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Functional Behavioral Assessment (FBA)

STUDENT: AM DOB: ##/##/## Page 1 of 8 Functional Behavioral Assessment (FBA) Student: AM DOB: ##/##/## Age: 7-2 Grade: 1 School/District: Sunshine Academy/SFUSD Case Manager: Ms. H Assessor: Dr. L, PsyD, BCBA Date of Report: ##/##/## Background Information AM is a seven-year-old, male, Hispanic student currently receiving Special Education (SPED) support as a student exhibiting characteristics most consistent with the educational eligibility of Autistic-Like Behaviors (AUT). He is currently enrolled in a small, highly-structured, Special Day Class (SDC) setting at Sunshine Academy, a Non-Public School (NPS) program. He is a resident of San Francisco Unified School District (SFUSD). AM was referred for a Functional Behavioral Assessment (FBA) due to ongoing concerns regarding a number of maladaptive behaviors negatively impacting his access to the curriculum.

The Questions About Behavioral Function (QABF) is a measure designed for the functional assessment of behavioral problems in young people and adults. The QABF is an indirect assessment of behavioral function that consists of 25 items. Respondents familiar with the individual rates each item.

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