Functional Behavior Assessment Request from Parents to School

Sample Letter

Your Name
City, State Zip Code
Telephone Number
Email Address

Date

(Name of Special Education Director)
(Name of School District)
(Full Address of School)

Dear (Special Education Director),

Our family continues to be concerned about our child’s functioning in school and the impairment caused by their selective mutism and related social anxiety. I am formally requesting that the District conduct a Functional Behavioral Assessment (FBA) for the purpose of establishing a positive behavior intervention plan for my child, (___________). 

I understand that the FBA will be conducted by a person who has knowledge of behavior analysis with an emphasis on positive behavior interventions. I also understand that the FBA personnel will gather information from multiple sources, such as: direct observation, interviews with significant others (e.g., parents/guardians, current teachers and classroom aides, previous teachers and aides), rating scales, and review of available data in (______)’s file. 

I understand that the FBA will include an ecological analysis of the setting in which behaviors occur most frequently, considering factors such as physical setting, social setting, the activities and the nature of the instruction, scheduling, and the communicative intent of the behavior. The communicative intent (i.e., function) of the behavior is to be identified in terms of what (______) is either requesting or avoiding through their behaviors. I understand that the FBA report shall be a written report and shall include all of the following: a description of the nature and severity of the targeted behaviors(s) in objective and measurable terms, including baseline data; an analysis of antecedents and consequences that maintain the targeted behavior. 

I understand that the results of the FBA will be used to inform a positive behavior intervention plan, which will include evidence-based interventions used to replace specified maladaptive behavior(s) with alternative acceptable behavior(s) and never used solely to eliminate maladaptive behavior(s). I understand that I will be included in the development of the positive behavior intervention plan, and that implementation of this plan will be facilitated and/or supported by a staff member with training in behavior analysis and the use of positive behavioral interventions.  

Thank you for consideration of this request in order to more effectively address my child’s needs within the school setting.

Sincerely,

Name

CC: _______, Superintendent,
_______ School District

_________, Principal,
_________ School