Student ABC Chart Sample

A-B-C Chart
Student’s name: ______________________________________ School/site: ________________
Observed from ___/___/___ to ___/___/___ Completed by: ______________________________
Behavior of concern: (be specific and clear) ____________________________________________
________________________________________________________________________________
Date/Start
& end time
A=Antecedent: Location,
activity, people, etc.
B=Behavior What did the
child do?
C=Consequence What
happened after the behavior
Observer
Initials
Use this form at the beginning of an FBA to document what happens immediately before and after the behavior of
concern. This can help discover what is triggering & reinforcing the behavior. Use for only one behavior (e.g. hitting).
2009 D75 Forms
Page 1/1
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