Tier 3 Individual Behavior Intervention Plan
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Tier 3 Individual Behavior Intervention Plan
Student Name: _________________________________________ Grade: __________________________________
Student Data:
(
Enter relevant data
below):
Functional Behavioral Assessment (FBA)
FBA Date: ___________________________
Rationale:
The student is engaging in behavior that places them or others at risk of harm and or results in
substantial property damage.
Behavioral concerns may result in exclusion from participation in activities or settings with peers.
The education team is considering a more restrictive placement due to behavioral concerns.
The student’s behavioral difficulties persist despite consistently implemented behavior management
strategies (Tier 2) based on a less comprehensive or systematic assessment.
Student Profile:
Describe the student’s strengths, skills and interests:
Describe the student’s limitations
Target Behavior:
What is the specific behavioral difficulty identified for increase or decrease?
Baseline estimate:
(Use Tier 2 data, if available)
When does the Target Behavior occur?
(Check all that apply)
AM Before start of classes
1
Period
st
2
Period
nd
3
Period
rd
4
Period
th
5
Period
th
6
Period
th
PM after end of class
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