Applied Sciences Signature Assignment

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FunctionalAnalysisDataSheet_fillable.pdf

Functional Analysis Data Sheet Conduct sessions as described below and in the listed sequence (Session #1=Alone, #2=Attention, etc.) Add a Tangible condition only if it is strongly suspected that problem behavior is maintained by access to tangibles. Each session should last for 10 minutes. Record either the # or the rate of problem behavior (PB) in each session, and summarize as the mean per condition. Alone: Begin session: Student is alone in a room with no access to attention or leisure items.

If PB: No consequences.

Attention: Begin session: Inform student that you are busy; then ignore. If PB: Deliver a mild reprimand, statement of concern, physical comfort, then ignore again.

Play: Begin Session: Deliver frequent attention and allow free access to preferred items. Do not deliver demands.

If PB: Ignore briefly, then resume play.

Demand: Begin session: Deliver non-preferred academic or work tasks. If PB: Remove task and ignore for 30 seconds; then resume tasks.

Tangible: Begin session: Allow brief access to preferred item then remove and ignore. If PB: Provide brief access to preferred item; then remove again.

Other: Begin session:

If PB: Client: ______________________________________________________ Start Date: ________________________ Problem Behavior: _____________________________________________ End Date: ________________________

Session Alone Attention Play Demand Tangible Other 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Mean PB

  1. Client:
  2. Start Date:
  3. Problem Behavior:
  4. End Date:
  5. Alone1:
  6. Attention1:
  7. Play1:
  8. Demand1:
  9. Tangible1:
  10. Other1:
  11. Alone2:
  12. Attention2:
  13. Play2:
  14. Demand2:
  15. Tangible2:
  16. Other2:
  17. Alone3:
  18. Attention3:
  19. Play3:
  20. Demand3:
  21. Tangible3:
  22. Other3:
  23. Alone4:
  24. Attention4:
  25. Play4:
  26. Demand4:
  27. Tangible4:
  28. Other4:
  29. Alone5:
  30. Attention5:
  31. Play5:
  32. Demand5:
  33. Tangible5:
  34. Other5:
  35. Alone6:
  36. Attention6:
  37. Play6:
  38. Demand6:
  39. Tangible6:
  40. Other6:
  41. Alone7:
  42. Attention7:
  43. Play7:
  44. Demand7:
  45. Tangible7:
  46. Other7:
  47. Alone8:
  48. Attention8:
  49. Play8:
  50. Demand8:
  51. Tangible8:
  52. Other8:
  53. Alone9:
  54. Attention9:
  55. Play9:
  56. Demand9:
  57. Tangible9:
  58. Other9:
  59. Alone10:
  60. Attention10:
  61. Play10:
  62. Demand10:
  63. Tangible10:
  64. Other10:
  65. Alone11:
  66. Attention11:
  67. Play11:
  68. Demand11:
  69. Tangible11:
  70. Other11:
  71. Alone12:
  72. Attention12:
  73. Play12:
  74. Demand12:
  75. Tangible12:
  76. Other12:
  77. Alone13:
  78. Attention13:
  79. Play13:
  80. Demand13:
  81. Tangible13:
  82. Other13:
  83. Alone14:
  84. Attention14:
  85. Play14:
  86. Demand14:
  87. Tangible14:
  88. Other14:
  89. Alone15:
  90. Attention15:
  91. Play15:
  92. Demand15:
  93. Tangible15:
  94. Other15:
  95. Alone16:
  96. Attention16:
  97. Play16:
  98. Demand16:
  99. Tangible16:
  100. Other16:
  101. Alone17:
  102. Attention17:
  103. Play17:
  104. Demand17:
  105. Tangible17:
  106. Other17:
  107. Alone18:
  108. Attention18:
  109. Play18:
  110. Demand18:
  111. Tangible18:
  112. Other18:
  113. Alone19:
  114. Attention19:
  115. Play19:
  116. Demand19:
  117. Tangible19:
  118. Other19:
  119. Alone20:
  120. Attention20:
  121. Play20:
  122. Demand20:
  123. Tangible20:
  124. Other20:
  125. AloneMean PB:
  126. AttentionMean PB:
  127. PlayMean PB:
  128. DemandMean PB:
  129. TangibleMean PB:
  130. OtherMean PB: