FUNCTIONAL BEHAVIOR ASSESSMENT REPORT

An FBA is an analytical process based on observations, review of records, interviews, and data analysis to determine the
function the behavior serves for the student, how that function can be met more appropriately and how the environment can
be altered to better support general positive behaviors.
Date of Report: 02/04/17
Date(s) of FBA Data Collection: 01/23/17 - 02/03/17

SECTION 1: Student Information

Student Name: Rodriguez Tatiana B Male

Female
Last (legal) First (no nicknames) M.I.
Birthdate: 01/16/02 Grade: 8th
Resident District: Holland Public School of Hope Academy
attendance:

SECTION 2: Parent/Guardian Contact Information

Parent Name: Lousia Rodriguez Home (616)222-4444

Phone:
Foster Address: 12 Pine Street Work (777)465-7643
Parent Phone:
Guardian City/State: Holland, MI Cell Phone: ()-
Surrogate Zip: 494923 E-mail: lousida.r@gamil.com
Student

SECTION 3: Behavior Analysis

1. Behavior(s) of concern (State a clear, measurable, and observable description of the behavior or behaviors of concern)
TR displays off-task behavior defined as refusing to complete assigned work, putting her head on a desk for longer than 5
minutes, closing her eyes, making inappropriate comments such as "this work is boring so I'm not doing it" or "I'm not in
the mood to do the work today".

2. Frequency, Intensity, and/or Duration of current behavior:

TR off-task behavior on average lasts for 20 minutes, and occurs most often during Science and Algerba, and occasionly
occurs during Civics.

3. Analysis of this behavior was based on:

Interviews with Ms. Harris, Ms. Mason and Mr. Gerard
Student observation(s) on Duration, ABC and scatter plot recording at 01/23/17 - 02/03/17
Review of records, consisting of: health discipline other:
Environmental analysis for supportive and unsupportive variables on
Summary of Interview, Observation, Record Review, and Environmental Analysis:
Interview with Ms. Harris, Ms. Mason and Mr. Gerard: Teachers stated that TR is out-going and well liked by her peers.
She loves soccer and acting. She has particapted in several plays at her church. They state that the problem behavior is
rooted in work avoidance, and she displays this by being tardy, withdarn during class, does not complete work and puts
her head down on her desk. It was decided that the behavior was most likley to occur during Science (10:00 - 10:55am)
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 and Algebra (11:30am - 12:25pm). It was noted that the problem behavior occasioanly occurs during Civics (2:05 -
3:00pm). The teachers reported that TR does not complete work and puts her head on deak.It was also stated that
independt work often is the trigger for the off-task behavior. For example, when the teacher directs the student to
complete her indepenent work she will put her head down on deak for longer than 5 miuets, makes inppaoatie comment,
such as, "This work is boring, I'm not doing it". This often occurs for 15 - 30 minuets of the class. The teacher sugests that
this behavior may be due to the fact that the class work and homework is somewhat difficult. It was also observed that TR
perfers lecture and group work, when in the classroom. It was suggested that the problem behavior is low intensity. To
conlcude the interview, it was decided that the setting event is math, science and civics. The trigger is direction to
comeplte indepent work. Bheavior is head down and inapapropate comment. Conseqeunce of the behavior is to escape
work.

ABC Data: The antecnet behaviors are "Adult made a request/gave a direction", "Required task" and "Transition form one
activity to anyother". The setting event was recorded to be indpeent work. The behavior can be described as "Refuses to
follow adult directions" and "Passive refulass". The behavior intensity was noted to be mild. The conseqeunces are avoid
task and escape setting/activity. This is a summary of all the ABC data collected from 01/23/17 - 01/27/17, from 10:18am
- 2:30pm.

Duration Recording: It was recorded that the behavior usually beings during the first 30 minuets of a class beginning, and
alsted between 12 - 31 minuets. This data was recording from 01/23/17 - 02/01/17.

Scatter Plot Recroding: The problem behavior occurs during 3rd period, science, and 4th period, algebra. It occasialnly
occurs during 7th period, civics. It is improtant to note that during 1/23 and 2/3, TR was absent three times. These
recoridngs took place from 01/23/17 - 02/03/17.

4. Is the behavior impeding learning of the student or peers? Yes No

If yes, please describe:
Yes, because TR is distracting peers with her behavior and refuses to do work, as a result the classroom has to be
focused on her, rather than providing instruction to the other students.

5. Have Tier II Strategies or other Interventions been tried? (e.g., school/home notes, behavior contracts, self-monitoring)
Yes No
Describe previously selected intervention:
Ms. Mason implemented a self-monitoring strategy in English class to help TR stay alerted and on-task. The strategies have
been successful in the English class, and her grades have been slowly improving. However, in other classes where this
strategy is not implemented, TR's behavior continues to have a negative impact on her education.

6. Result of selected Tier II or other Positive Behavior Interventions and Strategies:

n/a

7. Is a behavior intervention plan recommended? Yes No Rationale: Yes, as result of TR's problem
behavior, she is falling behind in her class work and her grades are low, with the possibility of being held back for the
second time, before high school. TR is distracting peers with her behavior and refuses to do work, as a result the
classroom has to be focused on her, rather than be providing instruction to the other students.

8. Environmental Factors:
What are the reported and observed predictors for the current behavior(s)? (Antecedent events that trigger
problem behavior)

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 It has been suggested that the trigger is the direction to complete independent work and transitions during class.

What supports the student using the current problem behavior(s): summary based on the environmental
assessment portion of this assessment: (e.g., what is in the environment that should be eliminated or reduced?
What is not in the environment that should be added?)

9. Functional Factors:
Hypothesis of function (purpose) of this behavior for this student based on data collected in Section 3. above
The function of the behavior is escape. This is based on the problem behavior being rooted in work avoidance, and
she displays this by being tardy, withdrawn during class, does not complete work and puts her head down on her
desk. It was decided that the behavior was most likely to occur during Science (10:00 - 10:55 am) and Algebra (11:30
am - 12:25 pm). It was noted that the problem behavior occasionally occurs during Civics (2:05 - 3:00 pm). The
teachers reported that TR does not complete work and puts her head on the desk. It was also stated that
independent work often is the trigger for the off-task behavior. For example, when the teacher directs the student to
complete her independent work she will put her head down on the desk for longer than 5 minutes, makes an
inappropriate comment, such as, "This work is boring, I'm not doing it". This often occurs for 15 - 30 minutes of the
class. The teacher suggests that this behavior may be due to the fact that the class work and homework is somewhat
difficult. It was also observed that TR prefers lecture and group work, when in the classroom. It was suggested that
the problem behavior is low intensity. To conclude the interview, it was decided that the setting event is math,
science, and civics. The trigger is direction to complete independent work. the problem behavior is head down and
inappropriate comment. The consequence of the behavior is to escape work.

Suggested functionally equivalent replacement behavior:

Instead of putting her head on the desk and making comments, TR should ask her teacher for assistance in
completing her assignment or ask a peer to work with her. Additionally, TR's feelings of frustration regarding the work
should trigger her ability to ask for help so she does not fall behind in her coursework. TR's physical behavior of
putting her head on her desk should be replaced with sitting up and raising her hand for help.

SECTION 4: Conclusion/Recommendation
1. Conclusions: (Recommendations for IEP, 504, or school team consideration)
To conclude, it has been recommended that TR receives a BIP, which will allow for strategies to be implemented into the
classroom focusing on her problem behavior. The problem behavior is defined as off-task behavior defined as refusing to
completes assigned work, putting her head on a desk for longer than 5 minutes, closing her eyes, making inappropriate
comments such as "this work is boring so I'm not doing it" or "I'm not in the mood to do the work today".

2. Estimate of need for behavior intervention:

Extreme
Serious
Moderate
Needs attention, early stage intervention
Monitor behavior only; no formal behavior intervention plan is recommended at this time

3. If a Behavior Intervention Plan is NOT now recommended:

Behavior goals to be developed by: and contained in:
Consider Tier II interventions, or other interventions, such as
Consider assistance to students teacher to enhance environmental/student
Consider other Tier III interventions, such as district provided Cognitive Behavioral Therapy such as a Related Service
to address emotionally driven behavior

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 Consider WrapAround or Multiagency teaming

Rationale for selection of an alternate approach:

n/a

4. This team has determined that if a behavior plan is NOT to be developed as a result of this assessment, a
functional behavioaral assessment will be considered again if:
data demonstrates the problem behavior intensity, duration or frequency escalates or continues at current rate or
data demonstrates non-responsiveness to selected other approaches

Describe:
n/a

5. This student has: a current IEP a current 504 Plan neither

6. Goals to monitor future behavior will be added to:

a new or amended IEP
a new or amended 504 Plan
a school teams plan (no IEP or 504 Plan)

SECTION 5: Evaluation Personnel

Individuals contributing to this evaluation:
Name Position Name Position
Ms. Harris, Conselor
Ms. Mason English
Mr. Gerard Algebra
Special Ed Teacher Special Ed Teacher

Contact person for this report: SPED

Phone: (166)323-3243
E-mail: HELLO@gmail.com

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