Fba Sample

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Student __Thomas Jones__________________________ Age ___13_____ Sex ___M____Teacher(s) __Ms. Gilbow / Team B______________________ Grade ____6th___________Case Manager _Mrs. Brantley____________________________ Date(s) ___4/17/00_____ Reason for intervention plan:

Tom’s behavior often disrupts class. Yesterday he threw a dictionary across the room, knocked over his desk, kicked it, and began yelling obscenities at the teacher and the other students in the class (LD resource room). The teacher had to call for help from his ED resource room teacher to calm him down and safely remove him from the classroom. Participants (specify names):

(x) student __Tom________________________(x) family member_Mrs. Jones______________(x) special educator Ms. Gilbow_____________( ) general educator_______________________( ) peer(s)_______________________________ | ( ) special education administrator_____________(x) general education administrator_Mr. Scott____( ) school psychologist ______________________( ) other agency personnel _________________________________________________________ | ( ) other (specify) ___________________________________________________________________________________________________________________________________________________ |  

Fact Finding
General learning environment: Describe the student’s school class schedule, including any special programs or services. Tom receives special education to provide support for his emotional difficulties and learning disability in two resource rooms. These classes provide instruction in math, language arts, reading, social skills, and social studies. He is in the regular classroom for specials, lunch, and science. He rides a special bus with a paraprofessional to school. Problem behavior: Define the problem behavior(s) in observable, measurable, and countable terms (i.e., topography, event, duration, seriousness, and/or intensity). Include several examples of the behavior. Thomas has Tourette’s Syndrome, a learning disability that manifests itself in reading and language arts, and an emotional disturbance. Symptoms of Tourette’s lead him to display distracting tics and vocalize curses during the usual course of the day. This sometimes causes his classmates to make uncomplimentary comments. His emotional and learning disabilities often lead to frustrating academic and social situations. When he becomes frustrated he often throws objects (books, book packs, pencils) turns over furniture (chairs or tables), and curses obscenities at the adults and other students present in the classroom. Setting events: Describe important things that are happening in the student’s life that may be causing the behavior(s) of concern. Thomas recently started to be mainstreamed more often in the regular classroom. He has begun to take science (as area of strength and interest) in the general education setting. Review existing data: Summarize previously collected information (records review, interviews, observations, and test results) relevant to the behavior(s). An examination of Tom’s medical records and interviews with his parents and teachers all reveal that due to Tourette’s Syndrome he has uncontrollable tics that cause his head to jerk to the side. Often during these tics he curses, a behavior that has never been observed in isolation. A review of his IEP, test results, and interviews with his parents and teachers reveal that he has learning problems that keep him from realizing success in the mainstream classroom and causes him a lot of frustration. He also is frustrated by the many rude comments made by his classmates regarding his tics. During unstructured time (recess, before school, between classes), it has been observed that other students tease him. His parents and teachers report that this really bothers Tom and makes it difficult for him to make friends. He spends most of his spare time with his 4th grade sister who walks him to and from class in the...
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