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If you need this notice in a different language or communicated in a different way, or have questions about this notice,

please contact the school district at the telephone number at the bottom of this form.

S-26 - Behavior Intervention Plan


Student:

Birth Date

Owen

11/08/2006

Grade

District of Residence

District of Placement

Current School

Poynette

Poynette

Poynette Elementary School

Form Date
March 28, 2016
I. Operational Definition of the Target Behavior:
Owen will leave the classroom when frustrated, not follow directions the first time he is asked 4 out of 7 times, and talk
back to peers and teachers when he does not get his way.
II. Functional Behavior Assessment Hypothesis:
When Owen is presented with something he does not want to do or a task he finds uninteresting, he will mumble under
his breath about said task, cause distractions, refuse to complete it.
III. Goal - Expected Behavior (connect to operational definition, and state current baseline):
When Owen is presented with an assignment, he will complete it, not cause distractions for others, and stay engaged in
the classroom.
IV. General Approach:
A. Trigger / Setting - Event:
Uninterested in task/assignment

Classroom

Distracted by others

Classroom

Causes distractions

Classroom

B. Predictor Strategies:
Teacher will use proximity control to help Owen stay on task and focused.
When Owen is transitioning from one classroom to another, he will take a five minute break in a
designated spot before joining class.
Owen will be given an additional activity to complete if he gets done with his assignment early (to
eliminate causing distractions for others).
Owen will take a break in a break spot that him and his classroom teacher pick for five minutes when
Owen feels overwhelmed or frustrated.
July 1, 2014
Behavior Intervention Plan

2014 CESA 6

S-26 -

If you need this notice in a different language or communicated in a different way, or have questions about this notice,
please contact the school district at the telephone number at the bottom of this form.

C. Teaching Strategies (specific skills to teach/plan for addressing the behavior):


The classroom teacher and Owen will discuss and practice classroom expectations.
Together with the classroom teacher, Owen and that teacher will decide what a good day looks
like.

D. Consequence Strategies (include positive reinforcement as well as consequences, and address if


seclusion or restraint is anticipated and the conditions when and how it would be used):
Postive Reinforcement:
Owen will be acknowledged for staying on task with I noticed statement. (ex: I noticed how hard
youre working. etc. )
Owen will complete a behavior chart with teacher each day. For every three good days in a row,
Owen will earn lunch with a friend and teacher in the classroom.
For every five good days in a row, Owen will earn 15 minutes of computer time.
Consequences:
When Owen cannot stay on task, follow directions, or causing distractions, he will take a five minute
break in the office.
Owens parents will be notified about his daily behavior.
Owen will not be able to earn lunch in the classroom or extra computer time.

V. Routines (i.e. regular, positive expectations that establish the things that should be done first,
seconds, etc. how they need to be done - with positive reinforcement):
Owen will check in with his classroom teacher before school, after lunch, and before his third recess to talk about how
the day is going.
Together they will go over Owens progress so far in the day.
The classroom teacher will praise Owen for his appropriate behavior.
The classroom teacher and Owen will then practice routines or expectations Owen is still struggling with that day.
VI. Monitoring and Evaluation:
A. Responsibilities/Tools/Methods (relate to progress toward the target behavior):
The classroom teachers (specials included) will monitor Owens behavior on his chart daily.
Office Staff will be responsible for supervising Owen while he takes a break before transitioning to a new room.

July 1, 2014
Behavior Intervention Plan

2014 CESA 6

S-26 -

If you need this notice in a different language or communicated in a different way, or have questions about this notice,
please contact the school district at the telephone number at the bottom of this form.

B. Timeline (review and update baseline at least quarterly):


Owens behavior will be monitored daily using his behavior chart. A meeting with parents and other
school staff (that interact with Owen) will be held each trimester.

NAME AND TITLE OF DISTRICT CONTACT


Contact Name/Title:

Phone:
!
Email:

July 1, 2014
Behavior Intervention Plan

2014 CESA 6

S-26 -