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Purpose of this Time Study Data Collection Sheet for Behaviors: To provide a tool that can be used to collect data for Third Party Billing, FBA’s and to collect data to report on progress towards goals and objectives.How to Use This Time Study Data Collection Sheet for Behaviors:Complete Student Information section, Observer/Title, confirm medical diagnosis is included in IEP. For Third Party Billing Time Studies: A student must be dependent in at least ONE ADL (Activity of Daily Living, e.g., toileting, mobility,) OR demonstrate a Level 1 Behavior before you can bill for increased vulnerability due to cognitive deficits or socially inappropriate behavior and/or resisting care and verbal aggression that cause care to take longer than normally expected. Data collection should be conducted for 10 consecutive school plete Behavior Description using a clear description of the behavior that passes the “stranger” test (i.e. a stranger to the child would know what they are to be recording). This information should come from teacher reports/descriptions, observation and/or FBA information. Poor example: Physical aggression to peersBetter example: Student will make a fist and strike peers, kick others and pinch peers upper bodyIf need further space for descriptions of behaviors, use more than one form for tracking. More than one form may be needed if the behavior occurs frequently.Start time and stop time can be timed on a clock, stop watch or approximate duration.Notes regarding Behavior: Allows you to track other information you are interested in knowing about each behavior episode such as antecedent, response to behavior, exact behavior seen, etc.Intensity can be completed if an intensity scale has been previously completed and if the observer has been trained in the observational differences between degrees of intensity.For Third Party Billing Level 1 Behaviors are described as physical aggression towards self or others or destruction of property that requires the immediate response of another person. Descriptions of these three types are as follows:Self-injurious behavior - causes injury to one’s own body; examples: hitting, biting, head-banging, burning, poking or stabbing, ingesting foreign substances or objects, pulling out hair, and suicide threats.Physical injury to others - causes physical injury or has the potential for causing physical injury to other people; examples: hitting, biting, pinching, scratching, kicking, stabbing, and pulling out hair.Destruction of property - causes damage or has the potential to cause damage to things; examples: breaking desks or chairs, tearing clothes, setting fires, and using tools or objects to damage property. ................
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