FUNCTIONAL BEHAVIOR ASSESSMENT REPORT

An FBA is an analytical process based on observations, review of records, interviews, and data analysis to determine the
function the behavior serves for the student, how that function can be met more appropriately and how the environment can
be altered to better support general positive behaviors.
Date of Report: 2/3/16
Date(s) of FBA Data Collection: 1/13/16, 1/14/16, 1/21/16, and 1/11/16-1/22/16

SECTION 1: Student Information

Student Name:

Villalobos

Mark

Male
Female

Last (legal)

First (no nicknames)

Birthdate: 1/1/2004

M.I.

Grade: 6th

Resident District: Holland

School of Hope Elementary School

attendance:

SECTION 2: Parent/Guardian Contact Information

Parent
Foster
Parent
Guardian
Surrogate

Name: Jose and Tatiana Villalbos

Home (123)456-7890
Phone:

Address: 4321 Home Street

Work (321)654-0987
Phone:

City/State: Holland, MI
Zip: 49423

Cell Phone: (789)654-0321

E-mail: jose.tatiana@gmail.com

Student

SECTION 3: Behavior Analysis

1. Behavior(s) of concern (State a clear, measurable, and observable description of the behavior or behaviors of concern)
Off-task Jokes: talks out of turn, murmurs under breath, makes inappropriate jokes, laughs and talks in louder than usual
voice during instruction
2. Frequency, Intensity, and/or Duration of current behavior:
Mark's behavior is most prevalent during math class and lunch time. Data from observations shows that Mark displayed
the problem behavior 90% of observed time frames in math class over a two week period. The behavior is disruptive and
interrupts learning.
3. Analysis of this behavior was based on:
Interviews with teachers and parents
Student observation(s) on 1/13/16, 1/14/16, 1/21/16, and 1/11/16-1/22/16 at Hope Elementary School
Review of records, consisting of:
health
discipline
other:
Environmental analysis for supportive and unsupportive variables on
Summary of Interview, Observation, Record Review, and Environmental Analysis:
Mark displays off-task behavior commonly during math class with Mr. McGreevy when surrounded by his peers. He
laughs, murmurs jokes, makes inappropraite comments, and does not complete required assignments. This behavior
happens every time he is in math class, lunch, or homeroom and impedes learning. Mark is currently failing math class
Diana Browning Wright, M.S., L.E.P. with contributions from Sioux City Iowa Schools

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due to a lack of submitted assignments and poor scores on assessments. He most specifically does not like when he has
to complete an assignment during class.
While in math class, Mark was observed by Mr. Jackson. This observation showed that the problem behavior occurred 49 times in one class period.
This behavior does not happen in Mrs. Johnston's English class. She has implemented an individual positive
reinforcement system in addition to a class wide token economy.
Through a parent inventory, it was discovered that there are no preventative strategies used at home. Mark demonstrates
problem behavior when asked to complete chores.
Mark shared that he desires to do better in school, but often gets distracted.
4. Is the behavior impeding learning of the student or peers?
Yes
No
If yes, please describe:
This behavior distupts instruction and impedes the learning of Mark and his peers. The teacher is unable to refocus
attention to the lesson while Mark remains off-task.
5. Have Tier II Strategies or other Interventions been tried? (e.g., school/home notes, behavior contracts, self-monitoring)
Yes
No
Describe previously selected intervention:
There is an individualized positive reinforcement system in place in Mrs. Johnson's class.
6. Result of selected Tier II or other Positive Behavior Interventions and Strategies:
Mark does not have behavior issues in Mrs. Johnson's class where the individualized positive reinforcement system is in
place.
7. Is a behavior intervention plan recommended?
Yes
No Rationale: The data shows that his behavior is
impeding Mark's and his peers' education. Current strategies are not effective.
8. Environmental Factors:
What are the reported and observed predictors for the current behavior(s)? (Antecedent events that trigger
problem behavior)
The behavior commonly occurs during whole group instruction, academic demands, and when the teacher has
his/her back turned away from Mark. Other times that the problem behavior is triggered occurs when the teacher
asks Mark to complete an independent assignment, when Mark turns around in his chair to look at and talk to other
classmates, or when his teachers are working with other students or completing other types of tasks such as taking
attendance.

What supports the student using the current problem behavior(s): summary based on the environmental
assessment portion of this assessment: (e.g., what is in the environment that should be eliminated or reduced?
What is not in the environment that should be added?)
The problem behavior is supported when Mark sits at a table instead of an individual desk. In addition, when Mark
does not take his Adderall for Attention Deficit Hyperactive Disorder, he demonstrates the problem behavior more.

9. Functional Factors:
Hypothesis of function (purpose) of this behavior for this student based on data collected in Section 3. above
The data shows that the function of the behavior is receiving attention from teachers and peers.

Diana Browning Wright, M.S., L.E.P. with contributions from Sioux City Iowa Schools

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Suggested functionally equivalent replacement behavior:

Mark will remain on task (raising his hand to gain attention, speaking in an appropriate tone/level, making comments
related to classroom instruction, making age appropriate comments, and self- monitoring his behavior) during
seatwork.

SECTION 4: Conclusion/Recommendation
1. Conclusions: (Recommendations for IEP, 504, or school team consideration)
It is recommended that Mark have a Behavior Intervention Plan created and implemented into his education. This will
allow him to learn how to remain on task when in the educational setting.
2. Estimate of need for behavior intervention:
Extreme
Serious
Moderate
Needs attention, early stage intervention
Monitor behavior only; no formal behavior intervention plan is recommended at this time
3. If a Behavior Intervention Plan is NOT now recommended:
Behavior goals to be developed by: and contained in:
Consider Tier II interventions, or other interventions, such as
Consider assistance to students teacher to enhance environmental/student
Consider other Tier III interventions, such as district provided Cognitive Behavioral Therapy such as a Related Service
to address emotionally driven behavior
Consider WrapAround or Multiagency teaming
Rationale for selection of an alternate approach:

4. This team has determined that if a behavior plan is NOT to be developed as a result of this assessment, a
functional behavioaral assessment will be considered again if:
data demonstrates the problem behavior intensity, duration or frequency escalates or continues at current rate or
data demonstrates non-responsiveness to selected other approaches
Describe:

5. This student has:

a current IEP

a current 504 Plan

neither

6. Goals to monitor future behavior will be added to:

a new or amended IEP
a new or amended 504 Plan
a school teams plan (no IEP or 504 Plan)

SECTION 5: Evaluation Personnel

Individuals contributing to this evaluation:
Diana Browning Wright, M.S., L.E.P. with contributions from Sioux City Iowa Schools

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Name
Mr. Jackson
Mr. McGreevy
Jose Villalobos
Tatiana Villalobos

Position
Case Manager
General Education Teacher
Father
Mother

Contact person for this report:

Phone:
E-mail:

Name

Position

Mr. Jackson
(654)321-0987
jackson@gmail.com

Diana Browning Wright, M.S., L.E.P. with contributions from Sioux City Iowa Schools

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