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Chester County Intermediate Unit Home and Community Services Functional Behavior Assessment Client Name: Date Submitted: Current Services: TSS BSC MT Proposed Services: TSS BSC MT Submitted by: (BSC

How to fill out functional behavior assessment form

How to fill out a functional behavior assessment form:

1. Start by carefully reading the instructions provided on the form. This will give you an understanding of what information is required and how to accurately complete the form.
2. Begin with the personal information section. Provide your name, contact details, and any other requested information. If the form is for someone else, such as a child or a client, ensure that you accurately fill in their personal information.
3. Move on to the behavior description section. This is where you will describe the specific behavior that you are assessing. Be as detailed as possible, including information about when and where the behavior occurs, any triggers, and the frequency and intensity of the behavior.
4. Next, provide information about the antecedents, or the events or circumstances that occur before the behavior. Include any relevant environmental factors, people involved, and any other important details that may contribute to the behavior.
5. In the consequences section, describe what happens immediately after the behavior occurs. This may include the reactions of others, any rewards or punishments, or any other consequences that occur as a result of the behavior.
6. The functional analysis section is where you will analyze the function of the behavior. This involves identifying the underlying reasons or motivations for the behavior. Consider factors such as escape, attention-seeking, obtaining something desirable, or sensory stimulation. Provide your analysis based on observations and any relevant information.
7. If there are any other sections or questions on the form, ensure that you answer them accurately and to the best of your ability. Provide any additional information or details that may be necessary for a comprehensive assessment.

Who needs a functional behavior assessment form:

1. Individuals with challenging behaviors: Functional behavior assessment forms are typically used when someone is exhibiting challenging behaviors that are affecting their daily life or interfering with their ability to function effectively. These individuals may include children with behavioral issues, individuals with developmental disabilities, or individuals with mental health conditions.
2. Educators and school personnel: Functional behavior assessment forms are frequently used in educational settings to identify the function of problematic behaviors and develop appropriate behavior intervention strategies. Teachers, counselors, and other school staff may need to complete these forms to address behavioral concerns in the classroom.
3. Behavior analysts and therapists: Professionals in the field of behavior analysis or therapy may utilize functional behavior assessment forms as part of their assessment and treatment planning processes. These forms help them gather relevant information about behaviors and develop individualized interventions.
4. Caregivers and family members: If you are responsible for the care and support of an individual with challenging behaviors, you may need to complete a functional behavior assessment form. This can help you better understand the behavior and provide appropriate support and intervention strategies.

In conclusion, filling out a functional behavior assessment form involves carefully reading and following the instructions, providing accurate information about the behavior and its surrounding factors, analyzing the function of the behavior, and addressing any additional questions or sections on the form. The form is typically used by individuals with challenging behaviors, educators, behavior analysts, therapists, and caregivers.

For pdfFiller’s FAQs

What is functional behavior assessment form?

The functional behavior assessment form is a document used to gather information about a person's behavior, the antecedents that trigger the behavior, and the consequences that maintain it.

Who is required to file functional behavior assessment form?

Typically, professionals in fields such as psychology, education, or special education are required to fill out the functional behavior assessment form.

How to fill out functional behavior assessment form?

To fill out the functional behavior assessment form, you need to gather relevant information about the person's behavior, antecedents, and consequences. Then, you can complete the form by providing accurate and detailed descriptions of these factors.

What is the purpose of functional behavior assessment form?

The purpose of the functional behavior assessment form is to identify the underlying causes and functions of a person's behavior, in order to develop effective behavior interventions and supports.

What information must be reported on functional behavior assessment form?

The functional behavior assessment form typically requires information about the person's behavior, the circumstances or antecedents that trigger the behavior, and the consequences that follow the behavior.

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