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Functional Behavioural Assessment and Behaviour Intervention Plan

Lindsay Birchall
University of Calgary

Interventions to Promote Social-Emotional and Behavioural Well-Being EDPS 674

Dr. Erica Backenson
February 26th, 2015

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Functional Behavior Assessment

Date: 02/26/15
Name: Zack Black
Age: 4-5
Grade: Preschool
Classroom teacher: Ms. Canyon
School: Growing Smiles
Definition of Target Behaviors
Escalation when exposed to automatic flush toilets or loud hand dryers: screaming, shaking,
verbal protest (e.g. stop its loud, no, I dont want to), crying, physical protest (pushing up
against adults when prompted to go near the toilet or hand dryer, hitting adults, running out of
the washroom), fearful facial expressions, covering ears, flushed cheeks, rapid breathing, still
and rigid body posture, not speaking, refusing to move.
Assessment Methods Used
Evaluator collected data using Antecedent Behavior Consequence data sheets and
Behavior Rating Scale data sheets to measure the intensity of fear/anxiety responses when Zack
was exposed to the fear evoking stimulus. Other methods included behavioral observations by
evaluator in the home, community and school settings, and information provided by or elicited
from the staff, student, classroom teacher and the family. Previous standardized assessment
results and intervention information were provided by or elicited from the Intervention
Assistance Team (i.e. Speech and Language Pathologist (SLP), Occupational Therapist (OT),
Education Consultant (EC), Behavior Strategist (BS) and a cumulative file review, (Psychology
Report).
Historical analysis
Zack is a 4-5 year old student who attends Growing Smiles Preschool. In January, 2014,
Zack was diagnosed with Autism Spectrum Disorder by the Children's Hospital Early Childhood
Development Team. Zack has been receiving early interventions services, through the Cause and
Effect Foundation program since September, 2014. The Intervention Assistance Team includes a
Family Liaison Coordinator, SLP, OT, BS, EC and an aide (i.e. Child Development Facilitator
(CDF)).
Summary of Information
Information obtained regarding Zacks health, speech and language, motor skills, sensory
profile, educational, social, emotional and home environment was obtained from semi structured
interviews with parents and his Early Intervention Assistance Team members. Previously
conducted standardized assessments were also reviewed and relevant behavioral observations
were noted. Interviews and observations were conducted on several dates between February 2nd
and 7th.

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Health. Zack has good general health. He sleeps well, although sometimes presents with
challenging behaviors during his bedtime routine. Zack has a history of choking on food; this
may be attributed to his aversion to specific textures and/or premature chewing patterns,
resulting in frequent gagging and vomiting. Zacks vision and hearing are within normal limits. A
history of delayed language has been documented. Zacks older sister is also diagnosed with
Autism Spectrum Disorder.
Speech and Language. The psychology assessment conducted in March, 2014 noted a
severe language delay. In October, 2014, Zack obtained scores within typical limits on the Core
Language subtests of the Clinical Evaluation of Language Fundamentals-Preschool-2 (Sentence
Structure, 50th percentile; Expressive Vocabulary, 50th percentile; Word Structure, 50th percentile).
His SLP reported that Zack does not show scattered skills nor does he demonstrate any areas of
weakness, with regards to his speech and language abilities. Since October, his SLP has seen
him on a consultative basis, focusing on general language stimulation activities and strategies.
Motor Skills and Sensory Profile. In September, 2014, the Peabody Developmental
Motor Scales-2 was used to assess Zacks fine motor skills, grasping skills and visual motor
integration. Zack demonstrated a below average or mild delay for Grasping Skills and Visual
Motor Integration (9th and 16th percentiles, respectively). He scored in the 8th percentile for Fine
Motor skills, presenting with a poor or moderate delay. His OT reports that Zack has decreased
oral motor tone, jaw stability and oral motor strength for chewing. Information obtained
through the Sensory Processing Measure Preschool Home form and observations made by his
OT indicate that Zack presents with moderate to severe difficulties within sensory processing
systems. In an informal interview his OT identified that difficulty processing sensory
information may be contributing to Zacks fear and anxiety surrounding loud and unexpected
noises such as toilets and hand dryers.
Educational/School. In general, Zack was observed to be independent in the classroom
for most classroom routines and activities. During a brief interview with his classroom teacher,
Ms. Canyon, she reported that Zack participates in table top work, circle time, structured group
work and independent play activities with very minimal support. She expressed concern for his
ability to appropriately navigate social interactions, especially when conflict resolution skills are
required. Mrs. Canyon was not concerned with his academic achievement; she even expressed
that he is ahead of the class with preschool concepts.
His EC also reported that she did not have any specific academic concerns for Zack;
standardized testing is scheduled for March, 2015. Within play, she identified that Zack
demonstrates functional use of objects and symbolic play (e.g. talks to animals and makes them
interact with one another, assumes different roles within fantasy play, uses logical sequences as
play develops and proceeds) and he demonstrates the knowledge and use of most age-appropriate
preschool concepts (e.g. all/none/less/same/different, identifying numbers 1-10, etc.). She noted
that although Zack often presents with a positive attitude, he can be uncooperative and rigid at
times. On occasion he demonstrates disruptive behaviors to avoid difficult tasks, but he is easily
re-directed.
During a one hour, classroom observation, Zack was observed to be very easily engaged
in adult directed classroom activities. He was polite, kind and considerate in conversations with
adults and peers and Zack often sought out classmates to play with during free time. Indeed,

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during the observation, Zack required very minimal support to engage in classroom tasks and
routines. His classroom teacher was observed to be strict, kind and fair. She provided all students
with an appropriate level of classroom structure and was observed to engage in fun imaginative
play with the children during free time.
When Ms. Canyon, the classroom teacher, was asked specifically if Zack demonstrates
any challenging behaviors when he is required to use the hand dryer or the toilets in the
classroom washroom; she said that Zack doesnt have any difficulty. However, Ms. Canyon did
note that he is afraid of the urinals, because they flush automatically. Upon further
investigation, the hand dryer is very quiet in the school washroom and the toilets do not have
automatic flush sensors.
Zacks CDF provided further information regarding his fear of toilets and hand dryers.
She described a recent incident at Tim Hortons where the automatic toilet began to flush while
Zack was sitting on it. She described Zacks reaction as scared and distressed; he jumped off
the toilet and climbed on to her while shaking, crying and yelling help. His CDF was unable to
coax him to finish using the toilet and subsequently, was unsuccessful in getting Zack to wash
and dry his hands or use the hand dryer.
Social Emotional. Zack was observed to play with many of his classmates during free
play. Mrs. Canyon reports that Zack has many friends in the classroom and he is well liked. His
EC added that Zack often prefers to play with two children who are his best friends, but he will
play with other classmates. In general, Zack is very kind, considerate and compassionate with all
of his classmates. However, there are times when Zack is directive and controlling within play.
Occasionally, if his friends protest his ideas, conflict arises. His classroom teacher reports that
she often has to intervene if Zack and a friend have a conflict; he gets stuck on wanting things
his way and struggles to move on. His EC reported that Zack often plays the same preferred
play scenarios. Indeed, he was observed to play car wash during free play for the entire 45
minutes. His CDF explained that is one of his favorite play ideas and it can be difficult to get him
to try new things or transition away from anything highly preferred.
Zacks EC described him as a rule follower; he stringently follows classroom rules and
demonstrates difficulty if/when the rules or routines change. Also, Zack will often take it upon
himself to ensure that other children in the class are following the rules (e.g. Zack told another
child to sit down during circle time; when that child didnt follow his direction he called out
Mrs. Canyon, ____ wont sit down!). Mrs. Canyon expressed that this behavior has become
increasingly disruptive, especially during circle time. Although Zack can become occasionally
upset within the classroom, neither his EC, his classroom teacher nor aide reported instances of
severe escalation or meltdown behaviors since the beginning of the year. His classroom teacher
emphasized that, when they are firm Zack is easily re-directed.
Ms. Fun, Zacks nanny, confirms that conflict resolution and flexibility can be
challenging for Zack when she brings her daughter over to play. When a conflict arises she often
has to help resolve it. She added that Zack will play what her daughter wants to play, but that her
daughter is very strong willed and persistent. Zacks parents report that he often chooses to play
on his own, rather than with other kids when they are in social situations (e.g. family gatherings,
birthday parties). However, his parents expressed that with their busy work schedules, they do

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not often take the kids out. His mother added that Zack will run away from her when they are out
in public, which is embarrassing. She avoids taking him out for this reason.
Home Environment. Zacks parents express they have consistent house rules. However,
Zacks behavior is consistently worse with his mother then with his father; they have requested
support from their Intervention Assistance team to help with this discrepancy. Mom and dad both
identified that Zacks rigidities and need for routine often cause problems for the family. Notably,
his sister demonstrates similar behaviors so they were unsure if Zack is really rigid, or is just
learning from his sister, who he admires. Specific situations, such as unexpected changes in
routine and loud noises often trigger Zack to become upset and escalate. When he has a
meltdown his parents put him in his room until he is calm and ready to come out, which may
take anywhere from 5 minutes to an hour. To increase Zacks success with new situations, his
parents discuss what they are going to do beforehand, give him explicit behavioral expectations
and identify the rules for where they are going. They profess that Zack likes to negotiate, which
they often give in to. Recently, Zacks mother returned to work full time; Zack has demonstrated
significant difficult adjusting. When it is time for her to leave Zack will verbally protest, cry and
cling to her.
In December, 2014, the Intervention Assistance Team supported the family and Zack with
toilet training. His parents and nanny worked diligently over Christmas holidays to help him
achieve this goal. Since Zack has become toilet trained, they have developed substantial concern
for Zacks fear of magic toilets (their term for automatic flush toilets) and hand dryers. They
own a restaurant and the kids are often there in the evenings. The restaurant has both an
automatic flush toilet and a hand dryer. There have been instances where mom or have had to
drive Zack home to use the washroom, because he was so fearful of the bathroom at the
restaurant.
Recently, in Costco, mom described a situation where an elderly woman was using the
washroom at the same time as Zack. When she flushed the toilet, Zack began to cry and protest,
yelling the flush was too loud. When she turned on the hand dryer Zack screamed stop it,
while crying and climbing on his mother. The women immediately stopped drying her hands and
left the washroom. Zacks mother explained that whenever she has attempted to get him to use
public washrooms with automatic flush toilets and hand dryers, Zack demonstrates fear; he
escalates to a point where she cannot get him to use the washroom, so they have to leave. This
behavior has been happening since August, 2014 when his parents first started to work on toilet
training. Because Zacks success with toileting is recent, his fear and anxiety surrounding public
washrooms has become a more prominent issue for him and his parents.
Student Functional Assessment Interview (February 2nd, 2015)
Although Zack is young, his language skills are age-appropriate. As such, it was decided
that a brief play based interview would be conducted to further investigate Zacks feelings and
perceptions regarding automatic flush toilets and hand dryers. While playing a structured game
(Hi Ho Cherri O), Zack was asked why he does not like hand dryers. He said that they were
loud and fast. When asked about magic toilets (what his parents call automatic flush toilets),
he said they are scary and he doesnt like them, then he said, I wont pee on it. The examiner
then asked Zack to describe what he does when his mother or father ask him to use a magic
toilet; Zack said that he cries, screams and runs because he is scared. He also noted that
sissy thinks they are scary. Sissy is what Zack calls his older sister. She is also diagnosed

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with ASD and has a long standing fear of automatic flush toilets and hand dryers. During the
student interview, Zacks mother interjected saying, that Zack really looks up to his sissy, so,
maybe he is acting scared because he has seen her do it. Zack also said that the toilets, splash
your bum, which may be contributing to the aversion.
Previous Behavior Interventions
Prior to Cause & Effect early intervention services becoming involved, Zack received
monthly SLP consultations through Alberta Health Services, from March 2014 to August 2014.
Within the Cause and Effect team Zack has received support from a BS, Mrs. Wong.
During an informal interview with Ms. Wong it was identified that reinforcement strategies and
visual supports were provided during toilet training, which were highly successful strategies.
Specific functional behavioural interventions have been recommended to build flexibility and
reduce directive and rule following behaviours within the classroom. Within the classroom
there are currently no class-based contingency systems in use. To date there have not been any
recommendations or interventions provided to address Zacks fear of automatic flush toilets or
loud hand dryers.
Strengths
Zack is a polite and caring child who has a good sense of humor. He is motivated and
interested in making friends; he can be considerate and helpful when playing with others. Zack
demonstrates good attention and participation in the classroom and often attends school when his
CDF is unavailable. His teacher, Ms. Canyon, commented that when Zack is there without his
CDF, he does not require any more support than his other classmates would.
Baseline Data: Behaviour Rating Scale Data
Zacks fear/anxiety response has been operationally defined using a behaviour rating
scale in Table 1. The behaviour rating scale was also used to accurately collect baseline data,
specifically identifying the varying intensities of Zacks fear/anxiety responses to the fear
evoking stimulus of hand dryers and automatic flush toilets.
Table 1
Behaviour Rating Scale
Rating 1
Zack is calm
willingly
engages in
exposure target
no verbal
protest -no
physical
protest-no signs
of physical
anxiety

Rating 2
Zack is
minimally
anxious easily
redirected
minimal verbal
protest -no
physical protestno signs of
physical anxiety

Rating 3
Zack is anxious
but is able to be
redirected when
adults persist for
him to engage in
the exposure
target
demonstrates
some verbal
protest but tis

Rating 4
Zack is anxious
refuses to
engage in the
exposure target
verbal and
physical protest
using a loud
voice some
physical signs of
anxiety (fearful

Rating 5
Zack is very
anxious verbal
and physical
protest yellingrigid body
posture-standing
still refusing to
move
climbing/clinging
to adult - crying

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easily redirected
no physical
protest no
physical signs of
anxiety

facial
expression, red
cheeks) but not
all (as in rating
5)

shaking change
in breathing
patterns (holding
breath) fearful
facial expression
flushed cheeks
runs out of
washroom

During the collection of baseline data different intensities of anxiety were observed for
different types of hand dryers and toilets. The volume associated with different types of hand
dryers and toilets coincided with the level of anxiety response demonstrated by Zack. As such,
data for each type of toilet and hand dryer was separated, coded and recorded. This data is
provided in Table 2. In addition, Zack was also observed to demonstrate some level of anxiety
when he was expected to use public washroom sinks that had an automatic sensor. As such,
baseline data for automatic sink taps with sensors was also documented.
Table 2
Legend:Stimulus Coding Key
Toilets
LFTL - Lever Flush Toilet Loud

Hand Dryers
PHD-Push Button Hand Dryer

Sink
AS

LFTQ-Lever Flush Toilet Quiet

AFTL-Automatic Flush Toilet (sensor) Loud

DHD-Dyson Hand Dryer

AFTQ-Automatic Flush Toilet (sensor)-Quiet

XHD-Xcelerator Hand dryer

Table 3 outlines data collected from baseline observations. The rating provided in the
final column reflects the level of anxiety Zack demonstrated according to the behaviour rating
scale. It should be noted that minimal baseline data was collected, (6 exposures in total), with the
intention being to minimize Zacks exposure to stress, while still being able to gather relevant
and accurate data. The fear evoking stimuli were presented in rotating order for each exposure, to
minimize carry over effects from one stimulus to another. For example, if Zack demonstrated an

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anxiety level of 5 with the first stimulus presentation, this level of anxiety would likely carry
over to the second presented stimulus, even if that second stimulus was not typically highly
anxiety provoking.
From the baseline data, an average stress response level was determined for each stimulus
in Table 4. A hierarchy of stressors appeared to be present within Zacks responses. Placing
stressors into a hierarchy may be helpful for the intervention process. Therefore, the data was
organized into a hierarchy of least to most stressful and graphed in Figure 1, to better convey the
differing intensity levels of anxiety/fear that Zack demonstrated for each stimulus. Importantly, a
rating of 4 or 5, according to the behavior rating scale, represents a substantially high amount of
fear and anxiety. It is also important to note that exposure observations with Zacks mother
yielded higher anxiety levels then exposures with his CDF, when Zack was exposed to
comparative stimulus (e.g. Lever flush toilet that is loud, automatic flush toilet that is quiet, push
button hand dryer).
Table 3
Baseline Data
Date

Location

Feb 3/15

Costco

Adult
present
CDF

Order of
Exposure
LFTQ
AS
DHD

Rating
LFTQ-2
AS-3
DHD-3

Feb 3/15

Wal Mart

CDF

LFTL
AS
PHD

LFTL-4
AS-2
PHD-1

Feb 3/15

Tim Hortons

CDF

AFTQ
AS
XHD

AFTQ-3
AS-2
ZHD-5

Feb 4/15

Wal Mart

Mom

LFTL
AS
PHD

LFTL-5
AS-1
PHD-2

Feb 4/15

Winners

Mom

AFTL
AS
PHD

AFTL-4
AS-2
PHD-2

Feb 4/15

Tim Hortons

Mom

AFTQ
AS
XHD

AFTQ-4
AS-3
ZHD-5

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Table 4
Mean Stress Response to Fear/Anxiety Evoking Stimulus
Exposure Type

Average Rating

AS
LFTQ
LFTL
AFTL
AFTQ
PHD
DHD
XHD

2.16
2
4.5
4
3.5
1.7
3.0
5.0

Figure 1. Mean stress response values for individual stimuli. Stimuli have been ordered in a
hierarchy from least (value of 1) to most stressful (value of 5).
Hypothesis Formulation/Summary Statement: Behavior Analytic Problem Solving Model
The Behavior Analytic Problem Solving Model (Steege & Watson, 2009, p.177) was used
following the completion of indirect and direct descriptive and functional analysis procedures to
organize and summarize assessment results. Relevant information from the Behavior Analytic
Problem Solving Model (Steege & Watson, 2009, p.177) is listed below to assist in hypothesis
formulation.
Problem Behavior. Fear/anxiety response to toilets and hand dryers. Operational
definition provided within behavior rating scale.

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10

Setting. Community washrooms, or any washroom outside of Zacks home.

Contextual Variables. The behavior has potential to occur in any washroom outside of
Zacks home, based on unique controlling variables (i.e. previous experience, type of hand
dryer/toilet, presence of a sensor, volume of hand dryer or toilet, etc.). The presence of Zacks
mother also appears to be associated with increased intensity of his fear/anxiety response.
Antecedent: Discriminative Stimuli. The behavior occurs with differing intensities
based on the presentation of stimuli presented (i.e. quiet hand dryers do not evoke fear but Dyson
hand dryers do). More specifically, individual stimuli can be placed in to a hierarchy based on
the level of fear response they elicit, as identified in Figure 1. The volume of the hand dryer and
toilets appear to be associated to Zacks level of fear. The presence of a sensor is also a
contributing antecedent. Zacks mother may also be an antecedent to heighted anxiety responses
in comparison to when other adults are present. Modifications to his mothers behaviors maybe
required.
Antecedent: Unconditioned/Conditioned Motivating Operations. Although the
stimulus may have initially been unlearned, it can now be considered a Conditioned Motivating
Operation because of the lengthy history of the behavior. When the hand dryer or the automatic
flush toilets are presented to Zack, this increases the value of escape from the stimulus as a
reinforcer; avoidance of the fear evoking stimulus results in negative reinforcement.
Individual Mediating Variables. Zack is highly sensitive to loud noises. He has been
observed to cover his ears and move when he is in the presence of loud or unexpected noises at
preschool, according to his classroom teacher and CDF. His OT has emphasized that Zack
struggles with sensory processing. Indeed, during baseline data, those exposures involving loud
hand dryers and loud toilets elicited the highest levels of anxiety, even when there was no
automatic sensor present (e.g. Lever Flush toilet that was loud elicited a mean stress response of
4.5; Xcelerator hand dryer elicited an mean stress response of 5).
Importantly, Zacks older sister has a fear of all automatic flush toilets and all hand
dryers; this anxious reaction has been modeled for Zack. His mother expressed that Zack may
have learned to be afraid of automatic flush toilets and hand dryers from watching his sister.
Zacks mother has recently returned to work. She expressed that is always difficult for her
to leave for work and he has become more clingy in general. As such, moms attention may
have more recently become an established operation, (i.e. the value of her attention is much
higher than it had been previously).
Individual Behavior Deficits. Zack lacks coping skills, therefore he struggles to cope
with anxiety and fear when he is exposed to loud toilets and loud hand dryers. He also lacks
tolerance when these loud noises occur in the washroom. The only observed coping skills Zack
demonstrated was to cling to his mother or yell at others in the bathroom, possibly as a means to
gain control over the fear evoking situation.
Reinforcing Consequences. Three reinforcing consequences were identified. First,
Zacks protest and anxiety results in the removal of the anxiety provoking stimulus on most
occasions. So, his behavior (i.e. protest, crying, running , covering his ears, etc.) is negatively

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reinforced by being able to escape the fear provoking situation. Second, the value of
escape/avoidance as a negative reinforcer is increased because it results in an immediate
reduction of Zacks anxiety. Third, the increased attention and interaction from Zacks mother
resulted in higher rating of fear/anxiety, compared to his response to the same stimuli with
others. His mothers attention and support may be positively reinforcing more intense levels of
fear demonstrated by Zack.
It is also important to note that within baseline observations, Zacks mother offered him a
bribe when he would not comply with her instruction. After Zack had been engaging in protest
behaviors, his mother stated that if he calmed down, they could get a donut. When children
demonstrate undesirable behaviors, which are then followed by an adult offering a preferred
activity or item, in hopes to cease the undesirable behavior, this is a bribe. A bribe occurs either
before the expected behavior, to elicit the desired response, or after an undesirable behavior as a
means to correct the undesirable response; bribes are often worded using if__, then___,
(Fisher, Piazza & Roane, 2011, p.50). This creates an environment where the child will comply
only when a parent offers a bribe, (Fisher, Piazza & Roane, 2011, p.50). In this case the value of
the stimulus (i.e. hand dryers and toilets) is an antecedent to the possible offer of a bribe, which
can be considered positive reinforcement of the anxious behaviors.
Interpretation of the Results of Assessments: Hypothesis Formulation & Function
1. Exposure to specific hand dryers and toilets result in an immediate negative consequence
(i.e. fear and anxiety response). Within exposure there is a hierarchy of stimuli that elicit
differing intensities of anxiety responses (i.e. from least to most anxiety provoking)
2. Anxiety/fear response is reinforced by escape/avoidance of the fear inducing stimuli. This
creates an immediate reduction of anxiety/fear, which can be considered negative
reinforcement.
3. Anxiety/fear response is reinforced by increased attention and interactions from Zacks
mother, including the offer of bribes, which are positively reinforcing.
4. There is a skill deficit present; Zack did not demonstrate any appropriate coping skills as
a means to reduce his anxiety, nor is he able to simply tolerate the anxiety provoking
stimulus.
Hypothesis Based Intervention Recommendations
1. Develop coping skills to build Zacks ability to tolerate the anxiety provoking stimulus.
Include teaching Zack what a sensor is and how it works.
2. Implement Exposure Therapy strategies to build Zacks tolerance to the anxiety
provoking stimulus.
3. Implement reinforcement strategies to increase motivation and participation.
4. Antecedent procedures: develop parents and CDFs abilities to teach through exposure
therapy, learn to implement reinforcement strategies (i.e. not bribes), develop awareness
of how attention from an adult may payoff and thereby increase an undesirable behavior.
Additional Considerations

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12

Before assessing specific evidence based interventions, it is important to consider a

childs age and developmental level, (Mennuti, Christner, Freeman & Arthur, 2012, p.95).
Especially when using CBT interventions with children, understanding the childs cognitive and
developmental functioning is an essential element to the intervention process (Knell & Ruma,
2003). It is important to note that Zack has not been cognitively assessed using standardized
measures, which is not uncommon for children under 6 years of age. As such, we must consider
the historical and background information that we do have access to. Importantly, his language
abilities are within typical limits. The Intervention Assessment Team did not bring forth and any
cognitive concerns, nor were there any concerns noted by his classroom teacher or the examiner
during observations. Although this information is speculative and subjective in nature, and does
not equate to a standardized cognitive assessment, it is likely that CBT strategies can be
considered for Zack. Importantly, interventions may need to be adapted and modified to fit with
Zacks skills and abilities, (Mennuti, Christner, Freeman & Arthur, 2012, p.95).

Behavior Intervention Recommendations and Strategies

1. Develop Zacks coping skills to increase his ability to tolerate stressful events, such as being
exposed to a loud flush toilet or a loud hand dryer.
Importantly, the development of relaxation techniques/coping skills should occur outside
of the presence of the stressor, to establish techniques and activities as calming. Sessions
should continue for as long as necessary for him to learn to become relaxed, (Leaf &
McEachin, 1999). Once techniques elicit a calm and relaxed state consistently, relaxation
techniques can then be used as a reactive strategy to reduce stress when Zack is exposed
to a stressor, (Leaf & McEachin, 1999, p.60).
Relaxation-based interventions are most often used with exposure-based interventions,
(Truscott, 2010, p.43).
For adults, relaxation-based interventions often include addressing muscle tension, heart
rate, blood pressure and hyperventilation, (Truscott, 2010, p.43). Progressive muscle
relaxation, whereby clients clench and release sets of muscles (e.g. arms, neck, shoulders,
chest, etc.) are most commonly used, (Truscott, 2010, p.43).
Importantly, we can adapt progressive muscle relaxation techniques for Zacks
developmental level. For example, teaching Zack to flex and release muscles in a more
game like way, may increase his willingness to learn (e.g. to a song, using pop culture
characters like the Hulk to associate his understanding of flexing muscles, placing a
sticker on the area to flex and release, providing a visual with a pattern of muscles to flex
will reduce demands on memorization, using a tangible object such as a Theraband or a
stress ball, to assist with muscle flexion, etc.)
Diaphragmatic Breathing may also be an effective relaxation technique, to prevent
hyperventilation, (Hazlett-Stevens & Bernstien, 2012). This may be adapted for Zacks
age and developmental level (e.g. blowing out candles, blowing into a pin wheel to make

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it turn, blowing into a straw to shoot cotton balls across a table, blowing into a piece of
tissue paper to make it fly, etc.)
Counting may also be an effective technique, especially when paired with diaphragmatic
breathing. Importantly, counting with a slow pace and quiet, monotone voice will be
more effective then fast paced counting. This can be adapted for Zacks age and
developmental level (e.g. lets count in a zombie voice, lets count quiet like mice,
or slow like Tow Mater).
After intense practice of relaxation-based techniques, Zack can utilize the strategies as a
means to reduce anxiety at low levels of stress/anxiety, before his response becomes too
intense, (Wedding & Corsini, 2014, p.213).
Reinforcement may be provided to Zack for the participation in relaxation techniques, to
increase his compliance and success, (Leaf & McEachin, 1999, p.60).
Adults may have to expose Zack to a variety of potential relaxation techniques in order to
assess his preference for specific activities. Choosing techniques Zack prefers will
increase adherence and efficacy of those relaxation strategies.
Adults may also choose to implement a manualized relaxation program such as the
Coping Cat Program (Kendel & Hedtke, 2006a; Kendel & Hedtke, 2006b). Importantly,
adaptations have been documented for the implementation of this program with preschool
aged children (Beidas, Benjamin, Puleo, Edmunds, Kendall, 2010).

2. Exposure Therapy to increase Zacks tolerance to loud hand dryers and toilets.
Importantly, for specific phobias (which we may consider congruent to Zacks behavioral
presentation), the primary evidence based approach is exposure to the phobic situation,
(Wedding & Corsini, 2014, p. 210).
Exposure based interventions involve exposure to feared stimuli; with in vivo (i.e. in life)
exposure being the preferred presentation, (Wedding & Corsini, 2014, p.210; Truscott,
2010, p.42). Individuals are systematically or gradually exposed to the stimuli so the
client can confront the stimuli directly, rather than avoid it, (Wedding & Corsini, 2014,
p.210, Leaf & McEachin, 1999, p.61).
In vivo practice should occur with therapist guidance and supervision. Parents and
paraprofessionals should practice exposures as homework between therapist sessions,
(Wedding & Corsini, 2014, p.211).
During the baseline observation Zack did not demonstrate an awareness or understanding
of what a sensor is or how it works. This skill deficit likely contributes to his fear because
it prevents him from having control over how certain toilets, hand dryers and sink taps
operate. As such, before implementation of any exposure therapy targets, adults should
invest time in teaching Zack how a sensor works, so he can have increased control.
Exposure should be gradual, beginning with less fear provoking stimuli (e.g. Automatic
flush toilet that is quiet) and moving to more frightening situations (e.g. Automatic flush
toilet that is loud), (Wedding & Corsini, 2014, p.211, Leaf & McEachin, 1999, p.61).
An exposure hierarchy should be developed (Truscott, 2010, p.43; Leaf & McEachin,
199, p.61) for each stimulus. During baseline observation a hierarchy of stimulus
presentation was determined, ranking stimuli from least to most fear evoking as shown in
Figure 1.

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14

Importantly, not only should there be have a hierarchy of all stimulus as identified in
Figure 1, but there should also be a hierarchy developed for responses within each of
those stimuli (e.g. Dyson Hand dryers: 1. Standing within 5 feet of the hand dryer while it
is on for 5 seconds, standing within 3 feet of the hand dryer while it is on for 10 seconds,
putting lightning McQueen in the hand dryer for 2 seconds, etc.).
Exposure is most effective when it is predictable and is under the clients control,
(Truscott, 2010, p.42; Wedding & Corsini, 2014, p.211). Ways to provide Zack with some
control may include giving Zack a choice of exposure targets (e.g. do you want to put
Lighting McQueen in for 3 second or 5?), or having Zack countdown to initiate when the
exposure will occur (e.g. count from 10-1, at 1, the toilet will flush). It is imperative that
adults clearly communicate the exposure target to Zack before exposing him to the
stimuli, which will ensure predictability and built trust.
The intensity and duration of the exposure should be sufficient enough for Zacks fear to
decrease, (Wedding & Corsini, 2014, p.211). The use of a hierarchy of targets and
behavior rating scale to measure his anxiety response will be imperative in choosing
appropriate intensities, frequencies and the durations of each exposure.
Importantly, if an exposure target consistently elicits fear/anxiety with a rating of 5, the
exposure should immediately cease, the target should be re-assessed and expectations
should be reduced.
Practice with high and consistent frequency shows more successful outcomes (i.e. daily
rather than weekly) and longer practice sessions tend to be more effective then brief
sessions, (Wedding & Corsini, 2014). Zack should practice targets at minimum of three
times a week, with approximately three exposures per practice as a general guideline.
Practice should occur across a variety of settings and circumstances, (Truscott, 2010, p.
43). As such, it is imperative that adults plan to exposure Zack to a variety of stimulus
within each target (e.g. automatic flush toilets that are loud at Wendys, A&W, Sobeys,
Wal Mart, Costco, etc.). Adults may need to develop an inventory of available places for
each target exposure before taking Zack, so they can provide him with a predictable and
accurate level of exposure.
There should be a predetermined measurement of mastery, so those individuals
implementing the exposure therapy are able to know when to move forward to the next
target or the next stimulus. Using the already established behavior rating scale, setting a
mastery level of a minimum of 3 exposures, between a minimum of two adults, where
Zack demonstrates an anxiety level of 1, may be an appropriate measurement for mastery
of each target.

3. Modeling by a trusted adult or peer.

Modeling coping with the stressor, by the therapist, can be helpful, (Wedding & Corsini,
2014, p.211). Adults may model the target exposure (e.g. flushing a loud toilet) before
they ask Zack to participate. Indeed, during baseline observation, modeling appeared to
reduce Zacks anxiety somewhat. Because Zack is very social and has lots of friends in
the class, peer modeling may also be successful. This may be difficult to arrange in the
community, however, his nannys daughter may also be an accessible peer model outside
of class time.

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15

It will also be imperative that Zacks parents to eliminate his exposure to his sisters fear
based behaviors; further exposure will only hinder Zacks ability to tolerate stressors.
When Zack has made progress with an exposure target his parents may even encourage
him to model his ability to cope to his sister, so he can experience pride and intrinsic
reinforcement. However, this strategy will only be viable if Zacks sister is able to remain
calm.

4. Response Prevention.
When Zack covered his ears during the exposure the behavior appeared somewhat
automatic in nature. Importantly, response prevention can be used in the treatment of
unwanted impulsive behaviors (Truscott, 2010, p.43), such as Zack covering his ears. It
will be important for him to learn this in order to experience the stimulus within the
exposures; also Zack will not be able to cover his ears and dry his hands at the same time.
Zack will be encouraged to tolerate his discomfort until it subsides, (Wedding & Corsini,
2014, p.211).
Adults may prompt Zack to do something with his hands that is incompatible with
covering his ears, such as putting his hands in his pockets or squeezing them together.
When target behaviors are incompatible with the interfering behavior, the target behavior
is likely to increase, known as Response Covariation, (Steege & Watson, 2009, p.182).
During baseline data collection, this strategy was probed; Zack responded compliantly to
hands down, squeeze your fists, or hands down, hands in your pockets. Adults may
provide reinforcement in the form of praise for this target behavior.
5. Cognitive Reframing.
Zack may be able to learn to cognitively control his emotions.
Antecedent-focused strategies that are applied early in the generation of an emotional
response can regulate the cognitive (i.e. what you think) or behavioral (i.e. how you act)
responses to emotionally laden experiences, (Green & Malhi, 2006).
Specifically, Zack may learn to engage in self-focused reappraisal; the process of
detaching ones self from an emotional event and the ability to take on the viewpoint of
another individual, with respect to the emotional situation, (Green & Mahli, 2006).
Or, Zack may learn to engage in situation focused reappraisal; the ability to generate
alternative explanations for emotional events and then keeping these alternative
appraisals in mind for the duration of the eliciting stimulus, (Green and Malhi, 2006).
The approach to developing Zacks ability to reframe his thoughts will have to be
modified to ensure it is developmentally and age appropriate.
For example, self-focused reappraisal may occur when Zack watches others model and
narrate their calm experience while being exposed to the stimulus. Watching peers may
also be helpful. Asking his peers what they think of the automatic toilet may also give
Zack a different viewpoint (e.g. its fun to make the toilet go, I like to wave my hand
in front of it make it turn on, it is magic, its cool!, that toilet is a Lightning McQueen
toilet and that one is a Tow Mater toilet, etc.).
For situation focused reappraisal Zack may learn to categorize the stimulus as not a big
deal, or verbalize alternative explanations in his mind for the stimulus and his anxiety,

Running Head: FBA

16

such as, it is loud, but its not scary, its fun to watch the fast toilets, or its only 5
seconds, then it will be over, I can do it.
Importantly, Positive Self-Talk may be an effective strategy within the cognitive
reappraisal process (e.g. I can do it, I can stay calm, Its not scary).

6. Consequences.
By training Zacks parents to assist with relaxation based techniques and exposure
therapy techniques, the access to reinforcement and attention will be altered. That is,
obtaining attention and reinforcement will be associated with specific targets within
exposure therapy, rather than avoidance of the stressor.
Bribes vs. Reinforcement: it will be important to address Zacks mothers use of bribes.
Importantly, when bribes are used, children will often only comply when a bribe is
offered, (Fisher, Piazza and Roane, 2011, p.50). Instead, teaching Zacks parents how to
correctly implement reinforcement strategies will be imperative. Specifically, it is
crucial to teach that the parent not accompany the arrangement of contingencies for the
childs behavior with statement of those contingencies, (Fisher, Piazza & Roane, 2011,
p.50), especially when that statement happens after the undesirable behavior has already
occurred.
A list of potential reinforcers was developed with Zacks mother and CDF. Zacks parents
were asked to rate each reinforce as either an A (i.e. highly motivating, he would do
anything to access it) or a B (i.e. moderately motivating most days, may be highly
motivating on some days but not others).
Access to reinforcers will only be available when Zack demonstrates specific target
behaviors (i.e. exposure targets). As such, preferred activities that Zack regularly access
at home (e.g. TV, iPad) should not be included on the reinforcer list. Parents also
expressed that they initially used candy when they started toilet training, but it only
worked for the first day; Zack satiated on candy as a reinforcer. As such, the use of
tangible reinforcers should be limited.
Table 5
Reinforcers
B level Reinforcement
Candy (Starburst and Gummy Bears)
Playing his iPad
Playing games on the Wii (e.g. bowling)
Going on a sled ride
Tim Bits or Donuts

A level Reinforcement
Quad ride with Dad
Playing his sisters IPad (a rare privilege)
Getting a new game for his iPad
Playing Nerf Guns with Mom
Playing a new racing or quad game on the Wii
Dads orange Play Station gun
Wrapped Toys in a Treasure box (I.e. new surprise
toys)
Going to a movie
Anything with a Star Wars (especially Darth Vader)
theme

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17

Parameters of Reinforcement to Consider: From professional experience, parameters of

reinforcement are important to consider. Without careful consideration and
implementation of the quality, schedule, magnitude and timing of reinforcement, the use
of reinforcers can be ineffective, (Steege & Watson, 2009). This is especially important to
consider when working with anxiety provoking stimulus where reinforcers can increase
motivation to tolerate stressful events.
o Token Reinforcement System: Many of the reinforcers identified in Table 5 are
activities that can be provided only at home resulting in a considerable delay after
the exposure to the anxiety provoking stimulus. As such, a token reinforcement
system may be a viable strategy. This will provide Zack with immediate
acknowledgement for his coping/tolerance of the stressor, (in the form of a token),
but also ensure highly reinforcing activities are paired with his coping and
tolerance, (when he cashes in the tokens). The magnitude and quality of
reinforcement, using A level reinforcement, should be sufficient with a duration of
10-15 minutes for an acidity that he has earned.
o An example of the token reinforcement system:

o The token economy should not include more then 6-7 tokens, to prevent possible
carry over effecrt of anxiety form one stimulus to another. Breaks in between
exposure should also be considered for this reason.
o Importantly, Zack has not been exposed to a token reinforcement system before.
Therefore, pairing immediate verbal and social reinforcement (e.g. verbal praise,
high fives, fist pumps, under arm tickles), with the delivery of tokens, may be
considered. As Zack demonstrates success and understanding of the token
reinforcement system social reinforcement may be faded out, but verbal praise
should continue.
o For the target behavior, (i.e. specific levels of exposure to the anxiety provoking
stimulus), the reinforcement schedule should remain 1:1 (i.e. one token for each
successful exposure). The timing of reinforcement will be imperative. Tokens
should be delivered when Zack is calm, not when he is anxious or escalating,
(Leaf & McEachin, 1999, p.61). For current targets within exposures,
reinforcement provided should remain A level. Previously mastered levels of
exposure should receive no reinforcement, B level reinforcement or intermittent
schedules of reinforcement which can be guided by the therapist.
7. Evaluation Procedures:

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18

It is important to use the same measurement tool for outcome measures as was used to
collect and establish baseline data. As such, the behavior rating scale should be
incorporated into ongoing progress monitoring.
Use of a daily data sheet to record frequency, intensity and duration of exposures.
See Appendix for a sample daily data sheet.
A-B-C data sheet will be used for unanticipated or new behaviors.

8. Materials needed for program implementation:

Daily Data sheet, A-B-C data sheet, reinforcers, token reinforcement system, inventory of
places to access exposure targets.

Appendix: Daily Data Sheet: Exposure Therapy

Behaviour Rating Scale: Anxiety/Fear Response

Rating 1
Zack is calm
willingly
engages in
exposure target
no verbal
protest -no
physical
protest-no signs
of physical
anxiety

Rating 2
Zack is
minimally
anxious easily
redirected
minimal verbal
protest -no
physical protestno signs of
physical anxiety

Rating 3
Zack is anxious
but is able to be
redirected when
adults persist for
him to engage in
the exposure
target
demonstrates
some verbal
protest but tis
easily redirected
no physical
protest no
physical signs of
anxiety

Rating 4
Zack is anxious
refuses to
engage in the
exposure target
verbal and
physical protest
using a loud
voice some
physical signs of
anxiety (fearful
facial
expression, red
cheeks) but not
all (as in rating
5)

Rating 5
Zack is very
anxious verbal
and physical
protest yellingrigid body
posture-standing
still refusing to
move
climbing/clinging
to adult - crying
shaking change
in breathing
patterns (holding
breath) fearful
facial expression
flushed cheeks
runs out of
washroom

General Guidelines for Implementation (under the supervision of a clinician)

Running Head: FBA

19

-When working on one target (e.g. going in to the bathroom and looking at the hand dryer or
going into the bathroom to check if the toilet has a sensor) Z must demonstrate a rating of 1,
for a minimum of 3 exposures in a row, before you should move on to the next target.
-Refer to skill hierarchy when one target is mastered to determine which specific target to move
to next
-Only move ahead of the target number (e.g. skip from target #1 to target #3 if Z
initiates/requests to do so, and he is demonstrating a level of calm consistent with a #1 rating
when he requests.
-Of Z demonstrates an anxiety level of 5 within a stimulus target, 2-3 times consecutively, stop
the exposure target immediately.
-Take breaks between exposure to prevent carry-over effects
Reinforcement: Immediately after the skill demonstration, even if Z demonstrates a minimal
level of anxiety (i.e. rating of 1-3 on the behaviour rating scale), provide him with a token when
he is most calm, and immediate praise for tolerating the stressor. Time your exposures and
delivery of reinforcement so that Z will be able to fill the token reinforcement system within a
day, to ensure the delay between tokens and reinforcement is not excessively long.
Consider Stimulus Hierarchy: Implement stimulus targets from least to most stressful:
1. Push button hand dryers
2. Lever flush toilets that are quiet
3. Automatic sink taps
4. Dyson hand dryers
5. Automatic flush toilets that are quiet
6. Automatic flush toilets that are loud
7. Lever flush toilets that are loud
8. Xcelerator hand dryers
*Work through the skill hierarchy within each stimulus before introducing a new stimulus
Skill Hierarchy Within Each Stimulus Automatic Flush Toilets:
1. Check to see if the toilet has a sensor
2. Step #1, then if the toilet does have a sensor, discuss what will happen if you push the flush
lever/button
3. Step #1, #2 and have Z tell you when to flush the toilet this will give him some control,
but not push him to have to flush it himself
4. Step #1, #2 and have Z flush the toilet himself
5. Step #1, #2 and have Z sit on the toilet he doesnt have to pee then he can flush it after
by himself

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20

6. Step #1, #2 and have Z sit on the toilet to pee/BM, then flush after
Skill Hierarchy Within Each Stimulus Loud Hand Dryers
1. Look at the hand dryer do not turn it on
2. Z will stand 5 ft away from the hand dryer Nikki will dry her hands for 5 seconds
(Dont let Z cover his ears he wont be able to do this when he has to use the hand
dryer)
3. Z will stand 5 ft away from the hand dryer Nikki will dry her hands for 15 seconds
4. Z will wash a car or character (e.g. Darth Vader) and put them in the hand dryer for 2
seconds
5. Z will wash a car or character and put them in the hand dryer for 10 seconds
6. Z will wash his own hand and put them in the dryer for 2 seconds
7. Z will wash his own hands and put them in the dryer for 10 seconds

Daily Data Sheet Example

Date/Adult

Target Level of
Exposure

Feb 10/15-Mom

Looking at Dyson
Hand Dryer
Looking at Dyson
Hand Dryer
Looking at Dyson
Hand Dryer
Looking at Dyson
Hand Dryer
Looking at Dyson
Hand Dryer
Z is 5 ft from the
hand dryer adults
turns it on for 5 sec
Z is 5 ft from the
hand dryer adults
turns it on for 5 sec
Z is 5 ft from the
hand dryer adults
turns it on for 5 sec
Z is 5 ft from the
hand dryer adults
turns it on for 5 sec

Feb 10/15-Mom
Feb 10/15-Mom
Feb 10/15-Mom
Feb 11/15-aide
Feb 12/15-mom

Feb 12/15-mom

Feb 12/15-aide

Feb 12/15-aide

Anxiety Level
Demonstrated by Z
3
2
1
1
1
2

Comments

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21

References
Beidas, R. S., Benjamin, C. L., Puleo, C. M., Edmunds, J. M. & Kendall, P. C., (2010). Flexible
Applications of the Coping Cat Program for Anxious Youth. Cognitive Behav Pract.
17(2): 142-153. doi:10.1016/j.cbpra.2009.11.002.
Fisher, W., Piazza, C. C. & Roane, H. S. (2011). Handbook of Applied Behavior Analysis.
Guilford Press. Retrieved from: https://books.google.ca/books?
id=n0iPpV0MkcIC&dq=applied+behavior+analysis+bribe&source=gbs_navlinks_s,
February 24th, 2015.
Green, M. J. & Malhi, G. S. (2006). Neural Mechanisms of the Cognitive Control of Emotion.
Acta Neuropsychiatrica, 18:144-153
Hazlett-Stevens, H., & Bernstien, A. A. (2012). Relaxation. In W. T. ODonohue & J. E. Fisher
(Eds.), Cognitive behavioral therapy: Core principles for practice (pp.105-132).
Hoboken, NJ: John Wiley & Sons

Running Head: FBA

22

Kendall, P. C. & Hedtke, K. (2006a). Cognitive-behavioral therapy for anxious children:

Therapist manual. 3. Ardmore, PA: Workbook Publishing
Kendall, P. C. & Hedtke, K. (2006b). The coping cat workbook. 2. Ardmore, PA: Workbook
Publishing
Knell, S. M., & Ruma, C. D. (2003) . Play therapy with a sexually abused child. In M . A .
Reinecke, F . M . Dattilio, & A . Freeman (Eds .), Cognitive therapy with children and
adolescents: A casebook for clinical practice (pp . 338 368) . New York, NY: Guilford
Press .
Leaf, R. & McEachin, J. (1999). A Work in Progress: Behavioural Management Strategies and a
Curriculum for Intensive Behavioural Treatment of Autism (pp 59-62). New York, NY:
DRL Books Inc.
Mennuti, Rosemary B., Christner, Ray W., and Freeman, Arthur, eds. Cognitive-Behavioral
Interventions in Educational Settings : A Handbook for Practice (2nd Edition). Florence,
KY, USA: Routledge, 2012. ProQuest ebrary. Web. 12 February 2015.
Steege, M. W. & Watson, T. S. (2009). Conducting school-based functional behavioral
assessment: a practitioners guide (2nd ed). New York: Guilford Press. ISBN:
9781606230275
Truscott, D. (2010). Becoming an effective psychotherapist: Adopting a theory of psychotherapy
thats right for you and your client. Washington, DC: American Psychological
Association.
Wedding, D. & Corsini, R. J. (2014). Current psychotherapies (10th ed.). Belmont, CA:
Brooks/Cole.

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23
CRITERIA FOR ASSESSMENT

OF

LEARNING TASK 2

Functional Behavioural Assessment

Item
Evaluation
General Information
provided about:
individual, context,
and behavior (500
words or less)
(5/70)

Information
gathering
(5/70)

Identify triggering
antecedent events
(5/70)

Identify maintaining
consequence events

Identify possible
setting events
(5/70)

Develop summary
statement
(5/70)

Very Good (56-70)

Thorough description of
individual and context
(settings/activities, in
which functional
assessment was conducted
as well as the behavior:
Description of behaviour
includes all of the following
characteristics:
Clear Description of
specific actions;
Observable, can be
replicated by a stranger
Measurable Frequency
and/or duration can be
counted; beginning &
ending of behavior are
clearly delineated
Gathered thorough
information on antecedents
and consequences with
appropriate information
gathering techniques (i.e.,
direct observation,
interviews). Contains
information on how they
were collected (e.g., across
how many days)
One or more antecedent
events are identified that
trigger/predict problem
behavior and are described
in sufficient detail to inform
intervention planning
One or more consequences
identified that occur
immediately after the
problem behavior and are
described in sufficient
detail to inform
intervention planning
At least one setting event
is identified and described
in sufficient detail to inform
intervention planning or
data confirms no setting
event exists
Summary statement
includes all of the following
as identified by the FBA:
Antecedent
Problem behavior
Consequence
Setting event (if

Satisfactory (43-55)
Good description of
individual, but minimal
description of context.
Description of the
problem behavior
includes two of the
following
characteristics:
Clear, observable,
measureable

Inadequate (42 &

below)
Minimal to no
information provided
on individual, and no
information provided
on context.
Description of the
problem behavior
includes none to one
of the following
characteristics:
Clear, observable,
Measurable

Gathered some
information on
antecedents and
consequences. Missing
data gathering
techniques and/or how
information was
collected.

Gathered minimal/no
information on
antecedents and
consequences. Did
not use appropriate
data gathering
techniques and/or did
not include completed
data collection forms.

Antecedent events are

identified but not
described in sufficient
detail to inform
intervention planning.

No antecedent events
identified

Consequences are
identified but not
described in sufficient
detail to inform
intervention planning.

No consequences
identified

Setting events are

identified but not
described in sufficient
detail to inform
intervention planning

No indication setting
events were
considered

Summary statement
includes some of the
following as identified
by the FBA:
Antecedent
Problem behavior
Consequence

Summary statement
does not exist or one
exists that was not
based upon the FBA

Score

/5

/5

/5

/5

/5

/5

Running Head: FBA

24
applicable)
Function of the behavior

Identify desired
replacement behavior
(5/70)

Identify alternative
replacement behavior
based on function of
problem behavior
(5/70)

Identify common
reinforcing
consequences for
desired replacement
behavior
(5/70)

Select strategies &/or

environmental
manipulations that
neutralize impact of
setting events
(5/70)
Select strategies &/or
environmental
manipulations that
make triggering
antecedents
irrelevant
(5/70)
Select strategies that
teach individual skills
that will effectively
replace problem
behavior
(5/70)
Select strategies for
reinforcing

Setting event (if

applicable)
Function of the
behavior

Behaviour Intervention Plan

Replacement behavior
Replacement behavior is
identified that is specific,
not specific, objective,
objective, and measurable
and measurable, or
and serves the same function
replacement behavior
as the problem behavior or is
does not serve the same
incompatible with the
function as the problem
problem behavior
behavior or is not
incompatible with the
problem behavior
Replacement behavior
Replacement behavior is
identified that is specific,
not specific, objective,
objective, and measurable
and measurable, or
and serves the same function
replacement behavior
as the problem behavior or is
does not serve the same
incompatible with the
function as the problem
problem behavior
behavior or is not
OR
incompatible with the
Not applicable if alternative
problem behavior
replacement is not
appropriate
Reinforcing consequence for
Reinforcing consequence
desired replacement behavior
is identified and results in
is identified, results in same
same function as problem
function as the problem
behavior but is not
behavior, and is described in
described in sufficient
sufficient detail for
detail for implementation
implementation
Strategies and/or
environmental manipulations
are identified, linked to FBA
data, and described in
sufficient detail for
implementation or not
applicable due to no setting
event documented.
Strategies and/or
environmental manipulations
are identified, linked to FBA
data, and described in
sufficient detail for
implementation

Strategies and/or
environmental
manipulations are
identified, linked to FBA
data but lack sufficient
detail for implementation

Teaching strategies are

identified and described in
sufficient detail for
implementation

Teaching strategies are

identified but lack
sufficient detail for
implementation

Reinforcement strategies are

identified and described in

Reinforcement strategies
are identified but lack

Strategies and/or
environmental
manipulations are
identified, linked to FBA
data but lack sufficient
detail for implementation

No replacement
behavior is
identified
/5

No replacement
behavior is
identified
/5

No reinforcing
consequence is
identified or
reinforcing
consequence
does not result
in same function
as problem
behavior
No strategies
and/or
environmental
manipulations
are identified or
they are not
linked to FBA
data
No strategies
and/or
environmental
manipulations
are identified or
they are not
linked to FBA
data
No teaching
strategies are
identified

No
reinforcement

/5

/5

/5

/5

Running Head: FBA

appropriate behavior
(5/70)
Select consequence
strategies that make
problem behavior
ineffective
(5/70)

25
sufficient detail for
implementation
Consequence strategies are
identified and described in
sufficient detail that:
Minimize the impact of the
problem behavior on other
individuals
Reduce the reinforcement
of the problem behavior
Minimize damage to the
individuals reputation

sufficient detail for

implementation
Consequence strategies
are identified are
identified that meet some
of the following:
Minimize the impact of
the problem behavior on
other individuals
Reduce the
reinforcement of the
problem behavior
Minimize damage to
the individuals reputation
Or all of the above are
met but not described in
sufficient detail

strategies are
identified
No consequence
strategies are
identified are
identified or they
focus on
punishments
and/or reinforce
the problem
behavior

/5

/5