Battle Ground School District

Battle Ground School District Functional Behavioral Assessment

Name: Birthdate: School: Date:

Setting Events Problem Behaviors Antecedents/Predictors Maintaining Consequences Are there environmental factors What are the behaviors that are What triggers the behaviors, or What does student appear to that make behaviors more likely? unsafe or disruptive to learning? “sets them off”? achieve from the behaviors? Person: Safety: Expectations: Get or obtain: Location:

Instructional context: Respect: Changes: Escape or avoid:

Internal events:

Responsibility: Need for support:

External events:

Functional Behavior Assessment – 2/02 White – Central Office Yellow – Parent Pink – Teacher Gold – Case Manager