Target Behavior Questionnaire for Teachers 
           Student: ____________________________ Teacher: ______________________ Class: ______________  
           Grade: ______________________________ Date: ____________________________________________  
           Identified target behavior: _______________________________________________________________  
           Directions: Check the frequency of incidents specific to the identified target behavior. 
                   
                                      Incident                              Never    Sometimes  Often  Always 
           1.  The target behavior occurs when the student is given a                           
               directive. 
           2.  The target behavior occurs when the student is asked to                                          
               complete an academic task. 
           3.  Peers give the student attention verbally when the                                               
               behavior is exhibited. 
           4.  The target behavior occurs in an academic class.                                                 
           5.  The target behavior occurs during nonacademic class.                                             
           6.  The target behavior occurs during transition times.                                              
           7.  The target behavior occurs when there is a change in                                             
               routine. 
           8.  The target behavior occurs in the presence of peers.                                             
           9.  The target behavior occurs in the morning.                                                       
           10. The target behavior occurs in the afternoon.                                                     
           11. The target behavior stops when the student is given a                                            
               verbal redirection. 
           12. The target behavior stops when the demands of the task                                           
               are removed. 
           13. The student responds favorably to positive reinforcement.                                        
           14. The student demonstrates the desired appropriate                                                 
               replacement behavior. 
            
            © Park Place Publications, L.P. Copyright is waived for educational support use by purchasers of Andrea Ogonosky and Karen Mintsioulis’s RtI—Three Tiers of Behavior (2010).