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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).

The information obtained during this assessment came from a variety of sources: interviews with staff and parents; review of student records; indirect measurements (such as behavioral surveys), and direct observation. A summary of the information gathered from these sources is discussed below. Formal Observation(s) & Data Collection

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