Reason for Referral (Basic Info)

Clinical Use:  Reason for Referral

Reason for Referral:  Use this section to briefly state who requested the assessment, the problem being assessed, assessment procedures used, context where the assessment was conducted, and types of recommendations provided.

For example (FBA & BIP), North Union High School referred Adam for a functional behavior assessment (FBA) and behavior intervention plan (BIP) within his educational placements.  Record review and staff interviews detail a history of interfering behaviors that have impeded Adam’s ability to learn and access curriculum.  These behaviors have included:  aggression and work refusal.  Preventative recommendations and positive behavior supports are provided.  The following report is based on direct observations over three days, clinical interviews, record review, and other functional behavior assessments.

For example (Simple BIP), North Union High School referred Adam for a pre-referral behavior intervention plan within his educational placements.  Staff collaborations describe a history of interfering behaviors that have impeded Adam’s ability to learn and access curriculum.  These behaviors have included:  inappropriate social behaviors (blurting out, profanity, and teasing peers).  Preventative recommendations and positive behavior supports are provided.

Tip:  To save time, copy, cut, and paste one of the above italicized Reason for Referral templates into the Reason for Referral text box within the Basic Info section of your Behavior Advantage report.  Remember to individualize this template for the student you are supporting (e.g., change name, pronouns, and specifics).