Individual Behaviour Support Plan

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Personalized Learning Plan - Individual

Behaviour Support Plan (PLP-IBSP)


Student: Date of Birth:
School: Grade:
Support Plan Date: Implementation Date:
PLP-IBSP Lead and Role: Teacher(s):

Parent(s)/Guardian(s):
Parents/Guardians preferred method of communication:

Description of Learner and Current Services:

Pertinent Medical Information:

Justification and Target Behaviours:

Baseline and Current Data:

Functional Behaviour Assessment Results:

Objectives (Target Behaviours):


Replacement Behaviours:

Intervention Plan
Preventive Strategies:

Teaching and Reinforcement Strategies:

Behaviour Reduction Strategies:

Emergency Procedures:

Staff Training:

Description of Training Necessary for Implementation:

Staff Member Initials:


I have participated in the training opportunity as outlined above and will participate in ongoing
training and coaching opportunities as required.

Name Role Initials and Date

Document ongoing staff learning opportunities related to PLP-IBSP in Appendix A - Staff Training
Log

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Data Collection and Monitoring Procedures:

Data Collection:

Monitoring Procedures:

Procedures to Facilitate Inclusion, Maintenance and/or Generalization:

Risks of Implementing Intervention:

Risks of NOT implementing Intervention:

Signatures

Teacher PLP-IBSP Lead

Principal (Title)

(Title) (Title)

(Title) (Title)

I have read the PLP document and believe the planning described to be representative of that agreed to
in discussion with the school. This information may be used by the Department of Education and Early
Childhood Development for statistical analysis or monitoring purposes.

Parent/Guardian Date

Parent/Guardian Date

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Recommendations for Change:
During review periods, please indicate any changes needed.

Date Progress Actions

List of Appendices:
Appendix A Staff Training Log

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Appendix A: Staff Training Log

Date Description of Provided by Participants


Training

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