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FBATemplate_Revised8_20201.docx
FBA Template Candidate Name:
**Please use the “Tips for Writing the FBA” document as a guide for fill
Jun 02, 2025
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Help with Homework
FBATemplate_Revised8_20201.docx
FBA Template Candidate Name:
**Please use the “Tips for Writing the FBA” document as a guide for filling out this template. That document will explain in more detail what should go in each section!**
Functional Behavioral Assessment – NAME OF STUDENT
STUDENT’S BEHAVIORAL STRENGTHS
Positive Behaviors and Skills:
Where and when do strengths occur?
Positive behavior is reinforced by:
STUDENT’S BEHAVIORAL CONCERNS
List of behaviors/concerns:
Target (Problem) Behavior:
Prioritize the behavior that will be the focus of the assessment and intervention plan.
Choose the behavior that most interferes with the student's functioning in the school environment. Be specific and describe the behavior in measurable and observable terms. Also address your reasons for NOT choosing the other behaviors on your list.
Baseline Data:
Indicate the frequency (how often), the intensity (distracting, disruptive, destructive – mild, moderate, severe) and the duration (how long does the behavior last) of the target behavior.
Interventions:
Indicate what interventions have been tried, how long interventions were used, and what interventions are currently employed to prevent the problem behavior. Include the impact of each intervention on the student’s behavior thus far.
CONDITIONS, TRIGGERS, REINFORCERS:
Contributing Factors:
Include a description of “long term” or “chronic” factors/variables that may affect the behavior.
Setting Events:
Identify any “short term” setting events that make the target behavior more likely to occur.
Antecedent:
Include statement of the event(s) that
most commonly immediately precede the behavior.
Consequence:
Include a description of the result of the behavior (i.e. – removed from class, not able to complete assignments/tests, etc.). What consequence appears from the data
most likely or most commonly present to maintain the problem behavior(s)?
Function:
FUNCTIONAL HYPOTHESIS STATEMENT:
Based on your analysis of data, make a statement that represents your “best guess” about the reason for the behavior(s). Please use appropriate hypothesis statement wording and
make sure all parts of the statement are present (Antecedent, Behavior, and Consequence)
ABCBlankDataChart2.docx
Antecedent
Behavior
Consequence (immediate)
Consequence (longer term)
Antecedent
Behavior
Consequence (immediate)
Consequence (longer term)
FBACaseStudyCarl_2025.pdf
FBA Case Study - Carl
FBA Case Study - Carl
Student Background Information
Name: Carl
Age: 8 years old
Grade: 3rd Grade
Diagnosis: No formal diagnosis, though sensory processing challenges are suspected
Support Services: Receives occasional check-ins with the school counselor; no current IEP or 504 plan
Background: Carl has been struggling significantly in the classroom across multiple domains. His
teachers, past and present, have documented a consistent pattern of disruptive behavior, difficulty with
self-regulation, and challenges with peer interactions. While Carl does not currently have an
Individualized Education Program (IEP) or 504 Plan, school staff have expressed growing concern about
his ability to function successfully in a general education setting without additional support.
Concerns Expressed by Teachers and Staff
1. Frequent Disruptions During Instruction:
Carl often interrupts lessons with loud noises, physical movements, or talking out of turn. These
disruptions not only prevent him from accessing instruction but also significantly impact his
peers' ability to focus.
2. Difficulty Remaining Seated or Focused:
Carl struggles to remain in his seat for extended periods, especially during independent work or
structured lessons. He frequently moves around the room, stands up without permission, or lies
on the floor, which hinders his academic engagement.
3. Impulsivity and Safety Concerns:
Carl acts on impulse with little regard for potential consequences. For example, he has been
observed climbing on furniture, running in the classroom, and darting through hallways. These
behaviors pose safety risks to both himself and others.
4. Physical Aggression and Boundary Issues:
Though often not malicious, Carl sometimes uses physical touch inappropriately—pushing in
line, crashing into peers, or hugging too tightly. Some students have reported feeling
uncomfortable or anxious around him.
5. Poor Frustration Tolerance:
When faced with a difficult task, especially those requiring fine motor skills or delayed
gratification, Carl often reacts with defiance, avoidance, or by destroying materials (e.g., tearing
papers, throwing objects).
6. Sensory-Seeking Behaviors:
Carl frequently engages in behaviors that suggest a strong need for sensory input, such as
FBA Case Study - Carl
chewing on clothing, crashing his body into furniture, and humming or making repetitive noises.
These behaviors are especially prominent during quieter or more structured parts of the day.
7. Struggles with Transitions:
Carl has difficulty transitioning between activities, especially when moving from unstructured
time (e.g., recess) to structured learning. These moments often lead to heightened behavior,
such as refusal, defiance, or running.
8. Limited Academic Progress:
Although Carl shows potential, his off-task behavior and frequent need for redirection have
impacted his academic performance. He often completes less work than his peers and misses
instructional time due to behavioral interventions.
9. Difficulty Following Directions:
Even with clear, repeated instructions, Carl often fails to comply or forgets multi-step directions.
Staff are unsure whether this is due to attention deficits, sensory overload, or willful
noncompliance.
10. Social Challenges:
Carl wants to be included with peers but often struggles to engage appropriately. His impulsive
actions and unpredictable behavior make it difficult for him to maintain friendships, and he is
frequently involved in social conflicts.
Summary of Behavior Incidents
(Track ABC Data from these)
Incident #1
It was the start of silent reading time, and the room fell into a hushed calm. Students pulled out their
books and settled in. Within minutes, Carl was out of his seat. Without saying a word, he walked to the
classroom bookshelf, hoisted himself up, and stood upright atop it. While the other students watched
with mixed amusement and concern, Carl began leaping off, landing heavily on his feet with each jump.
Despite repeated redirections, he continued this pattern until the teacher intervened directly.
Afterward, he returned to his desk, where he appeared agitated and unable to sit still.
Incident #2
As the class lined up to walk to lunch, students waited quietly in the hallway. Carl began shifting from
one foot to the other, rocking back and forth. Moments later, he began nudging the student in front of
him with increasing force, eventually pushing with both hands. The student turned around to protest,
but Carl grinned and continued to fidget. When moved to the back of the line, Carl didn’t stop moving—
FBA Case Study - Carl
he began stomping his feet as they walked, occasionally brushing against the wall or skipping forward a
step or two.
Incident #3
During a mid-morning math test, the room was especially quiet, and students focused on their
worksheets. Carl sat with his pencil in hand, staring at the page. Then, without warning, he slid to the
floor and rolled underneath his desk. From there, he began pushing against nearby desks with his body,
making loud crashing sounds. A few students looked up in alarm. When Carl was escorted to the
counselor’s office, he curled up under a weighted blanket and, within minutes, became noticeably
calmer and quieter.
Incident #4
The teacher handed out a simple cut-and-paste worksheet. Most students began cutting out the boxes,
but Carl stared at his scissors, frowning. A few seconds later, he ripped the paper in half, then into
quarters, muttering about how he didn’t like the way it felt. When asked what happened, he shrugged.
Offered a blank sheet of paper and some markers, Carl retreated to a nearby table, where he knelt on
his chair and spent the next ten minutes drawing quietly.
Incident #5
During a projector-based group lesson, the lights dimmed and the class gathered on the rug. Carl sat
near the back, initially appearing engaged. Soon, a soft humming began. As the lesson continued, the
humming grew louder, shifting into rhythmic vocalizations. Some students turned around to look at him.
The teacher gave a gentle reminder to stay quiet, but the sounds continued until Carl was offered a
rubber twist toy. With the toy in hand, he shifted his focus and gradually stopped making noise.
Incident #6
Structured writing time had just begun when Carl raised his hand and asked to go to the bathroom. Ten
minutes later, he asked again. The teacher, noting the short interval, allowed it but followed up. A staff
member observed Carl skipping down the hallway, pausing to jump in place multiple times before
entering the restroom. He returned more settled, but the pattern repeated almost daily, often during
extended seated tasks.
Incident #7
During a writing block, students were working independently. Carl sat at his desk chewing on the collar
of his shirt, his sleeves damp from earlier. When reminded to stop, he looked away and continued
FBA Case Study - Carl
chewing. The teacher gave him a silicone necklace meant for chewing, which he accepted without
comment. With the necklace in place, he stopped chewing his clothes and completed his writing
assignment with fewer interruptions.
Incident #8
After the teacher explained the next activity—a reading comprehension packet—Carl slid off his chair
and lay flat on the carpet. He didn’t speak, but began slowly pushing himself across the floor using his
forearms, his body flat and still. The teacher approached and gently asked if he’d prefer to work at a low
table. Carl nodded. Once he moved to the floor workspace and was given a cushion to sit on, he picked
up his pencil and began the assignment.
Incident #9
Recess had just ended, and students entered the classroom in a line. Most went straight to their desks,
but Carl bolted across the room, weaving between desks and making sudden turns, laughing as he did
so. A few students joined briefly before being redirected. Carl was asked to take a break in the calm
corner. Once there, he selected a sensory bin filled with sand and small tools. He played quietly, and
after ten minutes, rejoined the group activity without further disruption.
Incident #10
During a game that required waiting turns, Carl initially sat with the group. As the minutes passed, he
began tapping a small plastic toy against the floor. The taps grew louder until he eventually stood up
and struck the toy against the wall in a repeated rhythm. The teacher asked him to take a break and
redirected him to the classroom's “heavy work station,” where stretchy resistance bands were available.
After several minutes of pulling and pushing against the bands, Carl returned to the group, visibly more
relaxed and ready to participate.
Student Background Information
Concerns Expressed by Teachers and Staff
Summary of Behavior Incidents
Incident #1
Incident #2
Incident #3
Incident #4
Incident #5
Incident #6
Incident #7
Incident #8
Incident #9
Incident #10
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