Functional Assessment Interview1

Student: Age Gender:

Date of interview: Interviewer:

1. Operational Definition of Target Behavior(s):

2. Organism Variables:
Are there any internal conditions, states, disorders, or disabilities that have behavioral features?
If so specify such and list the behavioral features.

3. Behavior History:
How long have the target behavior(s) been a problem?

What has previously been tried to address the target behavior?

What has been the effect of the previous behavior interventions?

1
Adapted from O’Neill, R.E., Horner, R.H., Albin, R.W., Sprague, J.R., Storey, K., & Newton, J. S. (1997). Functional assessment and program development for
problem behavior: A practical handbook. Pacific Grove, CA: Brooks/Cole.
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4. Consequences of the Target Behavior(s):

What happens immediately after the behavior(s) that might be reinforcing?

What does the student obtain?

What does the student escape or avoid?

Are there specific/unique situations that typically generate specific target behavior
consequences? If so what are those situations?

In the absence of identified external/observable consequences is there any reason to believe that
obtaining or escaping/avoiding any internal sensory state might be a function of the behavior? If
so what are those reasons?

5. Replacement Behavior(s):
What other behavior(s), which are incompatible with the target behavior(s) and might result in
the might result in the same consequences as target behavior, can be encouraged. Define the
replacement behavior(s) in terms that are measurable readily observable

Does the student currently display this behavior(s), or does it need to be taught to the student
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6. Consequences of the Replacement Behavior(s) [SRF]:

What happens immediately after the behavior(s) that might be reinforcing?

What does the student obtain?

What does the student escape/avoid?

Are there specific/unique situations that typically generate specific consequences? If so what
are those situations.

7. Motivating Operations
What circumstances, situations or events, when present, make it more or less likely that the
target or replacement behaviors will occur (e.g., increase the need for the reinforcing
consequence of the target behavior)?

a) What medications is the student taking?

What affect do they have on the target behavior?

What affect to they have on the replacement behavior?

b) Does the student have any medical or physical conditions (e.g., asthma, allergies, rashes,
dental problems, sinus infections, seizures, etc.)?

What affect do they have on the target behavior?

What affect to they have on the replacement behavior?

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c) What are the student’s sleep patterns?

What affect do they have on the target behavior?

What affect to they have on the replacement behavior?

d) What are the student’s eating patterns or diet?

What affect do they have on the target behavior?

What affect to they have on the replacement behavior?

e) How predictable is the student’s daily routine?

What affect does the routine have on the target behavior?

What affect does the routine have on the replacement behavior?

f) What are some of the choices the student may be able to make during the course of a
school day?
What affect does the ability to make choices have on the target behavior?

What affect does the ability to make choices have on the replacement behavior?

g) Are there some situations, settings, or days that present the student with an unusually
crowded and/or noisy environment?
What affect does a crowded or noisy environment have on the target behavior?

What affect does crowded or noisy environment have on the replacement behavior?

h) What is the pattern of staffing support present in the student’s environment (e.g., 1:1 or
2:1)?
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Is there a particular staffing level that has an affect on the target and/or replacement
behavior?
Are their types of staff interactions that appear to have an affect on the target and/or
replacement behavior?
Does the type of staff training have and affect on the target and/or replacement
behavior?
i) Are there any other events, occurring either the night before, or the morning that, the
behavior was displayed, that are suspected to play a role in the target and/or
replacement behaviors?

8. Immediate Antecedents [SD]:

What are the specific events that immediately precede/predict the target and replacement
behaviors? These events are the cues, signals, or signpost that tell the student that a given
behavior will yield a reinforcing consequence.

a) Time of day.
When is the target behavior most likely to occur?
When is the replacement behavior most likely to occur?
When is the target behavior least likely to occur?
When is the replacement behavior least likely to occur?
b) Setting.
Where is the target behavior most likely to occur?
Where is the replacement behavior most likely to occur?
Where is the target behavior least likely to occur?
Where is the replacement behavior least likely to occur?
c) People.
With whom is the target behavior most likely to occur?
With whom is the replacement behavior most likely to occur?
With whom is the target behavior least likely to occur?
With whom is the replacement behavior least likely to occur?
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d) Activity.
During what activities is the target behavior most likely to occur?
During what activities is the replacement behavior most likely to occur?
During what activities is the target behavior least likely to occur?
During what activities is the replacement behavior least likely to occur?
e) Other antecedents.
Are there any other antecedents that appear to cue or trigger the target behavior (e.g.,
specific task demands, noises, lights, clothes, smells, etc.)?

f) If you wanted to guarantee that the target behavior would occur, what would you do?

O
Summary Statements: EO[(SD)R>SRE)]

O
Internal conditions, states, disorders, or disabilities that have behavioral features

Antecedents Target Behavior Consequences

D
MO S R SRF
Motivator Immediate Antecedent  Response  Rewarding Stimulus
(Trigger)
 
 
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O
Internal conditions, states, disorders, or disabilities that have behavioral features

Antecedents Target Behavior Consequences

MO SD R SRF
Motivator Immediate Antecedent  Response  Rewarding Stimulus
(Trigger)
 
 


O
Internal conditions, states, disorders, or disabilities that have behavioral features

Antecedents Target Behavior Consequences

D
MO S R SRF
Motivator Immediate Antecedent  Response  Rewarding Stimulus
(Trigger)
 
 