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National Professional Development Center on Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
Functional Communication Training: Data Collection Sheets Page 1 of 2 National Professional Development Center on ASD 10/
Blank FCT Data Collection Sheet
Learner _______________________________________________________________
Person collecting data ___________________________________________________
Interfering Behavior (IB): Replacement Behavior (RB): Date Activity/ setting Antecedent (record what happens right before the IB or RB) IB or RB? Prompts Consequence (record what happens right after the IB or RB) Notes I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V I P G V Key: I = Independent, P = Physical prompt, G = Gestural prompt, V = Verbal prompt
National Professional Development Center on Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
Functional Communication Training: Data Collection Sheets Page 2 of 2 National Professional Development Center on ASD 10/
Example: FCT Data Collection Sheet
Learner: Tiffany
Person collecting data: Teacher
Interfering Behavior (IB): Tiffany hits peers when she wants toys they are playing with Replacement Behavior (RB): Tiffany will say, “My turn” when she wants a toy that a peer is playing with Date Activity/ setting Antecedent (record what happens right before the IB or RB) IB or RB? Prompts Consequence (record what happens right after the IB or RB) Notes 2/20 Free play Peer picks up toy near Tiffany RB I P G V Peer gave toy to Tiffany 2/20 Free play Peer sat near Tiffany with an animal IB I P G V Peer started crying 2/20 Small groups No more brushes at painting activity RB I P G V Peer gave Tiffany paintbrush 2/21 Outside Tiffany sat down in sandbox next to peer with shovel RB I P G V Peer gave Tiffany shovel I P G V I P G V I P G V I P G V I P G V Key: I = Independent, P = Physical prompt, G = Gestural prompt, V = Verbal prompt
