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A-B-C Checklist

Student: ____________________________ Teacher:____________________

Date: Time: Location/Setting:


Antecedent ​(Before Behavior) Behavior Consequence (​ After Behavior) Duration/Intensity
❏ Given direction/task ❏ Verbal redirection Duration:
❏ Difficult task/activity presented ❏ Physical redirection/prompt
❏ Preferred activity interrupted/stopped ❏ Teacher/Peer Ignored Start time:
❏ Preferred activity/item denied ❏ Restated direction End time:
❏ Ignored by peers ❏ Verbal reprimand (told to stop)
❏ interaction w/ specific person/group ❏ Remove from activity/location
❏ Teacher attention to others ❏ Given another task/activity
❏ Alone w/ activity ❏ Response blocked
❏ Other: ❏ Peer attention Intensity:
❏ Other: 1 2 3 4 5

Date: Time Location/Setting:


Antecedent ​(Before Behavior) Behavior Consequence (​ After Behavior) Duration/Intensity
❏ Given direction/task ❏ Verbal redirection Duration:
❏ Difficult task/activity presented ❏ Physical redirection/prompt
❏ Preferred activity interrupted/stopped ❏ Teacher/Peer Ignored Start time:
❏ Preferred activity/item denied ❏ Restated direction End time:
❏ Ignored by peers ❏ Verbal reprimand (told to stop)
❏ Interaction w/ of specific person/group ❏ Remove from activity/location
❏ Teacher attention to others ❏ Given another task/activity
❏ Alone w/ activity ❏ Response blocked
❏ Other: ❏ Loss of privilege Intensity:
❏ Peer attention 1 2 3 4 5
❏ Other:

Date: Time Location/Setting:


Antecedent ​(Before Behavior) Behavior Consequence (​ After Behavior) Duration/Intensity
❏ Given direction/task ❏ Verbal redirection Duration:
❏ Difficult task/activity presented ❏ Physical redirection/prompt
❏ Preferred activity interrupted/stopped ❏ Teacher/Peer Ignored Start time:
❏ Preferred activity/item denied ❏ Restated direction End time:
❏ Ignored by peers ❏ Verbal reprimand (told to stop)
❏ Interaction w/ specific person/group ❏ Remove from activity/location
❏ Teacher attention to others ❏ Given another task/activity
❏ Alone w/ activity ❏ Response blocked
❏ Other: ❏ Loss of privilege Intensity:
❏ Peer attention 1 2 3 4 5
❏ Other:

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