Functional Analysis Data Sheet
Conduct sessions as described below and in the listed sequence (Session #1=Alone, #2=Attention, etc.). Add a Tangible
condition only if it is strongly suspected that problem behavior is maintained by access to tangibles. Each session should
last for 10 min. Record either the # or rate of problem behavior (PB) in each session, and summarize as the mean per
condition.
Alone: Begin session: Student is alone in a room with no access to attention or leisure items.
If PB: No consequences.
Attention: Begin session: Inform student that you are busy; then ignore.
If PB: Deliver a mild reprimand, statement of concern, physical comfort, then ignore again
Play: Begin session: Deliver frequent attention and allow free access to preferred items. Do not deliver demands.
If PB: Ignore briefly; then resume play.
Demand: Begin session: Deliver nonpreferred academic or work tasks.
If PB: Remove task and ignore for 30 s; then resume tasks.
Tangible: Begin session: Allow brief access to preferred item then remove and ignore.
If PB: Provide brief access to preferred item; then remove again.
Other: Begin session:
If PB:
Molly Good-Fellow
Student: _________________________________________________________ 11/18
Start date: _____________
Elopement
Problem behavior: ________________________________________________ 11/22
End date: _____________
Session Alone Attention Play Demand Tangible Other
1 0
2 1
3 12
4 3
5 12
6 0
7 0
8 14
9 5
10 10
11 0
12 1
13 14
14 2
15 13
16 0
17 0
18 13
19 1
20 9
Mean PB
© 2002 The Florida Center on Self-Injury