Functional behavior assessment (FBA)

Page posted: 3/6/24

What is an FBA?

An FBA takes an in-depth look at a person’s behaviors. It is an assessment that:

· Operationally defines target behaviors. (For information about operational definitions, refer to Positive Supports MN – Relationship between ABA and Positive Behavior Support.)

· Identifies the situations in which the target behaviors are likely to occur and not occur.

· Generates a hypothesis of why the behaviors occur.

The purpose of an FBA is to guide the development of effective and efficient positive support strategies. Using an FBA can result in improved clinical effectiveness of psychotropic medications.

The FBA process typically includes interviews, document reviews, person-centered planning, data collection, direct assessments and observations. The FBA’s level of detail should be based on the complexity or intensity of the behaviors displayed by the person.

When to conduct an FBA

An FBA is not always required for people taking psychotropic medications. However, Minn. R. 9544.0040 requires an FBA when a qualified professional or external qualified professional develops or modifies a written intervention to change a target behavior.

FBAs must be conducted by qualified professionals, as defined in Minn. R. 9544.0020. Many 245D service providers have employees who are qualified to conduct these assessments. Other providers need to ask the case manager or other person coordinating supports to help find someone who is qualified. For example, the case manager could authorize positive support services to pay for a qualified professional’s help. For information on positive support services, refer to CBSM – Positive support services.

Content requirements for 245D service providers

Required information

The 245D service provider must ensure an FBA includes:

· Direct observation of the person.

· Assessment of biological factors, such as medical or dental needs, that may contribute to interfering behaviors.

· Assessment of psychological factors, which can include a diagnostic, suicidality and/or neuro-psych assessment.

· Assessment of environmental factors, such as observing relationships with other people, shared space, privacy, isolation, limited lighting or noisy environments.

· Assessment of quality-of-life indicators based on the person’s goals and needs within the domains of a meaningful life.

· Hypothesis about why the target behavior(s) occurs.

For more information, refer to Minn. R. 9544.0040.

Recommended information

It is best practice for the 245D service provider to also include:

· Observable and measurable definition of the interfering behavior(s) targeted for reduction.

· Identification of contexts, setting events and antecedents for the interfering behavior(s).

· Identification of consequences maintaining the interfering behaviors.

· Thorough description of the context, antecedent and consequence relationship.

· Identification of a possible replacement behavior to teach or reinforce.

Using the FBA

The results of the assessment should guide the development of positive support strategies. The 245D service provider might write these strategies into the FBA or develop them on a separate document. Depending on the circumstances, the provider might be required to use the FBA to develop a Positive Support Transition Plan, DHS-6810. For information on requirements for a PSTP (and an FBA), refer to the “When must a provider create a PSTP?” section of Positive Support Transition Plan Instructions, DHS-6810B (PDF).

Regardless of whether a PSTP is required, the provider can use the information gathered during the FBA process to:

· Explore evidence-based practices that emphasize positive approaches.

· Develop positive support strategies, as defined in Minn. R. 9544.0030, to augment the person’s use of psychotropic medications.

Additional resources

The provider can use FBA Quality Checklist, DHS-6810F to check whether the FBA includes the requirements and recommendations.

Guidelines for Positive Supports in DHS-Licensed Settings, DHS-6810C (PDF) has a variety of tools related to the development and understanding of FBAs.

Psychotropic Medication Manual
Psychotropic Medication Manual – Diagnostic assessments and medical evaluations
Psychotropic Medication Manual – Person-centered tools to support medication management