Behavioral Functional Assessment Checklist for Teachers ...



Please check the box which best describes the child’s behavior:

Cognitive Skills |Frequently |Occasionally |Seldom |Never |N/A |How do these problems affect academic performance in the classroom? | |1. Understands cause and effect, consequences. | | | | | | | |2. States birthday and address. | | | | | | | |3. Stays with one activity for appropriate amount of time. | | | | | | | |4. Demands increasingly detailed explanation until the adult is unable to answer. | | | | | | | |5. Listens attentively and for long periods of time. | | | | | | | |6. Answers all questions accurately. | | | | | | | |7. Makes logical relationships and solves problems verbally. | | | | | | | |8. Understands reality versus fantasy. | | | | | | | |9. Follows age appropriate directions. | | | | | | | | | | | | | | | |Pragmatic Skills |Frequently |Occasionally |Seldom |Never |N/A | | |1. Expresses his/her feelings verbally. | | | | | | | |2. Shows interest in things being funny. | | | | | | | |3. Comprehends subtle humor and giggles about silly things. | | | | | | | |4. Interacts with peers during the school day. | | | | | |Additional Comments: | | | | | | | | | |Semantic Skills |Frequently |Occasionally |Seldom |Never |N/A | | |1. Classifies objects by their form, color, use, or composition, e.g., "You eat with a fork." "A fork is made of metal." | | | | | | | |2. Knows concepts "more" and "less." | | | | | | | |3. Describes person, place, or thing using attributes. | | | | | | | |4. Names a time of day associated with an activity. | | | | | | | |5. Recites days of the week and names "penny," "nickle" and "dime." | | | | | | | |6. Understands and uses more words than you can count (uses 2000; understands 6000), and continues to ask the meaning of new words. | | | | | | | |7. Uses mature vocabulary, e.g., "surprisingly," "frightening," "disappointing." | | | | | | | | | | | | | | | |Phonetic Skills |Frequently |Occasionally |Seldom |Never |N/A |Pleas list error sounds: | |1. Uses all speech sounds correctly with the possible exception of /r/. | | | | | | | |2. Speech is error-free and adult-like. | | | | | | | | | | | | | | | |Syntactic Skills |Frequently |Occasionally |Seldom |Never |N/A | | |1. Relates fanciful stories. | | | | | | | |2. Answers questions about a story and its plot. | | | | | | | |3. Comprehends all question types including "How many." | | | | | | | |4. Comprehends complex questions related to remote events. | | | | | | | |5. Uses a sentence length of six to eight words. | | | | | | | |6. Uses grammatically correct sentences. Can use complex verbs such as "could have been," "will be going," etc. | | | | | | | |7. Uses passive sentences forms, e.g., "The bus was hit by the car." | | | | | | | |8. Corrects his/her own sentence errors. | | | | | | | |9. Uses mature expressions, e.g., "This is serious. Dad is allergic to cats and we have a mouse in the cellar." | | | | | |Further SLP assessment required

□ No further SLP assessment required | |10. Seldom makes grammatical errors. | | | | | | | |11. Argues verbally. | | | | | | | |12. Uses negation often, e.g., "I can't get it," or "I can't figure it out." | | | | | | | |

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LEVEL 3 - Communication

Student: _________________________

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