Tier 3 Individual Behavior Intervention Plan Page 2
Download a blank fillable Tier 3 Individual Behavior Intervention Plan in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Tier 3 Individual Behavior Intervention Plan with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5Where does the Target Behavior occur?
(Check all that apply)
Bus / bus area
Cafeteria
Classroom
Hallway
Restroom
Frequency: How often does the Target Behavior occur?
_____________(1-999) times a/an:
Duration: For how long does the Target Behavior last?
______________(1-60)
Intensity: Rate the severity of the Target Behavior:
(Choose one)
Record Review: (Check all that apply)
curriculum/IEP
disciplinary records
previous intervention (Tier 2)
anecdotal/home notes
psychological evaluation
other____________________________
Relevant information obtained:
Indirect Assessments: (Interviews)
student
parent/guardian
general education teacher
ESE Teacher
school administrator
related service provider
Other: _________________________
Direct Assessment: (Fill in specific data collection)
Data Type:
Date:
Conducted by:
A-B-C
Scatter Plot
Frequency
Duration
Latency
Relevant information obtained:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Life