7/27/2019 ABC Checklist - Version 2

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A-B-C ChecklistStudent Name: ___________________________________________________ Class:__________________________ School:________________________________________

Behavior of Concern:____________________________________________________________________________________________________________________________________________

Date: Time: Location/Setting:

Antecedent (before behavior) Behavior Consequences (after behavior)

Given direction/task/activity Asked to waitNew task/activity Difficult task/activity Preferred activity interrupted Activity/Item denied (told no) Loud, noisy environment Given assistance/correction Transition between

locations/activities Attention given to others Presence of specific person Attention not given when

wanted Left alone (no indiv. attention) Left alone (no approp. activity)Other: ____________________

__________________________

Refusing to follow directionsMaking verbal threatsDisrupting class (describe)Crying/whiningScreaming/yellingScratchingBitingSpittingKickingFloppingRunning away/boltingDestroying propertyFlipping furnitureHitting SelfHitting OthersVerbal RefusalOther____________________

Verbal redirectionPhysical assist/promptIgnored problem behaviorKept demand onUsed proximity controlVerbal reprimandRemoved from activity/locationGiven another task/activityInterrupted/blocked and

redirectedLeft aloneIsolated within classLoss of privilegeCalming/soothing:

verbal/physical/both

Peer remarks/laughterTime-out (duration)_________Other ______________________

Duration:

____