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ABC Data Checklist
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Student:_________________________________
ID #: _______________
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School: _________________________________
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Date:
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Time:
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Staff Initials:
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Behavior:
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Location where behavior occurred: (Specify)
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Classroom
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Hallway
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Cafeteria
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Bus
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Office
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Persons Present:
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Teacher
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Peers
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Specialists (SLP, OT, PT)
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Administrator
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Bldg Security
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Activity:
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Academic task
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Nonacademic task
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Breakfast/Lunch
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Transition (activity/locations)
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Directed break time/time out
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Recess
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Arrival/Dismissal
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Restroom
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Setting Events:
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Sleepy/Sick/Hungry
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Medication change/ no medication
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Environmental factors (noise/crowds)
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Work demands too difficult
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Disruption in routine
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Antecedents:
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Work demand
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Social interaction with staff/peer
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Ignored by staff or peer
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Activity/object removed or unavailable
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Student request denied
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Verbal redirection by adult
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Consequences:
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Staff/peer walked away
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Staff/peer verbally engaged
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Task stopped
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Student verbally redirected
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Choices offered
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Alternate activity/object provided
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Break offered
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Additional staff called (crisis team)
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