Blast IU 17 offers a step-by-step process to request a Functional Behavior Assessment.

  1. Complete the Online Request to complete a Functional Behavior Assessment. Your IU Contact will determine the availability of Behavior Intervention Staff and assign a IU staff member to complete the request. The IU Behavior Intervention Staff member will then contact the district to initiate the process.
  2. The student’s District will obtain permission to evaluate and complete the referral form submitting it to the assigned IU staff member. The IU staff member will schedule a consultation with the IEP Manager I Appointed Teacher and schedule two school based observations.
  3. At the first observation/consultation (maximum two hours) the IU staff will review necessary paperwork the district will need to complete including:
    • Functional Behavioral Assessment Interview form completed by parent and teacher
    • Motivational Assessment Scale form completed by parent and instructional teacher(s)
    • Identify an acceptable form to collect ten days of target behavior and identify district staff responsible to collect data
  4. IU staff will complete a second observation at maximum two hours
  5. District will the return 10 days of data, Interview form and Motivational Assessment Scale from instructional teachers and parents to IU Staff. The IU staff will compile data and complete the FBA Summary and develop and draft Behavior Intervention Plan. The IU staff will then contact referring source to schedule a team meeting.
  6. The IU staff will attend the team meeting and will review the draft FBA & BIP and seek input from the various team members. The IU staff will modify the FBA and BIP and return to the referring source. The district staff will then disperse to team members.
Functional Behavior Assessment Request
Positive Behavioral Support Referral Form
(Identify problem behavior, motivation, others involved, school consequences, when, where it occurs)

For more information or to ask questions, contact our Director of Student Services:

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