Circle the intensity (1-5 scale) and indicate the duration (in minutes). There is a space below each box to write clarification or tally frequency. The top of the page provides information about the time of day and setting.
This is a valuable tool when formulating Functional Behavior Assessments. Use to help assess the function of the behavior. For example: "When (antecedent), the student will (behavior) in order to (escape/avoid/postpone... or gain access to...)"
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