ABC OBSERVATION FORM Student Name Date Observer

abc observation form student name: ____________________ date: ___________________________ observer: _________________________ time: _____

ABC OBSERVATION FORM
Student Name: ____________________ Date: ___________________________
Observer: _________________________ Time: ___________________________
Setting: ___________________________ Staff:
___________________________
Task/Lesson: _________________________________________________________
Antecedent Events
Behavior
Consequent Events
(Describe what happened immediately prior to the behavior.)
(Describe what the student did in objective, observable terms.)
(Describe what happened immediately following the behavior.)
The following are some examples of possible Antecedents, Behaviors and
Consequences.
Please indicate the number in the columns above and make notes about
what you saw.
Possible Antecedents
1.
Task presentation
2.
Others’ comments
3.
Activity change
4.
Escalating chain
5.
Rate of instruction
6.
Other: ___________
____________________
____________________
Behavior
1.
Delayed initiation
2.
Refusal
3.
Verbal threats/agg.
4.
Physical aggression
Specify: ____________
5.
Running away
6.
Other: __________
____________________
Possible Consequences
1.
Task termination
2.
Activity change
3.
Neg. adult attention
4.
Neg. peer attention
5.
Pos. adult attention
6.
Pos. peer attention
7.
Other: _________
__________________
Using the ABC Observation Form
The ABC Observation Form is helpful in gathering information on a
specific behavior for a Functional Behavioral Assessment. Although
several possible behaviors are listed on the form, it is more
practical to limit the behavior that you are collecting information on
to one.
Circle the behavior in the column at the bottom that you are
observing. If it is not listed, write it in next to “Other.” When you
observe the behavior occurring, write the number in the column under
“Behavior” in the table above. Jot brief notes or key words to remind
you of exactly how the behavior was displayed.
In the column under “Antecedent Events,” think about what happened
immediately prior to the student displaying the behavior and write the
number of the possible antecedent from the column below the table. Jot
down brief notes to help you recall what happened. If it’s not listed
as a possible antecedent, next to “Other” write what you think it was.
In the column under “Consequent Events,” write down the number of what
you thought the possible consequence was from the list below the
chart. If it’s not listed, write it next to “Other.” Make some brief
notes to help you remember what form the consequence took.
Here are a couple of examples:
Antecedent Events
Behavior
Consequent Events
(Describe what happened immediately prior to the behavior.)
(Describe what the student did in objective, observable terms.)
(Describe what happened immediately following the behavior.)
3. Rdg. to Wrtg.
1. “Something you’re good at ….”
2. “Don’t want to!”
5. Tchr. encouraged. “You’re gd. at math.”
Antecedent Events
Behavior
Consequent Events
(Describe what happened immediately prior to the behavior.)
(Describe what the student did in objective, observable terms.)
(Describe what happened immediately following the behavior.)
4. Con’t ref. →
2. “Must do or no recess.”
5. Ran out of room.
3. Tried to catch
1. Sent to office rest of day.