FUNCTIONAL ASSESSMENT INTERVIEW FORM 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with Section A, where you will describe the behaviors of concern. Fill in each behavior, detailing how it is performed, its frequency, duration, and intensity.
  3. In Section B, define potential ecological events affecting the behaviors. Provide information on medications, medical complications, sleep cycles, and daily routines that may influence the child's behavior.
  4. Proceed to Section C to identify events and situations that predict occurrences of the behaviors. Note the times of day and settings where these behaviors are most likely to happen.
  5. In Section D, describe the child's play abilities and difficulties. Document how they interact with peers and adults during playtime.
  6. Section E requires you to identify the function of undesirable behaviors. Reflect on what the child gains or avoids through these actions.
  7. Complete Sections F through I by defining efficiency of behaviors, communication methods used by the child, supportive events or challenges they face, and summarizing key predictors and consequences.

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A functional behavior assessment (FBA) checklist is a valuable tool used in understanding and addressing challenging behaviors. It provides a structured approach to gather information about the behavior, its antecedents, consequences, and potential functions.
The process of conducting a Functional Behavior Assessment can be broken down into several steps: Collect Data: Uncover the Behavior in Question. Gather Baseline Data. Develop a Hypothesis. Test the Hypothesis. Collect Additional Data. Analyze Data Develop a Plan.
They emphasized that for ABA programs to be complete and successful they need to be applied, behavioral, analytic, technological, conceptually systematic, effective, and adept to generality.
Whats Involved? This assessment will include initial meetings, interview assessments, information and data collection gathering tools, up to two direct observations, analysis and a final report. The report will provide information about the function(s) of behaviour and recommendations.
They go on to define functional behavior assessment and how to utilize it through 6 steps: Collect Data, Develop Hypothesis, Direct Observation, Behavior Support Plan, Implement Scripts, and Evaluate/Redesign.

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The seven steps from FBA to PBS are: Identify the behaviour of concern. Gather Information (data collection) Analyse the Information. Formulate a Hypothesis. Develop a Positive Behaviour Support Plan (or Behaviour Intervention Plan) Implement the Plan / Intervention. Monitor and Evaluate.

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