DATA RECORDING FORM FOR A

FUNCTIONAL BEHAVIOUR ASSESSMENT

FBA Data Sheet

Student: Joey Date: ________________
Definitions of Target Behaviors:

Behavior A: Physical Aggression: Joey will kick a peer and kick and punch objects. This includes
swearing at teachers.

Behavior B: Non-Compliance: Behaviors can be defined as escaping tasks, refusing to comply with
redirection, laying on the floor with his hood up and/or using loud inappropriate language.

Behavior C: Compliance- Joey will comply with task demands for work, redirection to come back to
class, and use his red card to ask for a break. Indicate an R for the use of the red card.

Within each of these time frames please tick off the amount of times each of the behaviors noted above occur.
Homeroom Period 1 Period 2 Period 3 Period 4 Lunch Period 5

8:10-8:35 8:35-9:35 9:35-10:35 10:50-11:50 11:50-12:50 12:50-1:45 1:45-2:45

Behavior
A

Behavior
B

Behavior

Brief general notes and/or comments:

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