Functional behaviour assessment (FBA) template and example
An FBA template with sample entries that takes you from behaviour definitions and ABC data to reviewed hypotheses.
✓Evidence first, hypotheses last
✓Sample definitions with non-examples
✓Leads straight into a BIP
Free · No sign-up · Saves in your browser · Built into healhab as “Functional Behaviour Assessment and Support Summary”
What's inside
Assessment Question and Scope
Information Sources and Observation Conditions
Target Behaviour Definitions
Baseline Evidence
ABC and Setting Summary
Pattern Analysis
Communication, Adaptive, and Replacement Skills
Working Functional Hypotheses
+ 4 more sections
Preview · 12 sections
Functional Behaviour Assessment and Support Summary
Patient
Patient ID
Date of birth
Assessment date
Therapy
Therapist
Languages
Referred by
Assessment Question and Scope
Assessment question scope
Information Sources and Observation Conditions
Information sources
Observation conditions
Target Behaviour Definitions
Target
Observable Definition
Examples
Non-examples
Measurement Method
Baseline Evidence
Baseline evidenceDo not infer missing frequency, duration, or intensity.
ABC and Setting Summary
Date / Setting
Setting Event
Antecedent
Behaviour
Consequence / Response
Source
Pattern Analysis
Pattern analysis
Communication, Adaptive, and Replacement Skills
Current Skill
Needed Alternative / Replacement Skill
Evidence
Teaching Opportunity
Working Functional Hypotheses
Hypothesis
Supporting Evidence
Contradictory / Missing Evidence
Confidence / Review Need
Risk and Immediate Safety Supports
Risk and safety supports
Support Recommendations
Proactive Supports
Proactive supports
Teaching / Replacement Skills
Teaching replacement skills
Response Strategies
Response strategies
Data and Review Plan
Data review plan
Summary
Functional assessment summary
Therapist Sign-off
Therapist
Designation
Registration
Date
How to fill it in
1
Assessment Question and Scope
The question the FBA answers: which behaviours, which settings, and what period.
More guidance
State the question the FBA will answer and its limits: which behaviours, which settings, which period. One to three target behaviours is usually manageable. Record who requested the assessment and the consent obtained, and note any setting where you will rely on reports rather than observation.
2
Information Sources and Observation Conditions
Every source with its date, and the conditions of each observation.
More guidance
List every source with its date: caregiver and teacher interviews, review of earlier reports, ABC records, direct observation. For each observation, record the setting, activity, time of day, people present, and how long you watched. Readers need this to judge how far the findings apply beyond the times you observed.
3
Target Behaviour Definitions
Definitions two observers would apply alike, with examples, non-examples and a measure.
More guidance
Write a definition that two observers would apply the same way. Describe the action, when an episode starts and ends, and add examples and non-examples so edge cases are clear. Choose a measurement method that fits the behaviour: frequency for brief behaviours, duration for long ones, interval recording when counting every instance is not practical.
4
Baseline Evidence
Measured levels before support starts, with dates, method and number of observations.
More guidance
Summarise the measured level of each target behaviour before any new support starts, with the dates, method, and number of observations behind each figure. Keep counts and durations as recorded. Where data are missing for a setting, say so plainly rather than filling the gap from memory or impression.
5
ABC and Setting Summary
The most informative ABC entries and setting events, each with its source.
More guidance
Bring the most informative ABC entries into the table: setting events, antecedents, the behaviour, and what happened immediately afterwards, with the source of each row. Include setting events such as poor sleep, illness, or a change of caregiver, which make behaviour more likely without directly triggering it. Pull from your recorded data only.
6
Pattern Analysis
Repeating times, activities, people and demands, plus when the behaviour rarely happens.
More guidance
Describe patterns across the records: times of day, activities, people, demands, and consequences that come up repeatedly, and situations where the behaviour rarely happens. The quiet situations matter as much as the difficult ones, because they show what is already working. Note conflicting patterns and how much data each one rests on.
7
Communication, Adaptive, and Replacement Skills
Skills the person already has, and a quick, easy alternative to teach.
More guidance
For each target behaviour, describe the skills the person already has that could meet the same need, and the alternative skill that needs teaching. A replacement skill should be as quick and easy for the person as the behaviour it replaces, or it will not be used. Note where teaching opportunities naturally arise in the day.
8
Working Functional Hypotheses
Situation, behaviour and what it achieves, with the evidence for and against.
More guidance
Write each hypothesis as a statement linking the situation, the behaviour, and what it achieves for the person, followed by the evidence for it and the evidence that does not fit. Rate confidence in words, such as low, moderate or high, and note what would change your view. An authorised clinician reviews this section before the report is shared.
9
Risk and Immediate Safety Supports
Current risk, the immediate supports agreed, and who has been informed.
More guidance
Record any current risk and the immediate supports already agreed, with reference to the clinic's safety and escalation policy. Name who has been informed. Keep this section factual and short; detailed response procedures belong in the BIP, written and reviewed under the same policy.
10
Support Recommendations
Positive supports, replacement skills, adult responses and data review, each linked to a hypothesis.
More guidance
Use the four sub-sections to recommend proactive supports that make the behaviour less likely, replacement skills to teach, how adults should respond so the behaviour is no longer needed, and how data will be reviewed. Link each recommendation to a hypothesis by number. Recommend only positive, teaching-based approaches, and leave detail for the BIP.
11
Summary
A plain-language close for the family and team that adds nothing new.
More guidance
Close with a short summary written for the family and the team: the behaviours assessed, what the evidence showed, the reviewed hypotheses in plain language, and the next step. Keep it consistent with the sections above and introduce nothing new here.
Functional behaviour assessment (FBA) template and example: filled sample
Fictional entries, initials only, showing the level of detail to aim for. Impression and summary sections are left for the treating clinician.
Assessment Question and Scope
Question: in which situations does K. leave the classroom, and what happens afterwards? Settings: Class 2 at school and the clinic. Period: three weeks from the start date.
Information Sources and Observation Conditions
Direct observation: 3 × 40 minutes in class (maths, assembly, art), 2 × 45 minutes at the clinic. Interviews: mother and class teacher. ABC records from home kept by grandmother over 10 days.
Target Behaviour Definitions
Leaving the area: moves more than two metres from the assigned seat or activity without an adult's agreement. Episode ends when K. is back at the activity. Non-example: walking to the teacher to show work.
Baseline Evidence
Leaving the area, classroom: 4, 6 and 5 episodes in three 40-minute observations (frequency count). Home: not measured; grandmother's ABC records show 7 episodes in 10 days.
Communication, Adaptive, and Replacement Skills
Current skill: points to a picture of the swing. Needed alternative: hands a “break” card to the teacher. Teaching opportunity: every maths lesson, which has the most leaving episodes in class.
Replacement skills, preventive supports, response and safety plan, data review
Order
Comes first
Written from the FBA's reviewed hypotheses
Main readers
Supervising clinician and treatment team
Everyone who supports the person: therapists, family, teachers
How often it changes
Repeated when the behaviour changes or new concerns appear
Reviewed at set dates against the data
Tone
Analytical and evidence-led
Practical and step-by-step
Tips and mistakes to avoid
Do
Agree the behaviour definition with caregivers before anyone collects data.
Collect ABC data at home and school as well as in the therapy room.
Give caregivers a sheet in their preferred language, and accept WhatsApp voice notes on busy days.
Note when the behaviour does not happen, because those situations hold useful ideas.
In healhab, the FBA is a built-in starter, so every functional assessment follows the same order.
Avoid
Writing the hypothesis first and then collecting data to confirm it.
Defining behaviour by its assumed purpose, such as “attention-seeking crying”.
Targeting harmless stimming or differences in eye contact.
Recommending supports that do not connect to any hypothesis.
About this assessment report
A functional behaviour assessment (FBA) template helps you define a behaviour precisely, gather ABC and baseline data, look for patterns, and set out reviewed hypotheses about what the behaviour achieves for the person. It ends with support recommendations that become the behaviour intervention plan. This template keeps evidence and interpretation in separate sections.
A behaviour risks harm to the person or others
A behaviour keeps a child out of class or routines
Earlier strategies have not helped
Before writing or rewriting a BIP
Read more
An FBA, also called a functional behavior assessment, asks what purpose a behaviour serves for this person, and in which situations. A behaviour therapist or analyst leads it, with input from caregivers and teachers.
You define the behaviour, record ABC and baseline data across settings, and only then form a working hypothesis. Most FBAs need two to four weeks of data, so the evidence sections come first.
Questions
What is the difference between an FBA and a BIP?+
The FBA is the assessment: it defines the behaviour, gathers data and forms reviewed hypotheses about why it happens. The BIP is the plan built from those findings: the skills to teach, the supports to put in place, and how adults will respond.
How long does an FBA take?+
Most teams need two to four weeks of data across settings before hypotheses can be written responsibly. A rare behaviour may need longer, and an urgent safety concern may need interim supports under the clinic's policy while the FBA continues.
Who should be involved in an FBA?+
The person themselves where possible, the family and main caregivers, teachers or aides who see the behaviour, and the therapist leading the assessment. A supervising clinician reviews the hypotheses before they are shared.
What are the common functions of behaviour?+
Behaviour analysts usually describe four broad functions: getting attention or social contact, escaping or delaying something, getting an item or activity, and sensory experience. Your hypotheses should rest on this person's data rather than on which function seems most common.
Can an FBA be done for an adult?+
Yes. The method is the same. Adjust settings and sources to the adult's life, such as a vocational centre or a supported home, and involve the person in describing their own experience wherever they can.
Is there a filled FBA sample or report example?+
Each section guide shows a fictional sample entry for the descriptive sections, using initials only. The hypotheses, pattern analysis and summary have guidance only, because they must come from your own data and the clinician's review.
