FAST – Functional AnalysisName *Contact Number *Email AddressDate of Birth *Details about the problem / Case details *1. Problem Behaviours *AggressionSelf-InjuryStereotypyProperty DestructionOtherIf others, please specify *2. Frequency:HourlyDailyWeeklyLess often3. SeverityMild - Disruptive but little risk to property or healthModerate - Property damage or minor injurySevere - Significant threat to health or safety4. Situations in which the problem behaviour is MOST likely to occur: Days/Times, Settings/Activities, Persons present *5. Situations in which the problem behaviour is LEAST likely to occur: Days/Times, Settings/Activities, Persons present *6. What is usually happening to the person RIGHT BEFORE the problem behaviour occurs? *7. What is usually happening to the person RIGHT AFTER the problem behaviour occurs? *8. Current treatments *9. Does the problem behaviour occur when the person is not receiving attention or when caregivers are paying attention to someone else? *YESNONOT AT ALL APPLICABLE10. Does the problem behaviour occur when the person’s requests for preferred items or activities are denied or when these are taken away? *YESNONOT AT ALL APPLICABLE11. When the problem behaviour occurs, do care givers usually try to calm the person down or involve the person in preferred activities? *YESNONOT AT ALL APPLICABLE12. Is the person usually well behaved when (s)he is getting lots of attention or when preferred activities are freely available? *YESNONOT AT ALL APPLICABLE13. Does the person usually fuss or resist when (s)he is asked to perform a task or to participate in activities? *YESNONOT AT ALL APPLICABLE14. Does the problem behaviour occur when the person is asked to perform a task or to participate in activities? *YESNONOT AT ALL APPLICABLE15. If the problem behaviour occurs while tasks are being presented, is the person usually given a “break” from tasks? *YESNONOT AT ALL APPLICABLE16. Is the person usually well behaved when (s)he is not required to do anything? *YESNONOT AT ALL APPLICABLE17. Does the problem behaviour occur even when no one is nearby or watching? *YESNONOT AT ALL APPLICABLE18. Does the person engage in the problem behaviour even when leisure activities are available? *YESNONOT AT ALL APPLICABLE19. Does the problem behaviour appear to be a form of “self-stimulation?” *YESNONOT AT ALL APPLICABLE20. Is the problem behaviour LESS likely to occur when sensory stimulating activities are presented? *YESNONOT AT ALL APPLICABLE21. Is the problem behaviour cyclical, occurring for several days and then stopping? *YESNONOT AT ALL APPLICABLE22. Does the person have recurring painful conditions such as ear infections or allergies? *YESNONOT AT ALL APPLICABLEIf so, list:23. Is the problem behaviour MORE likely to occur when the person is ill? *YESNONOT AT ALL APPLICABLE24. If the person is experiencing physical problems, and these are treated, does the problem behaviour usually go away? *YESNONOT AT ALL APPLICABLEFunctional Analysis Screening Tool BRIANA. IWATAetal. (2013) - Potential Source of Reinforcement - Social (Attention / Preferred items)Functional Analysis Screening Tool BRIANA. IWATAetal. (2013) - Potential Source of Reinforcement - Social (Escape from Tasks / Activities)Functional Analysis Screening Tool BRIANA. IWATAetal. (2013) - Potential Source of Reinforcement - Automatic (Sensory Stimulation)Functional Analysis Screening Tool BRIANA. IWATA et al. (2013) - Potential Source of Reinforcement - Automatic (Pain Attenuation) )SubmitPlease do not fill in this field.
