6 final

CONFIDENTIAL – DO NOT DISPLAY

PREVENTION PART I: ENVIRONMENTAL FACTORS AND NECESSARY CHANGES

Observation & Analysis

What are the predictors for the behavior? (Situations in which the behavior is likely to occur: people, time, place, subject, etc.)

5.      

What supports the student using the problem behavior? (What is missing in the environment/curriculum or what is in the environment curriculum that needs changing?)

6.      

Intervention

Remove student’s need to use the problem behavior-----

What environmental changes, structure and supports are needed to remove the student’s need to use this behavior? (Changes in Time/Space/Materials/Interactions to remove likelihood of behavior)

7.      

Who will establish?       Who will monitor?       Frequency?      

ALTERNATIVES PART II: FUNCTIONAL FACTORS AND NEW BEHAVIORS TO TEACH AND SUPPORT

Observation & Analysis

Team believes the behavior occurs because: (Function of behavior in terms of getting, protest, or avoiding something)

8.      

Accept a replacement behavior that meets same need-----

What team believes the student should do INSTEAD of the problem behavior? (How should the student escape/protest/ avoid or get his/her need met in an acceptable way?)

9.      

Intervention

What teaching Strategies/Necessary Curriculum/Materials are needed? (List successive teaching steps for student to learn replacement behavior/s)

10.      

Who will establish?       Who will monitor?       Frequency?      

Intervention

What are reinforcement procedures to use for establishing, maintaining, and generalizing the replacement behavior(s)?

11.      

Selection of reinforcer based on:      

FORMCHECKBOX reinforcer for using replacement behavior FORMCHECKBOX reinforcer for general increase in positive behaviors

By whom?       Frequency?      

EFFECTIVE REACTION PART III: REACTIVE STRATEGIES

What strategies will be employed if the problem behavior occurs again?

12.

1. Prompt student to switch to the replacement behavior      

2. Describe how staff should handle the problem behavior if it occurs again      

3. Positive discussion with student after behavior ends      

Optional:

4. Any necessary further classroom or school consequences      

Personnel?      

OUTCOME PART IV: BEHAVIORAL GOALS

Behavioral Goal(s)

13.

Required: Functionally Equivalent Replacement Behavior (FERB) Goal

By when

Who

Will do X behavior

(line 9)

For the purpose of y

(line 8)

Instead of Z behavior

(line 1)

For the purpose of y

(line 8)

Under what contingent

conditions

At what

level of proficiency

As measured

by whom

and how

Option 1: Increase General Positive or Decrease Problem Behavior

By when

Who

Will do what, or will NOT do what

At what level of proficiency

Under what conditions

Measured by whom and how

Option 2: Increase General Positive or Decrease Problem Behavior

By when

Who

Will do what, or will NOT do what

At what level of proficiency

Under what conditions

Measured by whom and how

The above behavioral goal(s) are to: FORMCHECKBOX Increase use of replacement behavior and may also include:

FORMCHECKBOX Reduce frequency of problem behavior FORMCHECKBOX Develop new general skills that remove student’s need to use the problem behavior

Observation and Analysis Conclusion:

Are curriculum accommodations or modifications also necessary? Where described:      

FORMCHECKBOX yes FORMCHECKBOX no

Are environmental supports/changes necessary?

FORMCHECKBOX yes FORMCHECKBOX no

Is reinforcement of replacement behavior alone enough (no new teaching is necessary)?

FORMCHECKBOX yes FORMCHECKBOX no

Are both teaching of new replacement behavior AND reinforcement needed?

FORMCHECKBOX yes FORMCHECKBOX no

This BIP to be coordinated with other agency’s service plans?

FORMCHECKBOX yes FORMCHECKBOX no

Person responsible for contact between agencies      

FORMCHECKBOX yes FORMCHECKBOX no

COMMUNICATION PART V: COMMUNICATION PROVISIONS

Manner and content of communication

14.

1. Who?

2. Under what condition(s)

(Contingent? Continuous?)

3. Delivery Manner

4. Expected Frequency?

5. Content?

6. How will this be two-way communication

1. Who?

2. Under what condition(s)

(Contingent? Continuous?)

3. Delivery Manner

4. Expected Frequency?

5. Content?

6. How will this be two-way communication

1. Who?

2. Under what condition(s)

(Contingent? Continuous?)

3. Delivery Manner

4. Expected Frequency?

5. Content?

6. How will this be two-way communication

PARTICIPATION PART VI: PARTICIPANTS IN PLAN DEVELOPMENT

FORMCHECKBOX Student      

FORMCHECKBOX Parent/Guardian      

FORMCHECKBOX Parent/Guardian      

FORMCHECKBOX Educator and Title      

FORMCHECKBOX Educator and Title      

FORMCHECKBOX Educator and Title      

FORMCHECKBOX Administrator      

FORMCHECKBOX Other      

FORMCHECKBOX Other