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FBA Sam et al., Updated 2022 Page 10 of 39 Planning Checklist Learner's Name: ______________________________ Date/Time: _____________________________ Observer(s): ________________________________________________________________________________ Target Goal/Behavior/Skill (short): _______________________________________________________ Directions: Complete

FBA Sam et al., Updated 2022 Page 10 of 39 Planning Checklist Learner's Name: ______________________________ Date/Time: _____________________________ Observer(s): ________________________________________________________________________________ Target Goal/Behavior/Skill (short): _______________________________________________________ Directions: Complete this checklist to determine if this is an appropriate practice to use with the learner with autism as well as if this practice is ready to be implemented. DEFINE INTERFERING BEHAVIOR

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