Behavior Intervention Plan (Bip)

BIP – PAGE 1

Instructions for Completion of Behavioral Intervention Plan (BIP)

Must be completed as a part of a case conference committee. Teachers may request Covered Bridge staff attend any/all BIP conferences.

Target Behavior Objectives

List what you want the student to be able to do

Objectives must be measurable

Plan of Action

* Examples of Intervention Strategies and Reinforcers are attached.

Behavioral Interventions – Ensure that the positive behavioral supports for behavior reinforcement are immediate and powerful.

Consequences – Identify consequences for targeted behavior

Persons Responsible – Identify who will be responsible for implementing the intervention

Criterion – Select mastery criterion

Evaluation Procedures – List evaluation procedures to be used

Date for Review – Indicate date of review (must be reviewed at least once in twelve months)

Outcome/Follow-Up – This column should be completed when the BIP is reviewed

Identify Skills to be Taught and Indicate Person(s) Responsible – Identify skills to be taught and indicate person(s) responsible for teaching. It is not the sole responsibility of the special education teacher to teach all necessary skills.

Assurance and Approval

Severe Clause – Complete all pertinent information.

Signatures – Obtain signatures from committee members to ensure ownership of the BIP.

Distribution – Specify personnel who will receive copies of the BIP.

Implementation Agreement – Check appropriate box.

Note:

The FBA and BIP must be attached to case conference paperwork.

1)when the BIP is first developed and

2)at ACR.

Forms required at a case conference are FBA 2, 3, 4, 5 and BIP 2 and 3. There must be a form (amendment or 5A.5) for parent signature to approve the BIP.

Adopted 8/17/2004

Covered Bridge Special Education District

1320 Walnut Street

Terre Haute, IN47807 (812) 462-4364

BIP Page 2 – Behavior One
Behavioral Intervention Plan (BIP)
STUDENT / D.O.B. / DATE
GRADE / SCHOOL / ELIGIBILITY
MEDICATION(S) and other health issues
REVIEW DATES
I. Target Behavior Objective(s): (List what you want the student to be able to do.)
1.
II. Plan of Action:

Behavioral Interventions

/ Persons Responsible / MC /

EP

/ Date for Review / Outcome/ Follow-up
Positive Behavioral Supports:

Behavioral Interventions

/ Persons Responsible / MC /

EP

/ Date for Review / Outcome/ Follow-up
Consequences:
Mastery Criterion: (MC) a. 60-70% b. 71-80%
c. 81-90% d. 91-100% / Evaluation Procedures: (EP)
1) Observation 3) Meetings with teachers 2) Daily data collection 4) Progress reports frequency D 5) Discipline/Attendance
Other
Identify Skills to be Taught and Indicate Person(s) Responsible: / Progress Report (Insert appropriate date)
Stress Management / Social / 1)
Academic / Anger Management / 2)
Organizational / Drug Prevention / 3)
Communication / Sensory Processing / 4)
Other / Other / 5)
6)
BIP Page 2 – Behavior Two
Behavioral Intervention Plan (BIP)
STUDENT / D.O.B. / DATE
GRADE / SCHOOL / ELIGIBILITY
MEDICATION(S) and other health issues
REVIEW DATES
I. Target Behavior Objective(s): (List what you want the student to be able to do.)
1.
II. Plan of Action:

Behavioral Interventions

/ Persons Responsible / MC /

EP

/ Date for Review / Outcome/ Follow-up
Positive Behavioral Supports:

Behavioral Interventions

/ Persons Responsible / MC /

EP

Behavioral Interventions

/ Persons Responsible / MC /

EP

/ Date for Review / Outcome/ Follow-up
Positive Behavioral Supports:

Behavioral Interventions

/ Persons Responsible / MC /

EP

/ Date for Review / Outcome/ Follow-up
Consequences:
Mastery Criterion: (MC) a. 60-70% b. 71-80%
c. 81-90% d. 91-100% / Evaluation Procedures: (EP)
1) Observation 3) Meetings with teachers 2) Daily data collection 4) Progress reports frequency D 5) Discipline/Attendance
Other
Identify Skills to be Taught and Indicate Person(s) Responsible: / Progress Report (Insert appropriate date)
Stress Management / Social / 1)
Academic / Anger Management / 2)
Organizational / Drug Prevention / 3)
Communication / Sensory Processing / 4)
Other / Other / 5)
6)
BIP – PAGE 3
ASSURANCE AND APPROVAL
SEVERE CLAUSE:
If a pattern of misbehavior develops to the degree that it significantly interrupts the educational process or becomes
a safety issue for / or others, / may be sent
Student / Student
home with his/her work until a case conference can reconvene to determine appropriate changes in his/her IEP or appropriate changes in his/her educational placement.
School policy and practices regarding discipline will be enforced for all offenses not addressed by this plan or
‘s IEP.
Student
My signature indicates that I was involved in the development of this plan. / (* signifies the person who wrote the plan)
NAME / POSITION
The plan was distributed to the following school personnel on
Date
Check one of the two boxes below:
The committee mutually agreed to implement the BIP developed by this committee.
The committee has not reached agreement and will recess for not more than 10 school days. During the recess the members agree to gather additional information, obtain additional resources or professional assistance,
and/or consider alternative approaches. This recess does not apply if the student presents a danger of
physical harm to himself/herself or others, or if the student has committed an expellable offense.
If an agreement is not reached, the committee will reconvene at / on
Time / Date

BIP – PAGE 4

INTERVENTION STRATEGIES

Note:For staff use only as resource for completing BIP.

Positive Behavior Strategies for Increasing
Prosocial Behaviors /

Consequences Designed to Improve Behavior

And Enable Student to Receive Instruction

Remove distracters
Provide a structured environment
Set well-defined limits, rules, and task expectations
Establish consistent routine
Simplify activities
Review consequences before behavior escalates
Allow time to process information
Use visual cues and supports
Visual/written schedules
Offer choices
Set attainable daily goals
Premack principle (If…, then…)
Earn activities/privileges
Cooling off period/”Cool Down” pass
Planned ignoring of minor inappropriate behavior
Provide frequent positive feedback
Verbal/visual reminder
Proximity control
Nonverbal signal for appropriate behavior
Referral to counselor
Point/level system
Home/school reward system
Behavioral graphs/charting
Model/coach in problem-solving situations
Role play alternative behaviors
Contracts
Model and practice social skills
Set up and reinforce social interaction
Use timer for self-monitoring
Redirect overactivity into productive tasks
Provide student with a safe area to regain control
Permit student to engage in appropriate physical activities
Token system
Peer/buddy system
Social stories
AM/PM reinforcers
Participation in general education activities
Group activities
Time with preferred adults
Positive reinforcers:

(List:______
______
______) / ***Consequences should be determined based upon
the functioning level of the student and the
severity of behaviors exhibited.

Over correction
Loss of/failure to earn activities/privileges
Response Cost (Token system)
Teacher-initiated cooling off period
Supervision during transition periods
Parent conference
Use conflict management and mediation steps
After school detention
Lunch detention
In school suspension ______period/days
Suspend student for the remainder of the day
Suspension for up to three consecutive days
Saturday School/Tuesday Extension
Office/Dean referral
Regroup/Cool down
Time-out
Restitution
Isolated instruction/lunch
Apology/essay
Therapeutic restraint
Involve law enforcement
Citations
File truancy
Verbal and written reminders/warnings
Morning detentions
Lunch detentions
Other consequences:______

______
______

BIP – PAGE 5

REINFORCERS FOR ELEMENTARY STUDENTS

Jobs in the class (pass out papers, collect papers, put attendance slip on door, feed animals, put away materials, water plants, etc.)

Jobs outside the class (carry attendance or notes to office, take messages to other teachers, collect teacher’s mail, give announcements, etc.)

“First” club (called first to get in line, be dismissed, etc.)

“No homework” coupons

“Extra credit” coupons

Read to younger students or listen to students read

Sit in teacher’s chair

Sit next to a friend

Visit principal, counselor, custodian, secretary, etc.

Good news note home

Phone call home

Use special markers or other materials

Tangible rewards (food, drinks)

“Catch’em being good” tokens

IDEAS FOR MOTIVATING SECONDARY STUDENTS

Jobs in the class (pass out papers, collect papers, put attendance slip on door, put away materials, water plants, etc.)

Jobs outside the class (carry attendance or notes to office, take messages to other teachers, collect teacher’s mail, give announcements, etc.)

“No homework” coupons

“Extra credit” coupons

Read to younger students or listen to younger students read

Work as peer tutor

Preferred seating/Encouragements

Visit principal, counselor, custodian, secretary, etc.

Good news note home

Phone call home

Use special materials

Work in office or other parts of school

Restroom or water pass

Choice of task

Entry pass for extracurricular activity (e.g. football game, plan, etc.)

Tangible rewards (food, drinks)

“Catch’em being good” tokens