Behavior Intervention and Support Plan (BISP)

Name: Student ID: Date:

DOB: Age: Grade: Building/Site:

TO BE COMPLETED BY THE TEAM: Using the Functional Behavior Assessment (FBA), determine the appropriate behavior goal
and specific strategies for interventions to improve behavior and achievement. The Behavior Intervention and Support Plan (BISP)
must address the function, or purpose of the students behavior (as identified in the FBA). It is expected that the student and
parent(s)/guardian(s) will participate in the development of the BISP if possible and appropriate.

SUMMARY OF RELEVANT INFORMATION FROM FBA:

Include immediate trigger antecedents, setting events, typical consequences and relevant student history.

HYPOTHESIS STATEMENT:
Refer to the hypothesis statement included in the FBA.

When ,
(Contributing antecedents/consequences or conditions from student information section)

will
(Describe the target behavior what does it look like / sound like?)

in order to
(Consequences that serve as a pay off for the behavior)

Therefore, the function of the behavior is to (check the one(s) that apply):

ESCAPE/AVOID:

GAIN/OBTAIN:

COMMUNICATE:

BASELINE DATA:
With what frequency, intensity, and/or duration does this behavior occur?

Frequency Intensity Duration

(How often does behavior occur?) (How severe is the behavior?) (How long does the behavior last?)

times per minute seconds

1 2 3 4 5
hour (amount) minutes
day Low High hours
week (severity)

Other:

Form Revised: February 14, 2012

Name: Student ID: Date:

DOB: Age: Grade: Building/Site:

REPLACEMENT BEHAVIOR/BEHAVIORAL GOAL:

Specify one or more desired/expected behavior(s) (usually the behavior(s) that peers engage in given the same situation). The
replacement behavior to be taught and reinforced must be defined in observable and measurable terms.

Name: Student ID: Date:

PREVENTION STRATEGIES:
What can be done to prevent the inappropriate behavior from occurring? Refer to the FBA sections: Antecedents and Student
Information Summary (on Full FBA). What strategies can be put in place to reduce or eliminate antecedents identified in the FBA?
What support strategies can be put in place (i.e. providing choice, self-monitoring checklist)?

Strategy / Intervention Responsible Person(s) How often?/ When?

TEACHING STRATEGIES:
Based on information from the FBA, what skills need to be taught to increase the occurrence of appropriate behavior (i.e. social
skills, conflict resolution, choice-making, appropriate negotiation skills)? Methods and strategies for teaching the replacement
behavior(s) should be specified (i.e. prompts, environmental cues, opportunities for practice). Person(s) responsible for teaching the
replacement behavior(s) must be designated.

Skills Methods / Strategies Responsible Person(s) How Often?

2
Name: Student ID: Date:

DOB: Age: Grade: Building/Site:

TEACHING STRATEGIES CONT.

Skills Methods / Strategies Responsible Person(s) How Often?

REINFORCEMENT STRATEGIES:
What incentives can be used to reinforce the appropriate behavior? Refer to the FBA section: Student Information for Behavior
Intervention Planning Process.

Potential Incentives (does not exclude other incentives How will the student earn incentives?
that may be used)

RESPONSE/CONSEQUENCE STRATEGIES:
What will be done in response to the inappropriate behavior (i.e., timeout, loss of privilege, home contact)?
Refer to the FBA to ensure the consequence fits the function of the behavior. For example, if the behavior is for the purpose of
gaining adult attention, the response/consequence should limit access to adult attention.

3
Name: Student ID: Date:

DOB: Age: Grade: Building/Site:

CRISIS PLAN (IF NEEDED):

Specify 1) de-escalation strategies, 2) guidelines and procedures for summoning a crisis team if needed, and 3) procedures for
documentation and debriefing.

Name: Student ID: Date:

EVALUATION OF INTERVENTION(S): How will be effectiveness of the intervention be measured (i.e. Will data be taken on the
frequency, intensity, and/or duration of appropriate or inappropriate behavior? Who will be responsible for collecting the data? How
often will it be collected?)

REVIEW AND REVISION DATE:

BIP Start Date BIP Review / Revision Date

4
Name: Student ID: Date:

DOB: Age: Grade: Building/Site:

Signatures of Team:

Parent:

Student:

Special Education Teacher:

General Education Teacher:

Administrator:

School Psychologist / Psychometrist:

Other:

Other:

Other: