DOCUMENT: Document the date the FBA was completed.

DOCUMENT:  Indicate the date of the IEP meeting or date the IEP is revised without a meeting.

DOCUMENT: List the individuals who contributed to the writing of this report. Do not list those who contributed information but did not actually assist in the writing. 

DOCUMENT: Identify and provide contact information for the individual who would best be able to respond to any questions regarding this assessment.

DOCUMENT: State a clear, measurable, and observable description of the behavior(s) of concern. Be specific. There are many ways to be aggressive, inattentive, disruptive, etc. The definition should allow someone who is unfamiliar with the student to be able to recognize when the behavior is and is not occurring.

DOCUMENT: Describe student strengths that may support the development of interventions. Be specific. For example, the student has high language comprehension ability; the student is able to use picture cues/prompts; the student has good peer relationships; the student has strong math skills, with performance at or above his/her peers.

DOCUMENT: Based on a variety of information sources, summarize what is known about the behavior of concern and the conditions related to it. Include identification of resources. Identify outside information sources, if any. You may attach relevant documents (in the Web IEP “Associated Files” are uploaded).

DOCUMENT:  If “Yes” describe the skill deficit of concern. Is it that the student can’t use appropriate behavior instead of the behavior of concern (skill deficit) OR is it that the student won’t use appropriate behavior instead of the behavior of concern (performance deficit)? For example, the student is nonverbal and is expected to ask for help but does not do so (skill deficit) versus the child is verbal and is expected to ask for help but does not do so (performance deficit.

DOCUMENT: If “Yes” describe if the student possesses appropriate replacement behaviors. The purpose of this item is to help determine if new skills need to be taught or if existing skills need to be encouraged and reinforced. Has the student used appropriate behavior instead of the behavior of concern in the situations documented in the descriptive summary? For example, sometimes the student requests help verbally, sometimes the student uses a picture cue to request help, and then sometimes the student tantrums (commensurate with a performance deficit).

DOCUMENT:  Describe the aspects of the student’s behavior that make it a concern (frequency, intensity, etc.). For example, the frequency of aggressive behavior – specifically hitting peers.

DOCUMENT: For some behaviors (stealing, throwing rocks at others, etc.) desired performance is zero occurrences of the behavior of concern. For other behaviors (e.g., work completion) the reasonable expectation is the typical performance of others in the classroom. For example, peers engage in hitting 0 times per day.

DOCUMENT:  State the student’s current performance. Use positive phrasing whenever possible (James completes 80% of his homework assignments). For example, Johnny hits his peers 5 times per day.

DOCUMENT: State the difference in objective measurable terms. For example, the discrepancy between the student’s expected performance (0 hits) and the current performance (5 hits) is 5.

DOCUMENT: Using the Descriptive Summary data above, determine the common antecedents to the behaviors of concern. For example: “25/30 times that the student hit, the antecedent was independent play with no teacher or peer attention”. It is important to note the conditions must be what are actually observed, not what was believed to have happened. 

Describe: 

• The conditions that make the behavior more likely to occur, but do not directly or immediately trigger the behavior (e.g., time of day, certain classes, particular adults or peers present, etc.); and 
• The events that directly and immediately trigger the behavior (e.g., teasing, specific classroom demands, etc.)

• Describe the response of teachers/parents/caregivers to the behavior of concern 
• Describe the response of peers to the behavior of concern

DOCUMENT: State clearly and succinctly the conclusion related to the behavior’s function. Behavior generally falls into one of two functions: Gaining or Avoiding. What the student is trying to gain or avoid will differ based on the situation (e.g. gain attention; avoid a task; gain preferred object). Most commonly, students are attempting to escape or avoid an undesirable task or gain attention from peers or adults. A very small number of behaviors are automatic (i.e., not readily modifiable through strictly behavioral approaches). Consideration may also need to be given to outside factors that may inform intervention strategies such as gang affiliation, and relevant internal cognitive variables and beliefs. Gain and/or Escape functions should be ruled out before an automatic function can be determined.

DOCUMENT: An FBA is typically completed only when there is a behavior of concern that is significant enough to require a systematically applied approach to dealing with the behavior (i.e., a plan). Indicate whether the behavior of concern will be addressed through a Behavior Intervention Plan (BIP), or through some other means.

For additional information on Documenting a Functional Behavior Assessment (FBA) and Behavior Intervention Plan (BIP).

DOCUMENT: Indicate whether this is a new BIP, a revision of an existing BIP, or a review of an existing BIP without any changes being made. A review without change indicates that the information contained in the BIP is accurate, sufficiently current, and provides a sound basis for the actions described.

DOCUMENT: Indicate the date of the IEP meeting or IEP revision without a meeting.

DOCUMENT: Indicate the date of the most current FBA Summary Form that provides the foundation for this BIP.

DOCUMENT: BIPs are developed or modified through an IEP process (initial, review, reevaluation or an IEP amendment with or without a meeting). Involve all appropriate parties on the IEP team or as a part of the group of individuals who will amend the IEP without a meeting.

DOCUMENT: State the behavior of concern identified in the FBA.

DOCUMENT: Skill deficit indicates that the behavior of concern occurs because the individual lacks alternative, appropriate behaviors that serve the same function as the behavior of concern. Performance deficit indicates that the individual has an alternative, appropriate behaviors that serve the same function as the behavior of concern, but does not use these skills or does not use these skills at an expected rate.

DOCUMENT: Often alternative, appropriate behaviors have not been observed or have not been observed to occur at an acceptable rate. 

• Observed. Indicate if alternative, appropriate behaviors have been observed. Determine the alternative or replacement behavior to document on page 2. 
• Elicited by reinforcement. If alternative, appropriate behaviors have not been observed, indicate whether the individual displays the behaviors, given reinforcement. Determine the level of reinforcement necessary to maintain the alternative/replacement behavior.

DOCUMENT: State the student’s current performance on the indicator that will be used to measure progress towards the goal. The baseline, just like the goal, must be observable, measurable, and specific. 

• The baseline must include a number! 
• The baseline number is also the graph starting point for progress monitoring 
• The measurement tool used to determine the baseline must also be the measurement tool used in progress monitoring.

Example: Carl follows teacher directions within 10 seconds 43% of the time.

DOCUMENT: The goal must include: 

Conditions: In 36 weeks, given a teacher direction 

Behavior: Carl will follow that direction within 10 seconds 

Criterion: 90% of the time

DOCUMENT: Each section of the Implementation Plan calls for a clear description of the action to be taken, the individual(s) who will be responsible for the action, and the timeframe for the action. In the Web IEP additional actions may be added or new actions, replacing previous actions may be added.

DOCUMENT: Review all salient information on the FBA Summary Form, as well as Problem Analysis results, specifically Environmental Conditions and Antecedents to develop appropriate prevention strategies. Actions might include adaptations to procedures, schedules, routines, behavioral expectations, room or seating arrangements, and/or materials.

DOCUMENT: Review all salient information on the FBA Summary Form, specifically the Alternative or Replacement behavior section to develop appropriate strategies to teach the alternative/replacement behavior. 

Actions might include:

• Direct teaching (explanation, demonstration, feedback related to correct responding) of behavioral expectations, new skills, acceptable behaviors that serve the identified function of the behavior(s) of concern. 
• Structured assessment of the effects of potential reinforcers. 
• Reinforcement of desirable behaviors, those directly taught or others desirable behaviors that are demonstrated. 
• Reinforcement of progressively lower rates of the behavior(s) of concern.

DOCUMENT: Review all salient information on the FBA Summary Form, as well as Problem Analysis results, specifically the pattern documented under Consequences in relation to the hypothesized function to develop appropriate response strategies that do not reinforce the behavior(s) of concern and do prompt and reinforce the alternative/replacement behavior. 

In a prioritized order, the classroom, home or community actions might include:

• Reinforcement of specifically targeted replacement behaviors or alternative skills. 
• Reinforcement of acceptable behavior, whether or not the behavior is a specifically targeted replacement behavior or alternative skills.
• Ignoring occurrences of targeted undesirable behaviors.
• Prompting or redirecting undesirable behavior to desirable behavior. 
• Providing a negative consequence for undesirable behavior.

DOCUMENT: When the behaviors of concern may pose a danger to the individual, other students, or adults, a safety plan may be required. If a safety plan is needed, define a crisis for this student and identify actions to be taken based on the function of the student’s behavior. 

Actions might include: 

• Assuring that any necessary assistance is available when needed.
•  Appropriately preparing (with information, training, etc.) all responsible adults to implement the safety plan.
•  Establishing a system of timely communication.

DOCUMENT: Certain life circumstances do not directly trigger or make more likely an undesirable behavior, but rather place an individual generally at-risk for various undesirable outcomes. This item is intended to stimulate discussion of this potential. 

Actions might include: 

• Referral to outside resources. 
• Promoting success in other aspects of the individual’s life.

DOCUMENT: The monitoring plan allows the description of both goal monitoring and replacement skill monitoring. This allows tracking a goal to reduce one behavior while efforts are also undertaken to increase the occurrence of replacement behaviors. If the goal itself calls for increasing replacement behaviors, only the Goal Monitoring section needs to be completed.

DOCUMENT: Indicate how progress toward this goal will be measured and how often progress will be measured. Recall, if the BIP goal is the same as an IEP goal, you may state: “See IEP”.

Describe frequent and repeated measures.

• Actions: tallies, observations, record books, etc.
• Frequency: weekly, daily, every two weeks, etc.

DOCUMENT: If the BIP goal targets reducing the behavior of concern, efforts to increase the occurrence of behavior(s) that are acceptable and serve the same function as the behavior of concern should be undertaken. Indicate how, how often, and who is responsible for this monitoring.

DOCUMENT: Describe how the implementation of the plan will be monitored. Treatment integrity is critical to the success of any BIP.

For additional information on Documenting a Functional Behavior Assessment (FBA) and Behavior Intervention Plan (BIP).

DOCUMENT: It is imperative that the demographic information is complete and accurate. This includes the individual’s name, date of birth, and resident and attending district.

DOCUMENT: Briefly describe the behavior subject to discipline under the school’s code of conduct.

DOCUMENT: The manifestation determination must be completed within ten school days of the determination that the potential consequence for the violation constitutes a change in placement. These dates are important and must be recorded accurately. 

Example: Thomas receives an immediate three-day suspension for fighting, pending a parent conference. Thomas’s parents are informed immediately of Thomas’s behavior and the suspension and are invited to a meeting at school. The purpose of the meeting is to discuss Thomas’s behavior in light of the school’s code of conduct. At the meeting, the statements of witnesses and Thomas’s statements are presented to the parents. Thomas has the opportunity to explain his actions. [NOTE: IDEA 2004 states “School personnel may consider any unique circumstances on a case-by-case basis when determining whether to order a change in placement for a child with a disability who violates a code of student conduct.”]. Thomas and his parents are told that this violation would ordinarily draw a suspension for the remainder of the semester. Because Thomas is a student with a disability, a manifestation determination is required before a decision can be made about the consequence for Thomas’s behavior. The school has ten school days from the date of the meeting with Thomas and his parents to hold the manifestation determination.

DOCUMENT: Indicate the information sources that were discussed at the manifestation determination meeting.

DOCUMENT: Indicate “Yes” or “No”. If there has been no history of behavioral concerns, indicate “No” and proceed to the Manifestation Determination section. There, the team will be prompted to conduct a Functional Behavior Assessment (FBA) and create a Behavior Intervention Plan (BIP) or review the existing plan if the behavior is a manifestation of the student’s disability. If the behavior is not a manifestation, the team is prompted to consider the need for an FBA and BIP. If there is a history of behavior concerns, briefly describe that history.

DOCUMENT: Answer “Yes” if there is some reasonable relationship between the behavior being discussed and past behavior (e.g., recurrence of past behavior, a more intense occurrence of past behavior, a progression from past behavior – e.g., a history of verbal confrontations progressing to a physical fight).

DOCUMENT: Answer “Yes” if an FBA has been conducted and indicate the identified function of the behavior that was evaluated in the FBA. Indicate if this function was related to the code of conduct violation. For example, if peer attention was the identified function of related, past behavior, was peer attention also a factor in the code of conduct violation?

DOCUMENT: Indicate “Yes” if the code of conduct violation or related behaviors have been addressed in the current IEP.

DOCUMENT: Indicate if behavior(s) of concern have been addressed through an IEP or BIP. Think broadly, not just about the behavior subject to discipline. If behaviors have been addressed in the past, the following questions are intended to stimulate discussion of future behavioral needs. The answers to these questions are not intended to influence the manifestation determination.

DOCUMENT: Indicate YES or NO. 

If a child whose disability includes the diagnosis of Tourette Syndrome and the symptoms of that condition include loud vocal tics, it would be unreasonable to suspend that student because those vocalizations disrupt the class. That, of course, is an obvious example. Many situations will be less obvious.

DOCUMENT: Indicate YES or NO.

First, discuss whether there has been any failure to follow the IEP. If the IEP has been implemented as written, the correct response to this question is “No”. Don’t forget, if the IEP calls for a behavior plan, carrying out that plan is an expectation of implementing the IEP. 

Answering either question “Yes” means the behavior is a manifestation of the individual’s disability. 

Answering both questions “No” means that the behavior is not a manifestation. 

Indicate the consensus of the team. When it is not possible to reach a consensus, the school must make a determination and inform the parents of that determination with a Prior Written Notice.

DOCUMENT: IDEA 2004 requires that the group conducting a manifestation determination include the local educational agency [the school district], the parent, and relevant members of the IEP team (as determined by the parent and the local educational agency). List all participants. The signature or listing does not indicate agreement with the determination.

DOCUMENT: The determination of the team (behavior is or is not a manifestation) and the nature of the code of conduct violation (special circumstances are present or are not) create four possibilities, each with different implications for actions that can, may or must be taken. Carefully review the implications of the particular circumstances and proceed accordingly.