Behavior Intervention Plan (1)
For Behavior Interfering with Student‘s Learning or the Learning of His/Her Peers

 
 
This BIP attaches to:    dated dated  
 
Student name   Today's date Today's date Next review date Next review date
 

 
Description of academic achievement and functional performance:
 
  1.   The behavior impeding learning is (describe what it looks like)
     
 
  2.   It impedes learning because
     
 
  3.   The need for a Behavior Intervention Plan 
 
  4.   Frequency or intensity or duration of behavior
      reported by   and/or  observed by 
 
     
 

 
PREVENTION PART I: ENVIRONMENTAL FACTORS AND NECESSARY CHANGES
 
      Observation and Analysis  
  5.   What are the predictors for the behavior?
(Situations in which the behavior is likely to occur: people, time, place, subject, etc.)
 
 
 
     
 
  6.   What supports the student using the problem behavior?
(What is missing in the environment/curriculum or what is in the environment curriculum that needs changing?)
 
 
 
     
 
      Intervention  
  7.   What environmental changes, structure and supports are needed to remove the student's need to use this behavior?
(Changes in Time / Space / Materials / Interactions to remove likelihood of behavior)
 
 
 
     
 
      Who will establish?   Who will monitor?   Frequency?
 
Diana Browning Wright, Behavior/Discipline Trainings   Note: Numbers correspond with the scoring system on the BIP Quality Evaluation Guide