Behavior Chart Student Name:
________Day: __Monday __Tuesday __Wednesday __Thursday ____Friday ________Date:
Behavior goals to work on Number needed for goal
Instructions for the behavior chart forms Designed by Dr. Gaston Weisz, 4/10/08
This form can be filled out with behavior goals that you will monitor and check when the behavior is occurring. For example, goals can be using polite words, completing homework, brushing teeth, etc. The behavior must be something you can objectively know if it happened or didn’t happen that day or that period of the day. The graphing form on the next page can be used to graph baseline of the behavior(s), changes, etc. The third page can be used to indicate the menu of rewards or privileges that can be earned with the points from the chart.
Graph for behavior goal points Student Name:
Date
__ __ __ __ __ __ __ __ __ __ __ __ __ __
Instructions for the behavior chart forms Designed by Dr. Gaston Weisz, 4/10/08
This form can be filled out with behavior goals that you will monitor and check when the behavior is occurring. For example, goals can be using polite words, completing homework, brushing teeth, etc. The behavior must be something you can objectively know if it happened or didn’t happen that day or that period of the day. The graphing form on the next page can be used to graph baseline of the behavior(s), changes, etc. The third page can be used to indicate the menu of rewards or privileges that can be earned with the points from the chart.
Reward Menu for Behavior Goal Student Name: Reward Points Needed
Instructions for the behavior chart forms Designed by Dr. Gaston Weisz, 4/10/08
This form can be filled out with behavior goals that you will monitor and check when the behavior is occurring. For example, goals can be using polite words, completing homework, brushing teeth, etc. The behavior must be something you can objectively know if it happened or didn’t happen that day or that period of the day. The graphing form on the next page can be used to graph baseline of the behavior(s), changes, etc. The third page can be used to indicate the menu of rewards or privileges that can be earned with the points from the chart.