate behavior.

When (A) a demand (other) occursa demand (academic) occursadult attention ends or is delayedpeer interaction occursa request is denieda transition occursa change in routine occursunstructured time occursa preferred activity endsan environmental need occursa sensory need occurs the student (B – describe behavior of concern) in order to achieve (C) escapeattentioncontroltangible (item,activity)sensory need

Additional comments/descriptions:

4.  If applicable, briefly describe other events, circumstances, and/or settings associated with the behavior that are not included in the summary statement.

BEHAVIORAL GOAL

(For students who receive special education services, this goal must be included on the IEP.)

1.  What is the desired behavior goal? The goal must include:

·  A condition (e.g., given one verbal reminder…, given a grade level text… etc.)

·  An observable behavior (e.g., raise their hand, write three sentences, etc.)

·  A phrase that replaces the function of the behavior (e.g., in order to gain appropriate attention, request a break from work, etc.)

·  How often desired behavior should occur (e.g., % accuracy, % increase, ___ out of ___ opportunities, etc.)?

2.  What data will be collected to monitor progress on the behavior goal (e.g., time on task, number of referrals, etc.)?

3.  How will this data be collected? You may use the same direct measure as when collecting baseline data.

4.  Who will be responsible for collecting data?

PREVENTING STRATEGIES

List what is being done or can be done BEFORE the inappropriate behavior occurs to address the function of the behavior (e.g., attention, escape, sensory, etc.)

Environmental Factors
(e.g., physical space, objects)
Physiological Factors
(e.g., basic needs – food/water, etc.)
Emotional Factors
(e.g., feelings leading to target behavior)
Situational Factors
(e.g., actions that people do, occurrences that may trigger behavior)
Curriculum and Instruction (e.g., repeat directions)

TEACHING STRATEGIES

List skills or behaviors that need to be taught to increase the occurrence of the appropriate behavior in order to accomplish the students’ purpose in a more acceptable way (e.g., social skills, conflict resolution, choice-making). Consider adding skill acquisition as an IEP goal.

Skill / Position Responsible for Teaching
1. 
2. 
3. 

REINFORCEMENT STRATEGIES

Describe the components that will formulate the reinforcement schedule. If applicable, attach a copy of the behavior card.

Reinforcers / How will it be earned? / Frequency / Duration
Immediate (as behavior occurs) & staff responsible for delivering:
Intermediate (end of activity/class) & staff responsible for delivering:
Long Term (end of class/day/week) & staff responsible for delivering:

Additional comments/descriptions:

RESPONSE STRATEGIES

Implement a hierarchal approach to responses beginning with possible warning signs leading up to the behavior of concern.

Behavior / Staff response & purpose
If physical transport/restraint is not necessary, remove the following statement:
** As a last resort, trained staff may implement physical transport and/or restraint as defined in Regulation 400-44. Documentation is required for every occurrence (you may use the Physical Restraint/Seclusion Incident Report).

1.  What can parent/guardians do in response to the inappropriate behavior?

2.  What can the student do in response to the inappropriate behavior?

3.  List any other behaviors that may be present and what response strategies are recommended by the team.

TRAINING OF PLAN

Training must occur prior to the implementation of the plan.

1.  What staff will be trained?

2.  How will training and/or awareness of the plan be shared?

3.  When will the training take place?

4.  Who is responsible for providing the training?

EVALUATION OF INTERVENTION

1.  What date will the team evaluate the intervention effectiveness? (4-6 weeks recommended)

2.  Who is responsible for documenting and reporting progress?

To be completed after 4-6 weeks:

3.  Summarize the data that has been collected from the time the BIP was implemented.

4. Describe the frequency that data will continue to be collected.

5.  Based on the review of data, the BIP will be (check one and record date at the top of the first page):

Continued as is Revised Discontinued

Participants:

Name / Position

Progress/Revision Addendum

Date / Revision

1

SE 28 Form Rev. 6/2012