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Dsa Behavioural Assessment Form 1

The document provides instructions for completing a behavioural assessment form for clients at a residential care facility. It instructs staff to describe in detail the client's behavior, what preceded it, and its immediate consequences in separate columns. Staff are then asked to note the date, time, location, and their interventions and their effects on the client's behavior. The form is to be used each time a significant incident occurs to document the details.

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148 views1 page

Dsa Behavioural Assessment Form 1

The document provides instructions for completing a behavioural assessment form for clients at a residential care facility. It instructs staff to describe in detail the client's behavior, what preceded it, and its immediate consequences in separate columns. Staff are then asked to note the date, time, location, and their interventions and their effects on the client's behavior. The form is to be used each time a significant incident occurs to document the details.

Uploaded by

mohammed.m
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Behavioural

assessment form (BAF)


Residential Care Facility:
Client Name:

Instructions: The BAF should be completed every time a significant incident takes place.

Section A:
1. Behaviour – begin by filling out the middle column, i.e. clearly describe the behaviour
2. Antecedents – describe what was happening before the behaviour occurred; and
3. Consequences – what happened immediately afterwards (before you intervened)

Consequences of the
Behaviour (what, exactly,
Antecedents or activating behaviour
was the incident).
events (what was happening (what happened immediately
Start in this section by
before the incident) afterwards? Who was
describing the behaviour
affected and how?)

Date: Observed behaviour: What interaction/s took


place immediately after
Time: the behaviour occurred?

Where did it take place?

What interaction was going on?

What else was happening? How long did it last? What else happened?
(Noise, unexpected events, etc.)

Section B:
Describe what your actions were and what effect they had on the person’s behaviour.

Intervention/s Effect
V2020: for review May 2022

1800 699 799 1800 921 223 [email protected] www.dementia.com.au

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