ABC Chart with Possible Function

Student: ____________________________________ Grade: ____ School: _________________________________________

Date(s): _____________________________________ Observer(s): __________________________________________________
Behaviour(s) of Concern: _____________________________________________________________________________________

Date Time/Place Others Antecedent Behaviour Consequences Possible Function

Involved (Describe what happens before (Describe what happens (Work avoidance/peer
(Describe what the student attention/ adult
the behaviour) does) after the behaviour)
attention/etc.)
 Low levels of adult/peer attention  Redirect  Peer attention
 Object/activity unavailable  Reprimand  Adult attention
 Activity or task________________  Ignore  Avoid work
 Social interaction with peer/adult  Office referral  Self-stimulation
 Reprimand  Time out/Break provided  Escape situation:___________
 Other  Loss of privilege  Avoid overload (anxiety)
_________________________________ _______________________________ _______________________________

 Low levels of adult/peer attention  Redirect  Peer attention

 Object/activity unavailable  Reprimand  Adult attention
 Activity or task_________________  Ignore  Avoid work
 Social interaction with peer/adult  Office referral  Self-stimulation
 Reprimand  Time out/Break provided  Escape situation:___________
 Other  Loss of privilege  Avoid overload (anxiety)
_________________________________ _______________________________ _______________________________

 Low levels of adult/peer attention  Redirect  Peer attention

 Object/activity unavailable  Reprimand  Adult attention
 Activity or task_________________  Ignore  Avoid work
 Social interaction with peer/adult  Office referral  Self-stimulation
 Reprimand  Time out/Break provided  Escape situation:___________
 Other  Loss of privilege  Avoid overload (anxiety)
_________________________________ _______________________________ _______________________________

 Low levels of adult/peer attention  Redirect  Peer attention

 Object/activity unavailable  Reprimand  Adult attention
 Activity or task_________________  Ignore  Avoid work
 Social interaction with peer/adult  Office referral  Self-stimulation
 Reprimand  Time out/Break provided  Escape situation:___________
 Other  Loss of privilege  Avoid overload (anxiety)
_________________________________ _______________________________ _______________________________

 Low levels of adult/peer attention  Redirect  Peer attention

 Object/activity unavailable  Reprimand  Adult attention
 Activity or task_________________  Ignore  Avoid work
 Social interaction with peer/adult  Office referral  Self-stimulation
 Reprimand  Time out/Break provided  Escape situation:___________
 Other  Loss of privilege  Avoid overload (anxiety)
_________________________________ _______________________________ _______________________________