FBA template: interviews, observations, hypothesis
By the IEP Atlas editorial teamLast updated
Short answer
An FBA template is the report outline a team fills in as it assesses a behavior: student information, the referral concern, an operational definition, interview and record findings, direct observation data, a pattern summary, a hypothesis, a test of the hypothesis and recommendations. Each section should hold numbers and dates, so the BIP and the IEP goal can be built straight from it.
The template below is the written record of a functional behavior assessment. It is not the process itself. For the steps, timelines and how to run interviews, use how to conduct an FBA, step by step. For where the FBA sits next to the behavior plan, start with the FBA and BIP guide.
Use this page when you sit down to write the report. Copy the fill-in version, then compare your draft with the completed example and the reviewer notes.
The fill-in FBA template
Copy each heading into your district's form or a blank document. The prompts in italics tell you what belongs there.
- Student and referral. Name, grade, eligibility category, date of referral, who referred, date consent was signed, assessment dates.
- Reason for referral. Two or three sentences in observable terms. What happens, where, and what has been tried.
- Target behavior. One operational definition, with an example and a non-example. Say when an episode starts and ends.
- Records review. Attendance, discipline entries, prior plans, health or medication notes, grades, relevant evaluation results.
- Interviews. Who was interviewed, the date, the tool used, and what each person said about when the behavior is most and least likely.
- Student interview. What the student says helps, what is hard, and what they want. Quote short phrases.
- Direct observation. Settings, dates, total minutes observed, the method, the baseline number and its range.
- Pattern summary. Tables of antecedents and consequences with counts. Setting events. Times of day.
- Hypothesis. When (setting event) and (antecedent), the student (behavior) to (get or avoid something). One function, with the data that supports it.
- Hypothesis test and recommendations. The planned change, what happened to the data, and what the BIP should include.
Keep the blank version short. A report that runs past 6 pages usually has interview transcripts pasted in. Summarize them and keep the raw notes in the file.
A completed FBA example
The student, school and numbers below are fictional. They show the level of detail each section needs.
1. Student and referral. Jonah, grade 6, eligible under other health impairment (ADHD). Referred September 18 by the math teacher and case manager. Consent signed September 22. Assessment September 25 to October 20.
2. Reason for referral. During math, Jonah leaves his seat and walks out of the classroom, usually to the hallway water fountain or the restroom. He misses an estimated 15 to 25 minutes of a 55-minute class on most days. Preferential seating, a daily check sheet and lunch detentions have not changed the pattern.
3. Target behavior. Leaving the classroom without permission: any time Jonah passes through the classroom door during class without a pass or adult approval. The episode starts when he crosses the doorway and ends when he is back in his seat. Example: walking to the fountain while the class does a warm-up. Non-example: leaving with a hall pass after asking.
4. Records review. 11 office referrals last year, 9 from math or science. No episodes recorded in PE, art or lunch. Math grade 58%. His last evaluation shows average reasoning and below-average math calculation fluency (11th percentile).
5. Interviews. Math teacher (September 26): leaves most often during independent practice and almost never during the lesson demo. Case manager (September 27): same pattern in science labs that involve written calculation. Parent (September 28): homework time at home ends in arguments when it is math worksheets.
6. Student interview. Jonah said math is "a wall of problems" and that he leaves "before I look stupid." He said he likes the warm-up when it is on the board and can be done with a partner.
7. Direct observation. 8 observations across 2 weeks, 340 minutes total, using ABC data and a frequency count. Baseline: median of 2 exits per class (range 1 to 4). Median time out of the room per exit: 9 minutes.
8. Pattern summary.
| Antecedent | Exits |
|---|---|
| Independent worksheet with 20 or more problems | 14 |
| Teacher asks him to show work at the board | 3 |
| Partner or group task | 1 |
| Lesson demo | 0 |
| Consequence | Exits |
|---|---|
| Worksheet not completed, no make-up required | 13 |
| Brief talk in the hall, then returns | 4 |
| Sent to office | 1 |
Setting event: exits were more likely on days with a quiz earlier in the week.
9. Hypothesis. When Jonah is given an independent math worksheet with many problems, especially in a quiz week, he leaves the classroom to escape the task. In 13 of 18 exits, the work was never finished or made up.
10. Hypothesis test and recommendations. For one week, the teacher split each worksheet into strips of 5 problems and checked in after each strip. Exits dropped from a median of 2 per class to 0 (range 0 to 1). Recommendations for the BIP: chunked tasks, a break card for a 3-minute break inside the room, explicit math fluency instruction, and a goal for requesting a break.
What reviewers and parents look for in each section
Compliance reviewers, district behavior staff and parents read the same report with different questions. The notes below cover what each section has to answer.
| Section | What a reviewer checks | What a parent often asks |
|---|---|---|
| Student and referral | Consent date comes before the first data date | Was I asked before you started? |
| Reason for referral | Observable words, no labels like "defiant" | Is this how you describe my child? |
| Target behavior | Two adults could count it the same way | Will every adult use this same definition? |
| Records review | Sources named and dated | Did you look at what worked last year? |
| Interviews | Parent and student voices included | Did you ask me what happens at home? |
| Direct observation | Enough minutes across settings and days | Did you watch the good classes too? |
| Pattern summary | Counts add up to the total episodes | Is there a time it does not happen? |
| Hypothesis | One function, backed by the counts | Does this make sense of what I see? |
| Hypothesis test | A planned change with before and after data | How do you know you are right? |
| Recommendations | Each one traces back to the hypothesis | What will be different on Monday? |
Two problems come up most often in review. The first is a report with no direct observation, only interviews and a checklist. The second is a hypothesis that names two or three functions "to be safe." The behavior hypothesis statement examples show weak and strong versions side by side.
Section notes: wording that holds up
Reason for referral. Write what someone would see on a video. "Leaves the room during math" holds up. "Refuses to work and is disrespectful" does not, because it tells the reader your view instead of the behavior. The guide to operational definitions of behavior has 16 before and after pairs.
Interviews. Record the date and the source next to each finding. When two adults disagree, write both views. A parent who sees no behavior at home is giving you real information about setting events.
Direct observation. Report the total minutes observed, not only the number of sessions. Ten 5-minute observations and two 50-minute observations tell different stories. If you collected data with a second observer, add the agreement figure; interobserver agreement explains how to calculate it.
Pattern summary. Use counts, not "often" or "usually." Make each table's column sum match the total episodes. A reader should be able to check your math.
Recommendations. Write recommendations a teacher can start, not a list of categories. "Break the worksheet into strips of 5 problems" is a recommendation. "Use antecedent strategies" is a heading.
From the FBA to the BIP and the goal
The FBA ends where the plan begins. Jonah's team used his report to write the BIP template with examples and a goal for requesting a break. The goal used the same unit as the baseline, so the first progress report could compare like with like:
"During independent math practice, when Jonah wants a break, he will hand the teacher his break card and take a break inside the classroom, then return to the task within 3 minutes, in 4 of 5 opportunities across 3 consecutive weeks."
The replacement behavior goal templates and the behavior IEP goals hub have more wording to adapt. To turn the hypothesis into a goal step by step, see writing a behavior goal from an FBA.
IDEA requires the IEP team to consider positive behavioral interventions and supports when a student's behavior impedes learning.[1] Under the discipline rules, an FBA is also required in some placement changes; the details and timelines are in the regulation and in state rules.[2] The IRIS Center module on FBA walks through each part of the assessment with case studies.[3]
Frequently asked questions
How long should an FBA report be?
Most school FBA reports run 3 to 6 pages. Longer reports usually include full interview notes or checklists that belong in the file, not the report. Keep the summary tables and the hypothesis, and attach the raw data sheets.
Who fills in the FBA template?
Usually a school psychologist, BCBA or trained special educator writes the report. Teachers, paras and parents contribute interview answers and data. The IEP team reviews the findings together before writing the behavior plan.
Does the FBA need a student interview?
Federal rules do not list required FBA sections. Most district templates include a student interview when the student can take part. The student's own words often explain the function faster than any checklist.
Can a parent see the FBA before the meeting?
Parents have the right to inspect their child's education records. Many teams send the FBA draft a few days before the meeting so the family can read it and bring questions. Ask your district how it handles drafts.
Use it in IEP Atlas
- FBA in the IEP glossary
- Function of behavior in the IEP glossary
- Behavior IEP goals
- Replacement behavior goals
- Frequency data sheet
Related guides
- FBA and BIP: a practical guide for IEP teams
- How to conduct an FBA, step by step
- Behavior hypothesis statement examples
- Writing a behavior goal from an FBA
- BIP template with examples
Sources
- 34 CFR §300.324: Development, review, and revision of IEP, Legal Information Institute, Cornell Law School
- 34 CFR §300.530: Authority of school personnel, U.S. Department of Education (IDEA website)
- Functional Behavioral Assessment: Identifying the Reasons for Problem Behavior and Developing a Behavior Plan, IRIS Center, Vanderbilt University
Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.