K4Health eToolkit Application: Delivering Essential Information to Health Professionals
ABC (Antecedent-Behavior-Consequence) Chart...
1
ABC (Antecedent-Behavior-Consequence) Chart To record baseline informaon for incongruent, challenging or problemac behaviors* Name: DOB / / Example Date Feb 6/10 John’s mother was in hospital with broken hip and could not visit. John had a toothache. John’s usual primary staff member was on vacaon. John was eang supper in kitchen when another resident bumped into him when passing food. John started to yell and threw his plate across the table. He ran out of room, screamed for 10 minutes and threw cushions around living room. The intensity was 4/5. Staff tried to direct John to his room for a me-out, but he became more agitated. They also tried to distract him with ice cream but were unsuccessful. They directed other residents to leave the room. John began to hit staff when they approached him. Staff observed him from a distance, gave him me and reduced smuli, and he calmed down in about 30 min. Time 6:30-7:10 pm Observer Rene – primary staff member Occasion Pre-exisng condions Antecedent Behavior Consequence Date Time Observer Factors that increase vulnerability or sensivity to triggers What happened just before the behavior occurred and might have triggered it? Include SETTING & ACTIVITY Describe the behavior as accurately and specifically as possible. Include frequency, duraon, and intensity on a scale of 1 to 5 (5 is most severe). Things that happened immediately aſter the behavior occurred, and make it more or less likely to happen again Date Time Observer with input from Caroll Drummond, behavior therapist, Surrey Place Centre Original tool: © 2011 Surrey Place Centre. Developed by Bradley, E, Drummond, C & Developmental Disabilies Primary Care Iniave Co-editors. Funded by the Ontario Ministry of Community and Social Services and Ontario Ministry of Health and Long-Term Care, Surrey Place Centre and the Surrey Place Centre Charitable Foundaon Reformaed with permission of Surrey Place Centre. • This tool was reviewed and adapted for U.S. use by physicians on the Toolkit’s Advisory Commiee; for list, view here. Date Time Observer Date Time Observer
Transcript of ABC (Antecedent-Behavior-Consequence) Chart...
ABC (Antecedent-Behavior-Consequence) Chart
To record baseline information for incongruent, challenging or problematic behaviors*
Name:
DOB / /
Example
Date Feb 6/10 John’s mother was in hospital with broken hip and could not visit.John had a toothache.John’s usual primary staff member was on vacation.
John was eating supper in kitchen when another resident bumped into him when passing food.
John started to yell and threw his plate across the table. He ran out of room, screamed for 10 minutes and threw cushions around living room. The intensity was 4/5.
Staff tried to direct John to his room for a time-out, but he became more agitated. They also tried to distract him with ice cream but were unsuccessful. They directed other residents to leave the room.
John began to hit staff when they approached him. Staff observed him from a distance, gave him time and reduced stimuli, and he calmed down in about 30 min.
Time 6:30-7:10 pm
Observer Rene – primary staff member
Occasion Pre-existing conditions Antecedent Behavior Consequence
Date
Time
Observer
Factors that increase vulnerability or sensitivity to triggers
What happened just before the behavior occurred and might have triggered it?
Include SETTING & ACTIVITY
Describe the behavior as accurately and specifically as possible. Include frequency, duration, and intensity on a scale of 1 to 5 (5 is most severe).
Things that happened immediately after the behavior occurred, and make it more or less likely to happen again
Date
Time
Observer
with input from Caroll Drummond, behavior therapist, Surrey Place Centre
Original tool: © 2011 Surrey Place Centre. Developed by Bradley, E, Drummond, C & Developmental Disabilities Primary Care Initiative Co-editors. Funded by the Ontario Ministry of Community and Social Services and Ontario Ministry of Health and Long-Term Care, Surrey Place Centre and the Surrey Place Centre Charitable Foundation Reformatted with permission of Surrey Place Centre. • This tool was reviewed and adapted for U.S. use by physicians on the Toolkit’s Advisory Committee; for list, view here.
Date
Time
Observer
Date
Time
Observer
kylie
Typewritten Text
*Adapted from the PEATNI organization
kylie
Typewritten Text
