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    Abc Data Checklist

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    api-367840577
    This document provides a checklist to track student behaviors, antecedents, and consequences over time. The checklist includes categories to document what triggered a behavior, the type of behavior observed, how staff responded, how long the behavior lasted, and the perceived intensity level. Staff can use this form to monitor behaviors and analyze patterns that may inform the development of a behavior support plan for the student.

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    Abc Data Checklist

    Uploaded by

    api-367840577
    806 views1 page
    This document provides a checklist to track student behaviors, antecedents, and consequences over time. The checklist includes categories to document what triggered a behavior, the type of behavior observed, how staff responded, how long the behavior lasted, and the perceived intensity level. Staff can use this form to monitor behaviors and analyze patterns that may inform the development of a behavior support plan for the student.

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    abc data checklist

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    This document provides a checklist to track student behaviors, antecedents, and consequences over time. The checklist includes categories to document what triggered a behavior, the type of behavior observed, how staff responded, how long the behavior lasted, and the perceived intensity level. Staff can use this form to monitor behaviors and analyze patterns that may inform the development of a behavior support plan for the student.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    806 views1 page

    Abc Data Checklist

    Uploaded by

    api-367840577
    This document provides a checklist to track student behaviors, antecedents, and consequences over time. The checklist includes categories to document what triggered a behavior, the type of behavior observed, how staff responded, how long the behavior lasted, and the perceived intensity level. Staff can use this form to monitor behaviors and analyze patterns that may inform the development of a behavior support plan for the student.

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    © All Rights Reserved
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    of 1

    KD 11/04

    ABC Checklist

    Student Name (D.O.B.): ____________________________________ School / Building: _________________________________

    Date Time Antecedent Behavior Consequence Duration Intensity


    What was happening before the What happened after? How long did the
    behavior occurred? behavior last?
    _____ Alone _____ Refusing to follow instructions _____ Student ignored ____ <1 minute 1 LOW
    _____ With peers _____ Disrupting class (describe) _____ Used proximity control ____ 1-5 minutes
    _____ Riding in bus/van _____ Making verbal threats _____ Gave a nonverbal cue ____ 5-10 minutes 2
    _____ Preparing for outing _____ Hurting self _____ Gave a verbal warning ____ 10-30 min.
    _____ Just ending an activity _____ Destroying property _____ Changed assignment ____ 1/2 1 hour 3
    _____ Participating in group _____ Screaming/yelling _____ Redirected ____ 1-2 hours
    _____ Asked to do something _____ Biting _____ Student lost privilege ____ 2-3 hours 4
    _____ Asked/told not to _____ Throwing _____ Sent to office ____ 3+ hours
    _____ Transitioning _____ Kicking _____ Suspended 5 HIGH
    _____ Working on academics _____ Running away _____ Gave detention
    (which one(s)?______________) _____ Grabbing/pulling _____ Gave a time out
    _____ At recess _____ Crying Loudly _____ Physical assist/prompt
    _____ Being ignored _____ OTHER (describe) _____ Physical escort
    _____ At lunch _____ Physical management
    _____ Given a warning _____ OTHER
    _____ About to begin new activity
    _____ OTHER (describe)

    NOTES:

    Date Time Antecedent Behavior Consequence Duration Intensity


    What was happening before the What happened after? How long did the
    behavior occurred? behavior last?
    _____ Alone _____ Refusing to follow instru ctions _____ Student ignored ____ <1 minute 1 LOW
    _____ With peers _____ Disrupting class (describe) _____ Used proximity control ____ 1-5 minutes
    _____ Riding in bus/van _____ Making verbal threats _____ Gave a nonverbal cue ____ 5-10 minutes 2
    _____ Preparing for outing _____ Hurting self _____ Gave a verbal warning ____ 10-30 min.
    _____ Just ending an activity _____ Destroying property _____ Changed assignment ____ 1/2 1 hour 3
    _____ Participating in group _____ Screaming/yelling _____ Redirected ____ 1-2 hours
    _____ Asked to do something _____ Biting _____ Student lost privilege ____ 2-3 hours 4
    _____ Asked/told not to _____ Throwing _____ Sent to office ____ 3+ hours
    _____ Transitioning _____ Kicking _____ Suspended 5 HIGH
    _____ Working on academics _____ Running away _____ Gave detention
    (which one(s)?______________) _____ Grabbing/pulling _____ Gave a time out
    _____ At recess _____ Crying Loudly _____ Physical assist/prompt
    _____ Being ignored _____ OTHER (describe) _____ Physical escort
    _____ At lunch _____ Physical management
    _____ Given a warning _____ OTHER
    _____ About to begin new activity
    _____ OTHER (describe)

    NOTES:

    This form created by: Kelly Dunlap, Psy.S., School Psychologist/Positive Behavior Support Consultant

    14

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