School: KES District: S Date: 8/15/16

Team Members (Initials):

Commented [DR1]: Very nice! Thank you for including all
1. ____SS_____________ 5. ___________________________________ docs in one file to upload!

2. _______________________________ 6. ___________________________________

3. _______________________________ 7. ___________________________________

4. _______________________________ 8. ___________________________________

Coach or Instructor: Dr. Royer

Step 4: Designing the Intervention

Directions: Complete step four, see notes in RED.

Check when Item

completed
X Step 4.1 Select an Intervention Method
Select Intervention Method and confirm with teacher HO 6 pages 4-9

X Step 4.2 Develop Intervention Components

Draft A-R-E components (Antecedent adjustments, Reinforcement adjustments,
and Extinction components)
Link each intervention tactic to the hypothesized function on the planning sheet
(page 6, 7, 8, or 9 depending on the method you select according to the
functional assessment intervention decision model.
(Posted)
Check when Item
completed
X Step 4.3 Components Related to Valid Inference Making
Draft Treatment Integrity Form including quality rubric HO 11
(Posted)

X Select and review social validity forms HO 12.1 and 13.1

(Posted)

X Prepare a plan for introducing the intervention to the parent include a check
for understanding.
Describe how it was done here:
*For SPED 743, write your response here.
I chose to introduce the intervention to the parent using scenarios on them. For
instance, I was the parent and they acted as R.M would. I demonstrated how to
use the proper questioning for R.M to realize what she needs to do and the
proper procedures they needed to follow in order for R.M. to be successful and
for them to have the result that they wanted. I then had us switch roles once I
felt that they understood. We completed with a questionnaire with scenarios. Commented [DR2]: Great role playing!

(Posted)
X Prepare a plan for introducing the intervention to the students include a check
for understanding.
Describe how it was done here:
*For SPED 743, write your response here.

I chose to show R.M what her parents and I were doing with the role play. I
talked her through her role and how to properly follow through with it. I
showed her pictures and we completed a checklist.

(Posted)
Check when Item
completed
Revise and finalize A-R-E Intervention Components using feedback from the
teacher and draft final TI form HO 11
(Posted)

X Prepare intervention materials

n/a Collect additional baseline data after any school breaks (3 pts.) with at least 1
IOA.
*For SPED 743, complete this step if a weekend or break from school (e.g.,
holiday, winter recess) occurs between the last day of baseline (A1) and first
day of intervention (B1). You may also continue to monitor baseline and have
additional data points while you continue to work through designing the
intervention.

X Complete and turn this checklist into your coach.

Commented [DR3]: There were some tips on the checklist that

you could respond to
 Functional Assessment and Behavior Intervention Plan: Planning Form

Student Name: Reese MarekRM Student ID: ___________ Commented [DR4]: Remember to use initials or a pseudonym
for confidentiality.
School: KES Date of Birth: 10/12/09
Parent(s): Mr. and Mrs. Dave and Chris Marek Parent(s) Contact Number: _860-305-3055_

Date of Assessment: 7/25/16 Teacher:

Person conducting the assessment: Samantha

Role: Behavior Specialist Teacher Intern X University Student Other

Identifying the Problem: Defining Target and Replacement Behaviors

Target Behavior: Off task

Operational Definition (observable, measurable, repeatable): Off-task behavior refers to any behavior that engages in activity (anger)
other than what Mom or Dad says or does.

Examples: Taking belly breaths, using anger avoiding strategies, taking cool off timeHitting, yelling, crying, stomping feet Commented [DR5]: These sound like non-example for off-task.
These would be examples for on-task, correct?

Nonexamples: Taking belly breaths, using anger avoiding strategies, taking cool off time Commented [DR6]: These sound like non-example for off-task.
These would be examples for on-task, correct?
Hitting, yelling, crying, stomping feet

Data Recording System (e.g. Event Recording, Permanent Product): Partial interval

Replacement Behavior: On task

Operational Definition (observable, measurable, repeatable): On-task behavior refers to any behavior that involves attending to
parental instruction or engaging in chores (tasks).
Examples: Eye contact with parents, speaking in a calm voice, using belly breaths, taking cool off time, using anger avoiding
strategies.

Nonexamples: looking away from parents, yelling, screaming, stomping feet

Data Recording System (e.g. Event Recording, Permanent Product): whole interval

Rationale: Reeses off task behavior is preventing her from calmly explaining her feelings when she doesnt get what she wants. The Commented [DR7]: For rationale, explain why you chose the
data recording system you chose. Why was it best to match the
data recording system chosen was partial interval. This was chosen to determine if there was a specific timer period where RM would behavior you are choosing to track?
melt down.

Baseline: During three 20 minute observation session, Reese was on- task 80% of the time. Commented [DR8]: Thats high! That is what we hope for in
school (its not really feasible to expect 100% attentativeness or on-
task behavior). Are you sure this person needs a FABI? Okay to
Functional Behavioral Assessment: Interviews and Direct Observations practice on them, but be aware for doing FABIs in your classroom
It wold make more sense if he was off-task 80% of the time

Interviews Completed: YES NO Lastly, include the range and/or standard deviation when reporting a
mean or other measure of central tendency.

Interviewees: Teacher Parent Student

Rating Scales:

Hours of Total Direct Observation (A-B-C): 3 hours

Setting(s) of Observations: 1) At home after dinner, 2) At home before bed

Determining the Function of the Behavior: Using the Function Matrix
Positive Reinforcement
(Access Something)
Attention
Parent Interview:
Q15: What are the identified
reinforcers for this student?
- Talking with peers,
parents
Tangibles ABC Data: 1.2, 2.2, 3,1
Activities
Parent Interview
Q15: What are the identified
reinforcers for this student?
-2 positive choices she
wants (different each
time)
Student Interview:
Q4: What changes could be
made so you would have fewer
problems with off-task
behavior?
- Go on bike trail, get ice
cream
Negative Reinforcement
(Avoid Something)
ABC Data: 3.2
ABC Data: 1.1, 1.2, 2.1, 2.2, 2.3,
3.1, 3.2
Parent Interview:
Q4: What do you think causes
(or motivates) the behavior?
- Not getting her way
- Being told no
Student Interview:
Q3: What causes you to have
problems with off-task behavior?
- They say no
- Dont let me do stuff
 Sensory

Outcome of Function Matrix: Hypothesized Function: At home after dinner and before bed, Reese engages in off-task behavior to
escape activities. That is when Reese is off task, she escapes chores or choices she doesnt want to do.

Behavioral Objective: During the time after dinner and before bed, R.M will engage in on-task behavior for at least 70% of the time
during the intervention phase for 5 consecutive sessions.
 Functional Assessment-based Interventions (FABI)
HO 6

Functional Behavioral Assessment: Determining the Intervention Method

Question 1: Can the student perform the replacement behavior?

Question 2: Do antecedent conditions represent effective practice?

Method Selected: Method 1: Teach the Replacement Behavior

Method 2: Improve the Environment
Method 3: Adjust the Contingencies
X Method 1 & 2: Teach the Replacement Behavior and Improve the
Environment
Note. After you have selected the appropriate method, draft an intervention for the selected
intervention on page 6, 7, 8, OR 9. Do not draft ALL interventions.
Method Description
Adjust antecedent conditions so new behaviors are learned and
Method 1: Teach the aversive conditions avoided.
Replacement Provide appropriate reinforcement for the replacement
Behavior behavior.
Withhold the consequence that previously reinforced the target
behavior.
Adjust antecedent variables so the conditions that set the
Method 2: Improve occasion for the target behavior are eliminated and new
the Environment conditions are established in which the replacement behavior is
more likely to occur.
Provide appropriate positive reinforcement for replacement
behavior.
Withhold the consequence that previously reinforced the target
behavior.
Provide the consequence that previously reinforced the target
Method 3 : Adjust the behavior, but only for the replacement behavior.
Contingencies Withhold the consequence when the target behavior occurs
(extinction).
Adjust the antecedent conditions to make it more likely that the
replacement behavior will occur.
Adjust antecedent variables so (a) new behaviors are learned
Method 1 & 2: Teach and aversive conditions avoided and (b) the conditions that set
the Replacement the occasion for the target behavior are eliminated and new
Behavior and Improve conditions are established in which the replacement behavior is
the Environment more likely to occur.
Provide appropriate positive reinforcement for replacement
behavior.
Withhold the consequence that previously reinforced the target
behavior.

10
Source: Lane, K. L., Menzies, H., Bruhn, A., & Crnobori, M. (2011). Managing challenging behaviors in schools:
Research-based strategies that work. New York, NY: Guilford Press. Reprinted with permission.
 Functional Assessment-based Interventions (FABI)
HO 6

Method 1 Teach the Replacement Behavior

Adjust antecedent
conditions so new
behaviors are
learned and
aversive conditions
avoided.

Provide
appropriate
reinforcement for
the replacement
behavior.

Withhold the
consequence that
previously
reinforced the
target behavior.

11
Source: Lane, K. L., Menzies, H., Bruhn, A., & Crnobori, M. (2011). Managing challenging behaviors in schools:
Research-based strategies that work. New York, NY: Guilford Press. Reprinted with permission.
 Functional Assessment-based Interventions (FABI)
HO 6

Method 2 Improve the Environment

Adjust antecedent
variables so the
conditions that set
the occasion for
the target behavior
are eliminated and
new conditions are
established in
which the
replacement
behavior is more
likely to occur.

Provide
appropriate
positive
reinforcement for
replacement
behavior.

Withhold the
consequence that
previously
reinforced the
target behavior.

Method 3 Adjust the Contingencies

12
Source: Lane, K. L., Menzies, H., Bruhn, A., & Crnobori, M. (2011). Managing challenging behaviors in schools:
Research-based strategies that work. New York, NY: Guilford Press. Reprinted with permission.
 Functional Assessment-based Interventions (FABI)
HO 6

Provide the
consequence that
previously
reinforced the
target behavior,
but only for the
replacement
behavior.
.

Withhold the
consequence when
the target behavior
occurs (extinction).

Adjust the
antecedent
conditions to make
it more likely that
the replacement
behavior will occur

13
Source: Lane, K. L., Menzies, H., Bruhn, A., & Crnobori, M. (2011). Managing challenging behaviors in schools:
Research-based strategies that work. New York, NY: Guilford Press. Reprinted with permission.
 Functional Assessment-based Interventions (FABI)
HO 6

Method 1 & 2: Teach the Replacement Behavior and Improve the Environment

Adjust antecedent Provide RM with a weekly schedule listing the chores to be

variables so (a) covered so she has an opportunity to review the list prior.
new behaviors are Allow RM to choose five out of the ten chores per week on the list Commented [DR9]: Are there 10 for the week? Or 10 for each
day and each day she chooses 5? Can you provide a copy of this list
learned and Teach RM how to scan all of the chores before to determine which please
aversive conditions ones will be the easiest to complete.
avoided and (b) the Teach Katie RM how to use her checklist to self-monitor. Review Commented [DR10]: Who is Katie? Mom?
conditions that set this procedure with her daily until she demonstrates mastery.
the occasion for Check in with RM individually prior to the end of the day to
the target behavior review her chores list and adjust as needed.
are eliminated and Review home expectations (i.e., be respectful, be responsible, do your
new conditions are best) prior to independent work
established in
which the
replacement
behavior is more
likely to occur.

Provide Provide behavior-specific praise when RM completes a chore Commented [DR11]: Also, praise for choosing her 5! And for
starting each chore! To teach a new procedure or skill, it takes a lot
appropriate If RM elects to complete chores beyondmeet her daily work of reinforcement in the beginning.
positive completion goal, she can receive an extra 5-minute break Commented [DR12]: I strongly suggest reinforcing her for
reinforcement for Give RM the option to engage in a preferred activity after she has meeting expectations, not for going above and beyond. Think PBIS
and all youve learned about expectation matrices and reinforcing
replacement completed her daily chores according to her daily list student for meeting expectations not being super stars.
behavior.
Also, in the beginning, she should be reinforced after each chore.
What if she does some but not all 5? Still progress right? Praise and
reinforce with some type of reward (is 5-min enough to be
reinforcing? Maybe if its between each chore completed But Im
thinking there should be something more substantial for a reinforcer.
What does she find motivating?)
Commented [DR13]: Have you created a list for RM to choose
from with her and parent input? Please include a copy. I encourage
you to think about activities on this list being ones that RM can only
access after doing her chores, meaning they arent something the
Withhold the parents will let her do later in the day regardless of whether she does
chores or not. What are unique activities she loves that can be
consequence that Remind RM of her daily work completion goal when getting withheld completely unless she completes chores?
previously distracted
reinforced the Provide a brief, verbal reminder to move on to the next chore
target behavior. Require RM to show and check off her list at the end of each day Commented [DR14]: For extinction components, please revisit
your A-B-C data for the function column, your function matrix, and
the hypothesis made after examining the function matrix. What did
RM find reinforcing after engaging in the target behavior? What
was the function regarding getting that reinforcement? That
reinforcement is what needs to be put on extinction. Did she get
attention by showing anger? Then that attention needs to be
completely withheld (e.g., no reminders or verbal interactions). Was
it to escape the task? Then she must complete the task before doing
anything else, and that can be tricky. Its like making your kid sit at
the dinner table all night long until they eat their broccoli. If the
parents give in at any point, then all is lost! Does that make sense?
Skype with questions!

Please revise this (if appropriate, it could be Im not understanding

the full situation with this student) before starting the intervention.
14
Source: Lane, K. L., Menzies, H., Bruhn, A., & Crnobori, M. (2011). Managing challenging behaviors in schools:
Research-based strategies that work. New York, NY: Guilford Press. Reprinted with permission.
 Functional Assessment-based Interventions (FABI)
HO 6

Data to be Collected

Target Behavior: None

Replacement Behavior: On-task behavior will be assessed using whole interval recording
procedure during 20- minute observation sessions (2 minute intervals) 2 to 4 days per week.
When I am observing there is no access to an inter-observer.

Treatment Integrity: The parent will collect treatment integrity data by completing a daily self- Commented [DR15]: Excellent having the parent do this and
you do as well for IOA.
report checklist. She will rate her implementation of each component of the intervention using a
Likert-type scale (0 = never; 1 = sometimes; 2 = always; NA = no opportunity). I will also collect Commented [DR16]: Excellent! Be sure to put this on the TI
form below.
data during at least 30% of sessions to assess inter-observer agreement (IOA).

Social Validity: Social validity will be assessed from the parent and child perspective prior to
the implementation of the intervention and at the end of the intervention.

Fading and Generalization: Once R.M reaches the behavioral objective, her parents will
decrease the level of support provided and monitoring progress toward goals.

Program Review Date: There will be a review following three weeks of implementation.

Personnel and Roles: The parent will be responsible for explaining the intervention components
and procedures to R.M., implementing the intervention, and collecting data to assess the fidelity
of the implementation.

Emergency Procedures: In the case of an emergency, the parents will follow their standard rules.

15
Source: Lane, K. L., Menzies, H., Bruhn, A., & Crnobori, M. (2011). Managing challenging behaviors in schools:
Research-based strategies that work. New York, NY: Guilford Press. Reprinted with permission.
SPED 743
Completion Checklist
Step 4: Designing the Intervention
Team Number 15
Treatment Integrity Checklist
Directions: Write yes or no in response to each question. Fill out this form daily.

Monday Tuesday Wednesday Thursday Friday

Provide RM with a
weekly schedule listing
Antecedent A1 the chores to be covered
Allow RM to select which
one of the five chores she
will be completing

A2

Teach RM how to choose

which chores she can
complete on her own.
Teach her how to self-
A3 monitor.
Check in with RM prior to
the end of the day to see
A4 what she completed
Review home
expectations prior to
A5 completing anything

Provide behavior specific

praise when RM
completes a chore and
does another one (if
Reinforcement R1 applicable)

Give RM the option to

engage in a preferred
activity after she has
completed her daily task
R2 according to her chart

Allow RM to discuss with

a parent any questions
about the task list
R3

Remind RM of her daily

Extinction E1 task completion goal Commented [DR17]: Adjust as needed based on my comments
above.
Provide a brief, verbal
reminder to move on to
E2 the next problem

Require RM to hand in
her daily task check list at
E3 the end of the day

Parent initials

Form Updated 07/23/2014

From Lane, K. L., & Oakes, W. P. (2014). Building efficiencies in functional assessment-based
interventions: A focus on training and coaching. Manuscript in preparation.
16
SPED 743
Completion Checklist
Step 4: Designing the Intervention
Team Number15

Comments

Form Updated: December 11, 2017December 4, 2017August 15, 2016

From Lane, K. L., & Oakes, W. P. (2014). Building efficiencies in functional assessment-based
interventions: A focus on training and coaching. Manuscript in preparation.
17
 SPED 743
Completion Checklist
Step 4: Designing the Intervention
Team Number15

Adapted Version of the Intervention Rating Profile-15 Commented [DR18]: Looks good. Who completed this?
The purpose of this questionnaire is to obtain information that will aid in the selection of classroom interventions. Mom? Dad?
These interventions will be used by teachers of children with identified needs. Please circle the number which best
describes your agreement or disagreement with each statement. Completed by Mom.
Strongly Disagree Slightly Slightly Agree Strongly
disagree disagree agree agree
1. This would be an acceptable 1 2 3 4 5 6
intervention for the childs needs.
2. Most teachers would find this 1 2 3 4 5 6
intervention appropriate for children
with similar needs.
3. This intervention should prove 1 2 3 4 5 6
effective in supporting the childs
needs.
4. I would suggest the use of this 1 2 3 4 5 6
intervention to other teachers.
5. The childs needs are severe enough 1 2 3 4 5 6
to warrant use of this intervention.
6. Most teachers would find this 1 2 3 4 5 6
intervention suitable for the needs of
this child.
7. I would be willing to use this 1 2 3 4 5 6
intervention in the classroom setting.
8. This intervention would not result in 1 2 3 4 5 6
negative side effects for the child.
9. This intervention would be 1 2 3 4 5 6
appropriate for a variety of children.
10. This intervention is consistent with 1 2 3 4 5 6
those I have used in classroom
settings.
11. The intervention is a fair way to 1 2 3 4 5 6
handle the childs needs.
12. This intervention is reasonable for 1 2 3 4 5 6
the needs of the child.
13. I like the procedures used in this 1 2 3 4 5 6
intervention.
14. This intervention would be a good 1 2 3 4 5 6
way to handle this childs needs.
15. Overall, this intervention would be 1 2 3 4 5 6
beneficial for the child.
Comments: ___________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Form Updated: December 11, 2017December 4, 2017August 15, 2016
From Lane, K. L., & Oakes, W. P. (2014). Building efficiencies in functional assessment-based
interventions: A focus on training and coaching. Manuscript in preparation.
18
 SPED 743
Completion Checklist
Step 4: Designing the Intervention
Team Number15

Adapted Version of the Childrens Intervention Rating Profile

I agree I do not
agree
16. The program we will use sounds x
fair.

17. I think my parents will be too x

harsh on me.

18. Being in this program may cause x

problems with my friends.

19. There are better ways to teach Didnt

me. know

20. This program will help other kids, n/a

too.

21. I think I will like being in this x

program.

22. I think being in this program will x

help me do better at home.

Comments: _____________________________________________________________

________________________________________________________________________

________________________________________________________________________

Source: Adapted from Witt, J.C. & Elliott, S.N. (1985). Acceptability of classroom intervention
strategies. In Kratochwill, T.R. (Ed.), Advances in School Psychology, Vol. 4, 251 288.
Mahwah, NJ: Erlbaum. Reprinted with permission.

Form Updated: December 11, 2017December 4, 2017August 15, 2016

From Lane, K. L., & Oakes, W. P. (2014). Building efficiencies in functional assessment-based
interventions: A focus on training and coaching. Manuscript in preparation.
19
SPED 743
Completion Checklist
Step 4: Designing the Intervention
Team Number15

Form Updated: December 11, 2017December 4, 2017August 15, 2016

From Lane, K. L., & Oakes, W. P. (2014). Building efficiencies in functional assessment-based
interventions: A focus on training and coaching. Manuscript in preparation.
20