| A | B | C | D | E | F | G | H | I | J | |
|---|---|---|---|---|---|---|---|---|---|---|
1 | ||||||||||
2 | Student Name | Grade | District | Date | Respondent | |||||
3 | ||||||||||
4 | Behavior: | |||||||||
5 | QUESTIONS ABOUT BEHAVIORAL FUNCTION (QABF) | |||||||||
6 | Rate how often the student demonstates the behaviors in situations where they might occur. Be sure to rate how often each behavior occurs, not what you think a good answer would be. | |||||||||
7 | Score | Behavior | ||||||||
8 | Engages in the behavior to get attention | |||||||||
9 | Engages in the behavior to escape work or learning situation | |||||||||
10 | Engages in the behavior as a form of "self-stimulation" | |||||||||
11 | Engages in the behavior because he/she is in pain | |||||||||
12 | Engages in the behavior to get access to items such as preferred toys, food, or beverages | |||||||||
13 | Engages in the behavior because he/she likes to be reprimanded | |||||||||
14 | Engages in the behavior when asked to do something (get dressed, brush teeth, work, etc.) | |||||||||
15 | Engages in the behavior even if he/she thinks no one is in the room | |||||||||
16 | Engages in the behavior more frequently when he/she is ill | |||||||||
17 | Engages in the behavior when you take something away from him/her | |||||||||
18 | Engages in the behavior to draw attention to himself/ herself | |||||||||
19 | Engages in the behavior when he/she does not want to do something | |||||||||
20 | Engages in the behavior because there is nothing else to do | |||||||||
21 | Engages in the behavior when there is something bothering him/ her physically. | |||||||||
22 | Engages in the behavior when you have something he/ she wants. | |||||||||
23 | Engages in the behavior to try to get a reaction from you. | |||||||||
24 | Engages in the behavior to try to get people to leave him/ her alone. | |||||||||
25 | Engages in the behavior in a highly repetitive manner, ignoring his/ her surroundings. | |||||||||
26 | Engages in the behavior because he/ she is physically uncomfortable. | |||||||||
27 | Engages in the behavior when a peer has something that he/ she wants. | |||||||||
28 | Does he/ she seem to be saying, "come see me" or "look at me" when engaging in the behavior? | |||||||||
29 | Does he/ she seem to be saying, "leave me alone" or "stop asking me to do this" when engaging in the behavior? | |||||||||
30 | Does he/ she seem to enjoy the behavior, even if no one is around? | |||||||||
31 | Does the behavior seem to indicate to you that he/ she is not feeling well? | |||||||||
32 | Does he/ she seem to be saying, "give me that (toy, food, item)" when engaging in the behavior? | |||||||||
33 | ||||||||||
34 | Attention | Escape | Non-social | Physical | Tangible | |||||
35 | Attention | 0 | Escape | 0 | Self-Stim | 0 | In Pain | 0 | Access to Items | 0 |
36 | Reprimand | 0 | Do Something | 0 | Thinks Alone | 0 | When Ill | 0 | Takes Away | 0 |
37 | Draws | 0 | Not Do | 0 | Nothing to Do | 0 | Physical Problem | 0 | You Have | 0 |
38 | Reaction | 0 | Alone | 0 | Repetitive | 0 | Uncomfortable | 0 | Peer Has | 0 |
39 | "Come See" | 0 | "Leave Alone" | 0 | Enjoy by Self | 0 | Not Feeling Well | 0 | "Give Me That" | 0 |
40 | Total | 0 | Total | 0 | Total | 0 | Total | 0 | Total | 0 |
41 | ||||||||||