Note: Numbers correspond with the scoring system on the BIP Quality Evaluation Guide

This form
CO NF ID E NT I AL D O NO T DI S P L A Y

BEHAVIOR INTERVENTION PLAN

For Behavior Interfering with Students Learning or the Learning of His/Her Peers

This BIP attaches to: IEP date: 504 plan date: Team meeting date:

Student Name Sarah Todays Date 03/7/17 Next Review Date

1. The behavior impeding learning is (describe what it looks like) the student has outburst of aggression to
teachers and other students.
2. It impedes learning because it affects her ability to stay on task.
3. The need for a Behavior Intervention Plan early stage intervention moderate serious extreme
4. Frequency or intensity or duration of behavior 3 out of 10 days.
reported by Mrs. Sipple and/or observed by Mrs. Sipple, Mr. Quinn

PREVENTION PART I: ENVIRONMENTAL FACTORS AND NECESSARY CHANGES

What are the predictors for the behavior? (Situations in which the behavior is likely to occur: people, time, place, subject, etc.)
Observation &

5. when she is given classwork, working on math problems, home life, abusive boyfriend, foster care.
Analysis

What supports the student using the problem behavior? (What is missing in the environment/curriculum or what is in the
environment curriculum that needs changing?)
6. The home life needs to be more stable.

Remove students need to use the problem behavior-----

Intervention

What environmental changes, structure and supports are needed to remove the students need to use this behavior?
(Changes in Time/Space/Materials/Interactions to remove likelihood of behavior)
7. Modified classwork and assignments. Sarah needs to be given chioces.
Who will establish? Mrs. Sipple Who will monitor? Mrs. Sipple Frequency? Daily

ALTERNATIVES PART II: FUNCTIONAL FACTORS AND NEW BEHAVIORS TO TEACH AND SUPPORT

Team believes the behavior occurs because: (Function of behavior in terms of getting, protest, or avoiding something)
Observation &

8. The behavior occurs because she is seeking attention.

Analysis

Accept a replacement behavior that meets same need-----

What team believes the student should do INSTEAD of the problem behavior? (How should the student escape/protest/
avoid or get his/her need met in an acceptable way?)
9. Go to cool down area and express frustrations.

What teaching Strategies/Necessary Curriculum/Materials are needed? (List successive teaching steps for student to learn
Intervention

replacement behavior/s)
10. Role Play how to appropriately deal with emotions. Sarah may need counciling.
Who will establish? The Special Education teacher Who will monitor? The general Education teacher Frequency?
Twice a week.

What are reinforcement procedures to use for establishing, maintaining, and generalizing the replacement behavior(s)?
Intervention

11. There will be a reward system like extra computer/ game time and fast food lunch.
Selection of reinforcer based on:
reinforcer for using replacement behavior reinforcer for general increase in positive behaviors
By whom? Frequency?

Diana Browning Wright, Behavior/Discipline Trainings 1

For the electronic expandable version, see www.pent.ca.gov/forms.htm.
 EFFECTIVE REACTION PART III: REACTIVE STRATEGIES

What strategies will be employed if the problem behavior occurs again?

12.
1. Prompt student to switch to the replacement behavior Verbal prompt
2. Describe how staff should handle the problem behavior if it occurs again Verbally tell the student that she is stepping over the
line and needs to do a behavior check.
3. Positive discussion with student after behavior ends have a private one on one conversation after class about the behavior
and maybe do a role play of a better way to handle emotions.
Optional:
4. Any necessary further classroom or school consequences
Personnel?

OUTCOME PART IV: BEHAVIORAL GOALS

Behavioral Goal(s)
13.
Required: Functionally Equivalent Replacement Behavior (FERB) Goal
For the For the As
Will do X Instead of Under what At what
purpose of purpose of measured
By when Who behavior Z behavior contingent level of
y y by whom
(line 9) (line 1) conditions proficiency
(line 8) (line 8) and how
End of Sarah they will go to get ahold bursting to get ahold in the 95% of the teacher
the to the cool of her out to get of her classroom the time by
school down room emotions attention emotions observation
year.

Option 1: Increase General Positive or Decrease Problem Behavior

Will do what, or At what level of Under what Measured by

By when Who
will NOT do what proficiency conditions whom and how

Option 2: Increase General Positive or Decrease Problem Behavior

Will do what, or At what level of Under what Measured by

By when Who
will NOT do what proficiency conditions whom and how

The above behavioral goal(s) are to: Increase use of replacement behavior and may also include:
Reduce frequency of problem behavior Develop new general skills that remove students need to use the problem behavior

Observation and Analysis Conclusion:

Are curriculum accommodations or modifications also necessary? Where described: ............................. yes no
Are environmental supports/changes necessary? ................................................................................................ yes no
Is reinforcement of replacement behavior alone enough (no new teaching is necessary)? .................................. yes no
Are both teaching of new replacement behavior AND reinforcement needed? .................................................... yes no
This BIP to be coordinated with other agencys service plans? ............................................................................ yes no
Person responsible for contact between agencies ................................................................................... yes no

Diana Browning Wright, Behavior/Discipline Trainings 2

For the electronic expandable version, see www.pent.ca.gov/forms.htm.
 COMMUNICATION PART V: COMMUNICATION PROVISIONS

Manner and content of communication

14.
2. Under what
3. 6. How will this be
condition(s) 4. Expected
1. Who? Delivery 5. Content? two-way
(Contingent? Frequency?
Manner communication
Continuous?)

2. Under what
3. 6. How will this be
condition(s) 4. Expected
1. Who? Delivery 5. Content? two-way
(Contingent? Frequency?
Manner communication
Continuous?)

2. Under what
3. 6. How will this be
condition(s) 4. Expected
1. Who? Delivery 5. Content? two-way
(Contingent? Frequency?
Manner communication
Continuous?)

PARTICIPATION PART VI: PARTICIPANTS IN PLAN DEVELOPMENT

Student
Parent/Guardian
Parent/Guardian
Educator and Title General Education teacher
Educator and Title Special Education Teacher
Educator and Title
Administrator
Other
Other

Diana Browning Wright, Behavior/Discipline Trainings 3

For the electronic expandable version, see www.pent.ca.gov/forms.htm.