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38. |
Functional
Behavioral Assessment Worksheet |
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When to use this form:
This form is used by the student’s IEP Team (that
includes the student’s parents/guardian) whenever
inappropriate student behavior is reported as a concern
by the district/cooperative staff, the parents/guardian,
or any other qualified individual(s). The IEP Team
examines existing classroom interventions, consequences,
pro-social behaviors, inappropriate behaviors, triggers,
concurrent events, and the function(s) of the
inappropriate behavior. After the assessment, the IEP
Team determines if a Behavioral Intervention Plan is
needed. |
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Printable Version
Computer Version |
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39. |
Behavioral
Intervention Plan |
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When to use this form:
This form is used after the student’s IEP Team has
conducted a functional behavioral assessment (FBA). The
Behavioral Intervention Plan identifies the student’s
problem behavior(s), functions of the student’s
behavior, establishes measurable student behavioral
goals, discipline policy the student will follow,
methods of teaching replacement behaviors, methods of
measuring progress, positive consequences, negative
consequences, accommodations needed, person(s)
responsible for implementation of the plan, and IEP Team
consensus. |
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Printable Version
Computer Version
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40. |
IEP Team
Manifestation Determination |
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When to use this form:
This form is used by the student’s IEP Team when the
school administration has recommended long-term
suspension/expulsion for alleged violation of school
rules or codes of conduct up to or exceeding ten school
days, or placement in an interim alterative educational
placement. The form identifies the specific behavior
that resulted in the student’s suspension/expulsion;
types of data collected and reviewed, FAPE requirements,
and the IEP Team’s determination of whether the conduct
in question was caused by, or had a direct relationship
to the student’s disability. Prior to completing a
manifestation determination, the district must have
completed a Functional Behavioral Assessment. |
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Printable Version
Computer Version
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41. |
Discipline Flow
Chart |
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When to use this form:
This form is an outline for school administrators when
it is determined that a change in placement is
appropriate for a student with a disability who has been
found to have violated a school code of conduct or other
law. The form outlines the procedures under the
Individuals with Disabilities Education Act when
disciplining students with disabilities. For removal of
more than ten (10) school days, school administrators
should seek the advice of council. |
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Printable Version
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