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FUNCTIONAL ANALYSIS INTERVIEW
Student: Roger ID# date: 3/ 15 /02 Teacher: Ms. Shell Shocked
Behavior of Concern: Tantrums that take the form of screaming, runing around, tearing up materials, kicking the walls, yelling profanity.
Positive Reinforcers: Taking a walk, drawing with markers, taking a walk, toy animals, candy. Negative Reinforcers: Escape from demands.
Instructions: Interview a person who has observed the behavior of the student for an extended period
of time in many different situations. Check the boxes whenever the respondent answer “YES” to a question. For every “YES” response there should be a qualifying comment written on the line corresponding to the question.
1. Physiological, Medical, EO Factors
Does the behavior occur during certain seasons of the year? NO
Could the behavior be the result of any form of discomfort (escape response to headache, stomach ache, dizziness, blurred vision, ear infection, etc.). NO
Could the behavior be signaling some deprivation condition? (Thirst, hunger, lack of rest, etc. BEHAVIOR IS MORE SEVERE WHEN HE IS TIRED AND MORE FREQUENT.
Could the behavior be a side effect of medication? (Tired, unsteady, thirst, confused, toxic levels) NO
Could the behavior be the result of a medical condition? (Seizures, PKU, allergies, CP) NO
2. Antecedents and Setting Event Factors
Are there any circumstances in which the behavior ALWAYS occurs? WHEN TRANSITIONING FROM PREFERRED TO UNPREFERRED AND WHEN DENIE A PREFERRED ITEM.
Are there any circumstances in which the behavior NEVER occurs? WHEN ENGAGED IN PREFERRED ACTIVITIES.
Does it occur at certain times of the day? NO, AT TIME WHEN MORE DEMANDS ARE PLACED UPON HIM BEHAVIOR OCCURS MORE FREQUENTLY.
Does the behavior occur only with certain people? NO
Could the behavior be related to any skill deficits? (Communication, excessive task requirements, physical ability)
YES, HE HAS POOR VERBAL SKILLS AND THEREFORE DOES NOT HAVE MANY WAYS TO NEGOTIATE.
Is the behavior related to any particular activities? IF THE ACTIVITY IS PREFERRED THEN THE TRANSITION WILL BE MORE DIFFICULT.
Is the behavior in response to aversive stimuli? (Tone of voice, ignoring, demands, noise level, number of people in the room, agitation/consequences delivered to other students, lighting, change in routine, transitions) NO
3. Operant (consequences) Factors
What does the behavior allow the student to gain? (Attention, preferred activities or items) IT APPEARS THAT THE TANTRUMS HAVE LED TO ROGER ESCAPING DEMANDS AND GETTING THINGS HE WANTS.
Does the behavior allow the student to postpone, avoid, or escape aversive stimulation?
(Unpreferred activities, demands, social interaction, pain) YES, BY RUNNING AROUND AND AWAY HE ESCAPES THE DEMAND MOMENTARILY.
Does the behavior provide self-stimulation activity? (Boredom, impoverished environment) NO Does the behavior occur collateral with any other behavior or as part of a chain of behaviors? THE
BEHAVIOR STARTS WITH SCREAMING AND THEN BECOMES DESTRUCTIVE OF PROPERTY. Does the behavior occur as a result of having a preferred activity terminated? YES.
FUNCTIONAL ANALYSIS SCREENING TOOL (FAST)
Student: Roger ID# Exceptionality: Autism
Date: 3 / 15 / 02 DOB: / / School: Grade: 2
Behavior Problem: Tantrums that take the form of screaming, runing around, tearing up materials, kicking the walls, yelling profanity.
Informant: Teacher Interviewer: V. Carbone
T o t h e I n t e r v i e w e r : T h e F A S T i s d e s i g n e d t o i d e n t i f y a n u m b e r o f f a c t o r s t h a t ma y i n f l u e n c e t h e o c c u r r e n c e o f b e h a v i o r p r o b l e ms . I t s h o u l d b e u s e d o n l y a s a n i n i t i a l s c r e e n i n g t o o l a n d a s p a r t o f a c o mp r e h e n s i v e f u n c t i o n a l a n a l y s i s o f t h e b e h a v i o r p r o b l e m . T h e F A S T s h o u l d b e a dm i n i s t e r e d t o s e v e r a l i n d i v i d u a l s w h o i n t e r a c t w i t h t h e c l i e n t f r e q u e n t l y . R e s u l t s s h o u l d t h e n b e u s e d a s t h e b a s i s f o r c o n d u c t i n g d i r e c t o b s e r v a t i o n s i n s e v e r a l d i f f e r e n t c o n t e x t s t o v e r i f y l i k e l y b e h a v i o r a l f u n c t i o n s , c l a r i f y a mb i g u o u s f u n c t i o n s , a n d i d e n t i f y o t h e r r e l e v a n t f a c t o r s t h a t m a y n o t h a v e b e e n i n c l u d e d i n t h i s i n s t r u m e n t . T o t h e I n f o r m a n t : A f t e r c o m p l e t i n g t h e s e c t i o n o n “ I n f o r m a n t - Cl i e n t R e l a t i o n s h i p , ” r e a d e a c h o f t h e n u m b e r e d i t e ms c a r e f u l l y . I f a s t a t e me n t a c c u r a t e l y d e s c r i b e s t h e s t u d e n t ’ s t a r g e t b e h a v i o r p r o b l e m, c i r c l e “Y e s . ” I f n o t , c i r c l e “N o . ” INFORMANT-CLIENT RELATIONSHIP
Indicate your relationship to the student: Parent Teacher/InstructorXXXXXXX
Therapist Residential Staff
How long have you known the student? 3 Years 5 Months
Do you interact with the student on a daily basis? XXXX Yes No If “Yes,” how many hours per day? 6 If “No,” how many hours per week? In what situations do you typically observe the student? (Mark all that apply)
X Self-care routines X Academic skills training
X Meals When the student has nothing to do Leisure activities Work or vocational training Evenings Other: