TBI FUNCTIONAL BEHAVIORAL ASSESSMENT (FBA) by hcj

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									   TBI FUNCTIONAL BEHAVIORAL ASSESSMENT Student _______________________________ Date __________
   Desired Outcome: _______________________________________________________________________________________

Slow and Fast Triggers              Specific Problem or Behavior Consequences                              Function of the behavior
What happens before the behavior    What is the specific problem or      What happens after the behavior   What is the student trying to
to increase the chance it will      behavior? Define in operational      to increase the chance it will    gain or escape through the
happen?                             terms that others could see (e.g.,   happen again?                     behavior?
TBI effects (e.g., memory and       B.J. throws his materials on the
executive functions difficulties)   floor; Maria kicks peers in the
                                    hallway before lunch)




Slow triggers (setting events
that “set the stage” for the
behavior; e.g., fatigue, noise)
   Internal




  External                                                              Is the behavior unintentionally   What is the student trying to
                                                                         rewarded by adults or peers?      communicate through the
                                                                                                           behavior?




Fast triggers (immediately
precede and trigger behavior)




   TBI Webcast Series; Wisconsin Department of Public Instruction
Hypothesis Statement (e.g., When B.J. is tired (slow trigger) and his teacher tells him he has to get back to work (fast trigger) B.J.
throws his materials on the floor (problem behavior) to escape working and to communicate his fatigue and frustration (functions).




Additional Information Related to Student’s Brain Injury




Additional Information Related to Student’s Strengths




Additional Information that Assists in Analyzing the Behavior




   TBI Webcast Series; Wisconsin Department of Public Instruction

								
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