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Functional Analysis Screening Tool

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24 views

Functional Analysis Screening Tool

Uploaded by

sabanasir.clinic
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Functional Analysis Screening Tool (FAST)

Client Name: Date:

Informant: Interviewer:

To the Interviewer: The FAST identifies factors that may influence problem behaviors. Use it only for screening as part of a comprehensive

functional analysis of the behavior. Administer the FAST to several individuals who interact with the client frequently. Then use the results to guide

direct observation in several different situations to verify suspected behavioral functions and to identify other factors that may influence the problem

behavior.

To the Informant: Complete the sections below. Then read each question carefully and answer it by circling "Yes" or "No." If you are uncertain

about an answer, circle “N/A.”

Informant-Client R elationshi p
What is usually happening to the person right before the problem

behavior occurs?
Indicate your relationship to the person:

Parent

Instructor

Therapist/ Residential Staff


Other:

H ow long have you known the person?

Years M onths

Do you interact with the person daily?

Yes No

In what situations do you usually interact with the person?

M eals Academic Training

Leisure Work or Vocational Training What usually happens to the person right after the problem

behavior occurs?
Self - care Other:

P ro b lem B ehavior Information

Problem behavior (check and describe):

Aggression

Self - In j ury

Stereotypy

Property destruction

Other:

Frequency

H ourly Weekly

D aily Less Often


Current treatments
Severity

M ild: D isruptive but little risk to property or healt h

M oderate: Property damage or minor in j ur y

Severe: Significant threat to health or safety

Situations in which the problem behavior is most likely to occur:

D ays/Time s

Settings/Activitie s

Persons present

Situations in which the problem behavior is least likely to occur:

D ays/Time s

Settings/Activitie s

Persons present

* Adapted from the FIorida Center on Self - In j ury.


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Client Name: Date:

Does the problem behavior occur when the person is not receiving Yes No N/A
attention or when caregivers are paying attention to someone else
Does the problem behavior occur when the person's requests for Yes No N/A
preferred items or activities are denied or when these are taken away
When the problem behavior occurs, do caregivers usually try to calm Yes No N/A
the person down or involve the person in preferred activities
Is the person usually well behaved when (she is getting lots of attention Yes No N/A
or when preferred activities are freely available
Does the person usually fuss or resist when (she is asked to perform a Yes No N/A
task or to participate in activities
Does the problem behavior occur when the person is asked to perform Yes No N/A
a task or to participate in activities
If the problem behavior occurs while tasks are being presented, is the Yes No N/A
person usually given a "break" from tasks
Is the person usually well behaved when (she is not required to do Yes No N/A
anything
Does the problem behavior occur even when no one is nearby or Yes No N/A
watching
Does the person engage in the problem behavior even when leisure Yes No N/A
activities are available
Does the problem behavior appear to be a form of "self-stimulation? Yes No N/A
Is the problem behavior less likely to occur when sensory stimulating Yes No N/A
activities are presented
Is the problem behavior cyclical, occurring for several days and then Yes No N/A
stopping
Does the person have recurring painful conditions such as ear Yes No N/A
infections or allergies? If so, list
Is the problem behavior more likely to occur when the person is ill Yes No N/A
If the person is experiencing physical problems, and these are treated, Yes No N/A
does the problem behavior usually go away?

Scoring Summary
Select the number of each question that was answered "Yes" and enter the number of items that were selected in the "Total" column.
Item Selected “Yes” Total Potential Source of Reinforcement
1 2 3 4 Social (attention/preferred items)

5 6 7 8 Social (escape from tasks/activities)

9 10 11 12 Automatic (sensory stimulation)

13 14 15 16 Automatic (pain attenuation)

*Adapted from the FIorida Center on Self-Injury. Powered by


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