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Open Ended Functional Assessment Interview PDF Form

Open Ended Functional Assessment Interview PDF Form

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to our client so the purpose of today's meeting is we would like to gain more information from you about Jen's problem behaviors and more just about her daily routine in the facility that she is in so can you state your relation to our client Jen yes I'm a caretaker at the facility okay and can you just confirm the information Jen is 35 years old female yes that's right so first I'd just like you to describe the behaviors what are the behaviors that are of concern and for each behavior we like information about how it was performed how often it occurs and how long it lasts when it does occur and the intensity okay first off is her biting hitting and pinching and we see this daily especially in the mornings when were waking her up but then also throughout the day we are asking her to do a certain task they last about five I guess to two minutes and usually the intensity is pretty high when she hits so when she bites and usually when she hurts someone behaviors that you're seeing yes oka

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