Behavior Intervention Plan
Behavior Intervention Plan
Student: _John Smith____________ Grade: 5th____ School: Grand Canyon Elementary_____
Date Developed: _____________________ Date of Implementation: _____________________
Base Line Data Results:
Hypothesis Statement:
Person(s) Responsible for Implementing Plan:
Behavior of Concern
Behavior Defined
Intervention Goal:
Behavior Intervention Plan-page 2
Intervention Plan
1.
2.
3.
4.
When and where the plan will be implemented:
Intervention Data Collection Summary
Follow-Up and Review Date(s):
Team Meeting Participants
Name Position
_____________________________________ _________________________ …show more content…
______________________________________________
______________________________________________
______________________________________________
DETERMINE SCHEDULE OF REINFORCEMENT:
How frequently can the student earn the above reinforcers?
_______________________________________________
_______________________________________________
_______________________________________________
IDENTIFY DELIVERY SYSTEM:
What intervention components will I use to monitor the student’s behavior and deliver reinforcement?
o Self-monitoring system o Point system o Behavioral contract o Token economy o Group contingency o Beep tape o Home note system o Chart moves o Lottery/raffle tickets o Tracking system o _________________________________________ _________________________________________ _________________________________________
CORRECTION PROCEDURES
Ask yourself: What will I do to decrease the occurrence of the problem …show more content…
Method of data collection: o
Frequency count across the day
o
Frequency count from _______ to ________ (time of day) (time of day)
o
Interval recording every __________ seconds or minutes across the day (circle one)
o
Interval recording every __________ seconds or minutes from _______ to ______ (circle one) (time of day) (time of day)
o
____________________________________
____________________________________
Describe exactly how data will be collected/recorded.
Attach copies of any forms utilized.
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
DAILY DATA
Behavior being measured/Unit of
Student: _John Smith____________ Grade: 5th____ School: Grand Canyon Elementary_____
Date Developed: _____________________ Date of Implementation: _____________________
Base Line Data Results:
Hypothesis Statement:
Person(s) Responsible for Implementing Plan:
Behavior of Concern
Behavior Defined
Intervention Goal:
Behavior Intervention Plan-page 2
Intervention Plan
1.
2.
3.
4.
When and where the plan will be implemented:
Intervention Data Collection Summary
Follow-Up and Review Date(s):
Team Meeting Participants
Name Position
_____________________________________ _________________________ …show more content…
______________________________________________
______________________________________________
______________________________________________
DETERMINE SCHEDULE OF REINFORCEMENT:
How frequently can the student earn the above reinforcers?
_______________________________________________
_______________________________________________
_______________________________________________
IDENTIFY DELIVERY SYSTEM:
What intervention components will I use to monitor the student’s behavior and deliver reinforcement?
o Self-monitoring system o Point system o Behavioral contract o Token economy o Group contingency o Beep tape o Home note system o Chart moves o Lottery/raffle tickets o Tracking system o _________________________________________ _________________________________________ _________________________________________
CORRECTION PROCEDURES
Ask yourself: What will I do to decrease the occurrence of the problem …show more content…
Method of data collection: o
Frequency count across the day
o
Frequency count from _______ to ________ (time of day) (time of day)
o
Interval recording every __________ seconds or minutes across the day (circle one)
o
Interval recording every __________ seconds or minutes from _______ to ______ (circle one) (time of day) (time of day)
o
____________________________________
____________________________________
Describe exactly how data will be collected/recorded.
Attach copies of any forms utilized.
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
DAILY DATA
Behavior being measured/Unit of