Fba Form
Fba Form
Adapted from: O'Neill, R.E., Homer, R. H., Albin, R. W., Sprague, J. R., Storey, K., & Newton, J. S. (1997).
Functional Assessment and Program Development for Problem Behavior. Pacific Grove, CA: Brooks/Cole Publishing.
Yrs 2
Mos 6
Sex:
How is it performed?
How often?
How long?
Intensity?
Biting - Most on children around her age, face, arm, or hand- 15 bites total since September (10 on one child "Peter Pan").
1. Medium to high intensity- bites do not bleed but usually leave a mark or bruising.
Arguing- sometimes with children, usually with teachers. 1-4 times per day. When children aren't following rules or listening to her
2. words, and when teachers ask her to do something she does not want to do, or confront her about hurting a friend. Medium intensity.
Hitting- (downward smacking) does not occur often, but sometimes when she gets very worked up and frustrated. Will attempt to hit
4. other children who are not following the rules by yelling or smacking if they do not listen.
5.
6.
2. Which of the behaviors described above occur together (e.g., occur at the same time; occur in a
predictable "chain"; occur in response to the same situation)?
Depending on the situation, all of these behaviors could occur together. If a child tries to take a toy from her or is in her
space, she may yell, smack, or bite to get them away from her (or get the toy back). When a teacher intervenes she may
argue with them or hit them when when the teacher tries to get her away from the situation to calm down.
None
2. What medical complication (if any) does the child experience that may affect his/her behavior
(e.g., asthma, allergies, rashes, sinus infections, seizures)?
None
Rev. 11/03
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csefel.uiuc.edu
H 3a.4
(P. 1/9)
Module 3a
3. Describe the sleep cycles of the child and the extent to which these cycles may affect his/her behavior.
Tinkerbell struggles to go down at night, not usually asleep until 9PM. She is an early riser. Naps
during the day from 1:30-3PM. This may effect her behavior because she usually has a much
better afternoon after her nap. She is not getting enough sleep for someone her age.
4. Describe the eating routines and diet of the child and the extent to which these routines may affect his/her
behavior.
Tinkerbell is typically a picky eater. She likes hot dogs, peanut butter and jelly, mac and cheese,
milk, and a few other select things. She likes fruit, but it is difficult to get her to eat vegetables. She
will try new foods, but usually does not like them. This could effect her behavior because it could
effect her energy level; she may not be getting the nutrients she needs.
5. Briefly list the child's typical daily schedule of activities and how well he/she does within each activity.
DAILY ACTIVITIES
Activity
6:00 am
7:00 am
8:00 am
9:00 am
10:00 am
11:00 am
12:00 pm
1:00 pm
2:00 pm
3:00 pm
4:00 pm
5:00 pm
6:00 pm
7:00 pm
8:00 pm
9:00 pm
Rev. 11/03
Child's Reaction
Transition to school- Easy transition. She enjoys coming to school, Will say goodbye and jump into playing.
Free Choice play, Potty, She is potty trained, but it's very important to her to go first on the potty, will run
back and push other children out of the way, screams and cries if another child goes first.
Breakfast- will eat once she gets to the table, sometimes refuses to come to the table.
Circle time- enjoys, sings along and participates, gets upset when other children don't follow the rules.
Book time- loves reading, very intelligent, will describe pictures, and has memorized some books.
Free play and Centers- loves writing art, and independent math activities, she gets overwhelmed if
there are too many children are around her.
Transition from Outside to Inside, loves playing outside, sometimes refuses to come in.
Transition from Lunch to Nap- Plays with her pacifier and monkey, needs back rubbed, takes about 30
minutes to fall asleep.
Sleeping
Wakes up- in a good mood, potties, dancing (loves to pick her favorite song) and transition to snack.
Playtime Outside/ Free play inside- enjoys playing with baby dolls and playing house.
Potties and Free play until parent arrives- easy transition, excited to see Mom or Dad and tell them
about her day.
Sleeping
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H 3a.4
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Module 3a
6 Describe the extent to which you believe activities that occur during the day are predictable for your child.
To what extent does the child know what he/she will be doing and what will occur during the day
(e.g., when to get up, when to eat breakfast, when to play outside)? How does your child know this?
Activities during the week are very predictable. We follow a schedule at school, there is a visual schedule at child
level. We have a Time Timer with a red countdown that we set during activities so children know when the next
activity is coming. Tinkerbell thrives with routine, if something is different with the day she will tell you about it.
She has had the same classroom and teachers and has has a similar schedule since she was an infant.
7. What choices does the child get to make each day (e.g., food, toys, activities)?
She has many opportunities to choose what she plays with during the day. She picks out what books she
would like to look at at book time, what centers she wants to visit during the day, what order to eat her
lunch, who she wants to play with, and how she creates art.
using.
Least likely: When she playing alone (no other children around), during a teacher guided activity, outside, or during
meals.
2. Settings: Where are the behaviors most and least likely to happen?
Most likely:
In the home living area (she likes to play with baby dolls), In other more confined areas.
Least likely: At the table, in an assigned seat, or larger areas like outside where she has space.
3. Social Control: With whom are the behaviors most and least likely to happen?
Most likely:
With other children her age, especially one 2-year-old boy "Peter Pan". Peter Pan tends to go out of his way
to be by Tinkerbell. He sometimes will go up and take a toy from her, hit her, or touch her. Tinkerbell gets
very annoyed by this. We have been working with Peter Pan on personal boundaries.
Least likely:
When playing with children that are older than her. She is very intelligent, she speaks in full sentences and
understands concepts that most children her age do not understand, so she prefers to play with older
children. She very rarely bites adults.
Rev. 11/03
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H 3a.4
(P. 3/9)
Module 3a
4. Activity: What activities are most and least likely to produce the behaviors?
Most likely:
Activities where there is less teacher coverage to uphold her boundaries from other children. The bites
usually happen during morning free time, where she is playing across the room and both teachers are
Least likely: Sit down activities like art or lunch, or one-on-one activities with teachers. She gets very engaged in
activities that challenge her and make her think, like puzzles, math activities, and art.
5. Are there particular situations, events, etc. that are not listed above that "set off the behaviors that cause
concern (particular demands, interruptions, transitions, delays, being ignored, etc.)?
Tinkerbell has a stubborn side and very little patience, which can be normal for 2 year olds. She is very particular about how
she likes things. For example, she refuses to put on gloves that don't match. She likes routine, to follow order, and steps. If you
showed her a finished art project and gave her the same materials, she would replicate it exactly. If other children are not
following rules, it makes her anxious and upset. For example, we sing before we eat lunch. A 1 1/2 year old started to put a
breadstick into his mouth before we sang, she ran up and knocked the breadstick out of his hand and said, "Don't eat yet!"
6. What one thing could you do that would most likely make the problem behavior occur?
To put her and Peter Pan in the same area with one toy.
7. What one thing could you do to make sure the problem behavior did not occur?
One-on-one with a teacher, you could almost guarantee it would not occur- If you let her dictate what she is doing,
and what other people are doing.
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H 3a.4
(P. 4/9)
Module 3a
5. Does your child play with other children his/her age? What toys or games?
She will play with children her age, home living, minnie mouse, and barbies, dancing. She prefers to play with
older children because she enjoys complex play.
6. How does your child react if you join in a play activity with him/her?
Sometimes she is very accepting, and sometimes she will assign a role for you (you build this, color this, or you
bake the cake). She likes opportunities to be in charge and direct people.
7. How does your child react if you stop playing with him/her?
If I stopped in the middle of the book she would probably be sad, and request to finish it later, but with most
other things she will carry on without me.
8. How does your child react if you ask him/her to stop playing with a toy and switch to a different toy?
She reacts negatively, she is not a fan of being told to move on or play with something else. She will usually
scream and request the toy she was playing with before.
Or
1. Biting- Gets people out of her space immediately, or gets the other child to drop the toy, she gains control of the situation.
2.
3.
4.
Arguing- gaining control, if she wins the argument she can do what she wanted to do, or get an option she prefers.
Hitting- She people out of her space immediately, gets child or adult's attention, gets out her frustration.
Behaving other children- makes her feel more comfortable, she gets upset when other children break rules. Gains control.
5.
6.
7.
8.
9.
10.
Rev. 11/03
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H 3a.4
(P. 5/9)
Module 3a
b. Are the above behavior(s) more likely, less likely, or unaffected if you interrupt a desired event
(eating ice cream, watching a video)?
Much more likely. If a child interrupts, they may get behaving, hit, or bitten. If an adult interrupts they may get screaming
and arguing.
c. Are the above behavior(s) more likely, less likely, or unaffected if you deliver a stem
request/command/reprimand?
More likely to get arguing.
d. Are the above behavior(s) more likely, less likely, or unaffected if you are present but do not interact with
(ignore) the child for 15 minutes.
Depends on the situation, if she is able to do what she wants to do you are less likely to get arguing. If in that time a
child came too close to her for comfort, or took a toy you would be more likely to see biting without teacher intervention.
e. Are the above behavior(s) more likely, less likely, or unaffected by changes in routine?
More likely, routine is very important to her.
f. Are the above behavior(s) more likely, less likely, or unaffected if something the child wants is present
but he/she can't get it (i.e., a desired toy that is visible but out of reach)?
More likely, she would probably argue with a teacher about wanting the desired toy.
g. Are the above behavior(s) more likely, less likely, or unaffected if he/she is alone (no one else is present)?
Less likely- she does not argue, bite, hit, or behave other children when she is alone.
It depends on the situation, at times she will have tantrums that last 20 minutes, at other times, simple verbal
outbursts.
outbursts. The biting is medium to high intensity.
2. Does engaging in the behaviors result in a "payoff (getting attention, avoiding work) every time?
Almost every time? Once in a while?
The behaviors almost always result in a temporary payoff. When she bites or hits the other child either moves
away from her or drops the toy. At the daycare arguing usually does not result in a pay off.
3. How much of a delay is there between the time the child engages in the behavior and gets the "payoff?
Is it immediate, a few seconds, longer?
The payoff for biting is usually immediate to a few seconds after the bite. Within a minute a teacher intervenes.
We talk to her about how biting hurts and ask her to look at their face and see how they are sad. She is given
a consequence (the toy is taken away or she has to sit down). We go by the philosophy that sorry doesn't fix
it. It's not okay that it happened and she needs to ask what will help her friend feel better (getting them ice,
asking if they want a hug, etc.)
Rev. 11/03
The Center on the Social and Emotional Foundations for Early Learning
csefel.uiuc.edu
H 3a.4
(P. 6/9)
Module 3a
She speaks clearly and very consistently- in full sentences. No other forms of communication are
needed because she is easily understood.
2. If your child is trying to tell you something or show you something and you don't understand, what will
your child do? (repeat the action or vocalization? modify the action or vocalization?)
She is doing much better, 3 months ago she would have screamed, now she will repeat it or
clarify until you understand.
Requests an Object
Requests an Action
Protests or Escapes
Requests Help
Requests a Social Routine
Requests Comfort
Indicates Illness
Shows You Something
**
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
NONE
OTHER
CRY OR WHINE
TANTRUM
AGGRESSION
SELF-INJURY
COMPLEX SIGNS
SIMPLE SIGNS
DELAYED ECHO
IMMEDIATE ECHO
VOCALIZE
FACIAL EXPRESSION
MOVE TO YOU
GAZE SHIFT
LEAD
POINT
GIVE
FUNCTIONS
MEANS
* **
*
****
*
*
*
Notes:
Rev. 11/03
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H 3a.4
(P. 7/9)
Module 3a
b. Is the child able to imitate someone demonstrating how to do a task or play with a toy?
Completely, and she will follow it as closely as she can. For example if we make an art project and show
her an example, she will imitate. She imitates her parents with her baby brother when she plays baby
dolls. She has had our calendar routine down and been saying the pledge of allegiance since before she
was 2.
c. Does the child respond to sign language or gestures? If so, approximately how many? (List, if only a few.)
She is intelligent, I'm sure she could if she was taught, but she was never exposed to it, and an early
talker so she never needed it.
d. How does the child tell you "yes" or "no" (if asked whether he/she wants to do something, go somewhere, etc.)?
She will tell you "yes" or "no" and respond in full sentences.
H. WHAT EVENTS. ACTIONS. AND OBJECTS ARE SUPPORTIVE OR PRESENT CHALLENGES TO THE CHILD
1. Describe the things that your child really enjoys. For example, what makes him/her happy? What might someone
do or provide that makes your child happy?
She enjoys any type of creative thinking- puzzles, stencils, coloring, art, magnet blocks, sorting, and dramatic play.
2. What kinds of things have you or your child's care providers done to try and change the problem behaviors?
1. Her parents bought her a rubbery biting necklace that she wears every day. I think that she craves some sensory stimulation for
her mouth, and this has helped.
2. We made a social story "Tinkerbell's book of things to bite". The story is about keeping our friends safe. Tinkerbell likes to bite
PB&J (with a picture) not Peter Pan (with a picture) It has pictures of her favorite foods and other children in her classroom. We read
this to before free time and it is always out on a low shelf if she would like to look at it.
3. We've talked to her and explained how this is hurting her classmates. She usually does feel bad after she bites and the last few
she has apologized to the child right after she does it, so we are making progress. The bites are getting few and farther in between.
4. We have reviewed language that she can use when she wants to be alone, needs space, or wants a toy.
5. We added a "safe space" and hula hoops to our room for physical boundaries
6. We have talked to Peter Pan about spatial boundaries. When the biting was at it's worst, we brought in an extra teacher and
shadowed Tinkerbell and Peter Pan, keeping them separate.
Rev. 11/03
The Center on the Social and Emotional Foundations for Early Learning
csefel.uiuc.edu
H 3a.4
(P. 8/9)
Module 3a
Immediate
Antecedent
(Trigger)
Problem
Behavior
Arguing.
- A teacher asks
Tinkerbell to do
something she does
not want to do.
- A teacher attempts to
put Tinkerbell in timeout.
Maintaining
Consequences
- Escaping Attention
- Gaining Personal
Space
- Obtaining tangible
Object
Function
- Escaping Attention
- Gaining Personal
Space
- Obtaining tangible
Object
- Gaining Control.
Hitting (downward,
open-handed
smacking)
- Gaining Control.
- Avoiding time-out.
- Gaining control
- Getting other
children to follow the
rules.
- Maintaining order.
Rev. 11/03
"Behaving" other
children.
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H 3a.4
(P. 9/9)