Functional Behavioral Assessment Teacher Interview Form (Page 2 of 2) in pdf

Functional Behavioral Assessment

Teacher Interview Form

8. What usually happens after the behavior? Describe what happens according to adult(s), peers, and student

responses._____________________________________________________________________________________

__________________________________________________________________________________________________

9. What is the likely function (intent) of the behavior; that is, why do you think the student behaves this way?

What does the student get or avoid? ______________________________________________________________

__________________________________________________________________________________________________

10. What behavior(s) might serve the same function (see question 9) for the student that is appropriate within the

social/environmental context? ____________________________________________________________________

__________________________________________________________________________________________________

11. What other information might contribute to creating an effective behavioral intervention plan (e.g., under

what conditions does the behavior not occur?) ______________________________________________________

__________________________________________________________________________________________________

12. Who should be involved in the planning and implementation of the behavioral intervention plan? ___________

__________________________________________________________________________________________________

Source: Gable, Quinn, Rutherford, & Howell (1998)

Functional Behavioral Assessment Teacher Interview Form Page 2