CompleteSection 3: Behavior Analysis from the PENT FBA template (see below). For the question re: Tier 2 interventions, note that this is only applicable in educational setti

Tier 3

Tier 1 (All Students)

Culturally responsive environments, classroom strategies with accommodation

planning (Likely to be sufficient for 85-90% of students)

Tier 2

Select an approach:  Cognitive Behavior Therapy/Counseling (CBT)  FBA based BIP with replacement behavior training  Wrap Around and other parent focused assistance  Inter-agency services

U N I V E R S A L S C R E E N I N G

(At-risk Students) Intensified classroom and small group

interventions (Likely to be sufficient for 7-10% of students)

Three-Tiered RtI Model for Behavior and Social/Emotional Support

(High-risk Students) Individual Interventions

(Likely to be sufficient for 3-5% of students)

Select a behavior intervention:  Self-monitoring  Structured adult mentor program (e.g., check in, check out)  Daily home/school notes  Behavior contracts  Small group social skills or SEL training  Escape Card  Positive Peer Reporting

 Positive Behavioral Supports (www.pbis.org)  16 proven proactive classroom management

strategies  Social Emotional Learning (SEL) Curriculum

(www.casel.org)  Firm, fair, kind, consistent teaching  Positive relationships with all students  Physiology for learning instruction

(diet, sleep, exercise, stress management)

The BIP Desk Reference See www.pent.ca.gov

Section 1 Page 14 of 14

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Rubric for Evaluating the FBA Report by Diana Browning Wright, M.S., L.E.P.

Methodology and Data

1. Specified the dates of data collection? 2. Specified the date of the report? 3. Student Information was complete?

a. Gender b. Birthdate c. Grade placement d. Location (e.g., school, district of residence, district of attendance)

4. Contact information for parent/guardian was complete? 5. Identified behavior of concern in clear measurable terms? 6. Data was analyzed based on frequency, duration and/or intensity? 7. Analysis methodology was indicated across a through d below:

a. Interviews b. Student Observations c. Review of Records d. Environmental assessment of student

8. Summary of the analysis incorporating a-d above was provided? 9. Determination as to whether behavior is impeding learning of student and/or peers was provided? 10. Description of other interventions (e.g. Tier 2) tried and their results were provided? 11. Is a Behavior Intervention Plan recommended by this consultant? 12. Were predictors or antecedents of the problem described? 13. Did the consultant describe what is missing or what is present in the environment that should be altered in order

to prevent or reduce incidents of the problem? 14. Did the consultant hypothesize the function of the behavior based on the data collected? 15. Did the consultant suggest a functionally equivalent replacement behavior?

Final Conclusions

1. Did the consultant give an overall conclusion about the behavior? 2. Was the severity of need indicated? 3. If a behavior intervention plan was not recommended, did the consultant suggest an alternate approach? 4. If an alternate approach was recommended, was the rationale given? 5. If no behavior plan was recommended, did the consultant describe what future data would indicate need? 6. Did the consultant indicate if the student has an IEP, 504 or school team plan? 7. Were all evaluation personnel listed? 8. Was a contact person identified for future contact?