What is PBIS?
Positive Behavior Interventions and Supports (PBIS) is a proactive systems approach for creating and maintaining safe and effective learning environments in schools.
The mission of PBIS is to build skills and develop structures for teaching expected behaviors and social skills creating academics and social/emotional learning at school.
Bartlett Elementary School has developed the following Behavior Matrix.
Behavior Matrix/Settings
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Expectations
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Classroom
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Bathroom
|
Lunchroom
|
Playground
|
Bus
|
Hallway
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Arrival/Dismissal
|
|
Be Safe
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Hands and feet to yourself
|
Wash Hands
|
Hands and feet to self
Wait your turn
Stay seated until dismissed
Good table manners
|
Inform playground staff if someone is hurt
Dress for weather
Play safe
|
No eating or drinking
Keep aisles clear
Face forward
Stay in
your seat
Use quiet voices
|
Walk in single file
Stay to the right
Hands to side
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Use crosswalk/sidewalk
Walk your wheels on school grounds
|
|
Be Caring
|
Be a good friend
Use kind words
Help others
Share
|
Keep bathroom
clean
|
Use kind words
|
Share
Include others
Play fair
Use kind words
|
Use kind words
|
Smile
|
Use kind words
Keep hands and feet to self
|
|
Be Respectful
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Honor people,
Possessions, and feelings
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Respect others privacy
Flush
Be quiet
|
Quiet voices
Eat your own food
Listen to Lunch Supervisors
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Use equipment appropriately
Take care of equipment
Use appropriate language
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Remain calm and orderly
Follow Bus Drivers instructions
Keep hands and feet to self
|
Walk Quietly
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Obey patrols and supervisors
Wait in line at designated areas
|
|
Be Responsible
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Complete work on time
Have supplies ready
Follow directions
Be your best
|
Use bathroom appropriately
Be quick
Be in your own space
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Follow directions
Put trash in garbage cans
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Line up promptly
|
Exit in orderly manner
Take belongings with you
|
Follow adult supervision
Stay together
Every be ready before you leave the classroom
|
Be on time
Enter and Exit assigned doors
School rules door to door
|
BARTLETT Elementary-- PBIS Referral Form 2009-2010
Student Name__________________________
Date:________________ Time:___________ Location______________________
Teacher:______________________________
Referring Staff:________________________
Grade: K 1 2 3 4 5 6
|
|
Problem Behavior
Circle appropriate problem behavior(s) on reverse side.
|
Possible Motivation
__ Obtain peer attention
__ Obtain adult attention
__ Obtain item
__ Avoid peer(s)
__ Avoid adults
__ Avoid task or activity
__ Don’t Know
__ Other:
________________
________________
|
Administrative Decision
__ Loss of privilege
__ Time in Office
__ Conference with student
__ Parent contact
__ Individual instruction
__ In-school Suspension
Days:_____
__ Out of school suspension
Days:_____
|
Others involved in incident: __ none __ Peers __ Staff __ Teacher
__ Substitute __ Unknown __ Other
If others were involved, list them:
___________________________________________________________________________________________
Give a brief description of incident: __________________________________________________________________________________________
What three interventions have been attempted before minor behavior became a major behavior:
___talk with student ____ notify parent ___other:____________________________________________
_____________________________________________________________________________________
What rule(s) did you break?
Being Respectful Being Responsible Being Safe Being Caring
Next time what could you do to follow Bulldog Pride?_________________________
__________________________________________________________________________
Teacher/Supervisor Signature______________________________________________
Student Signature_________________________________________________________
Parent/Guardian Signature_________________________________________________
Principal Signature________________________________________________________
