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5.2 Final PBIS Project
First and Last Name
ELSE 6163 Positive Behavior Interventions and Supports
Date
Part I: Functional Behavior Assessment
| Summary of Student Profile |
| Name: Date of Birth: Grade: Exceptionality: Summary of 16 questions form Student Profile Information Sheet |
| Interviews – Provide a detailed summary of the parent and student interviews |
| Summary of Results of Social Skills Checklist and Motivation Assessment Scale |
| Provide summary of the results of Social Skills Checklist and Motivation Assessment Scale |
| Target Behavior |
| State the behavior that you want to change (increase or decrease) |
| ABC Charts |
| Observation 1 |
| A-B-C Recording Form Date: _____________________Location: ____________________________________ Observer’s name _____________________________Length of time observed: ___________ Date / Time Antecedent Behavior Consequence |
| Observation 2 |
| A-B-C Recording Form Date: _____________________Location: ____________________________________ Observer’s name _____________________________Length of time observed: ___________ Date / Time Antecedent Behavior Consequence |
| Observation 3 |
| A-B-C Recording Form Date: _____________________Location: ____________________________________ Observer’s name _____________________________Length of time observed: ___________ Date / Time Antecedent Behavior Consequence |
| Antecedent, Behavior, Consequence Summary Statement |
| 1. The antecedent is….. 2. The behavior is…… 3. The consequence |
| Function of the behavior |
| Based on the ABC charts provided and the results of the Behavior Rating Scale the function of the behavior is…… |
Part II: Behavior Intervention Plan
| Behavior Objective |
| State the ONE behavior that you want the student to exhibit positively. Make sure you include the 4 components of an objective (Learner, Condition, Behavior, and Criterion) |
| Operational Definition |
| Provide a detailed description of the behavior that you will be targeting. Provide an example and non-example of the behavior. |
| Intervention Plan |
| Description of intervention selected supported by evidenced based research. Rationale of why this intervention is selected. |
| Description of individuals that will be involved and their roles in implementing the plan. |
| Proactive Strategies |
| Describe what strategies will be implemented to avoid triggering the BOC. This is not the intervention. |
| Replacement Strategies |
| Replacement behaviors to be taught |
| How the behaviors will be taught |
| When and how will the replacement skill will be taught |
| Consequence Strategies |
| Criteria for token economy system |
| Brief crisis intervention plan |
| Generalization |
| Setting(s) the behavior will be generalized in |
| Timeline of intervention for generalization |
| Identify strategies that will be used to maintain positive behavior skills |
| Monitoring |
| How will progress be monitored during and after the intervention is implemented |
| How the team will monitor or revise the intervention if needed |
INSERT BIP AT A GLANCE HERE
Part III: Intervention Implementation and Results
| Summary Analysis of Results and Recommendations |
| -Provide a detailed summary of the results of the interventions. -Links behavior change and the use of data collection to make educational decisions. – Provide detailed recommendations for the target student and to personnel involved based on the results of the intervention and the present level of performance of the student. |
| Baseline and Intervention Chart |
| Include a graph to show the data collected from BOTH baseline and Intervention phase. A minimum of 10 data points is needed. |
| Defensible Stability Statement |
| Write a statement of stability (state how baseline data was collected and if the behavior was consistent). This shows that the targeted behavior is continuous. |
| Reflective Journals | ||
| Baseline Day One Date | Intervention Week 1 Day One Date | Intervention Week 2 Day One Date |
| Baseline Day Two Date | Intervention Week 1 Day Two Date | Intervention Week 2 Day One Date |
| Baseline Day Three Date | Intervention Week 1 Day Three Date | Intervention Week 2 Day Three Date |
| Baseline Day Four Date | Intervention Week 1 Day Four Date | Intervention Week 2 Day Three Date |
| Baseline Day Five Date | Intervention Week 1 Day Five Date | Intervention Week 2 Day 4 Date |
| Impact on Student Learning |
| Include summary statement(s) of how the project has impacted student learning and recommendations for the future. |
| Final Reflection of Experiences |
| Include a final reflection about this entire project. Answer the following questions within this section. What have you learned? What was the most difficult part of the project? What was the easiest? How do you think this experience has impacted you personally and professionally? If you had to do it all over again, what would you do differently? What would you keep the same? |
References
Appendices
Scan Interview Forms Here
Scan Motivational Assessment Scale Here
Scan in Social Skills Assessment
Scan in Data Collection Sheets here
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