Before you watch a single session, someone has usually already written a lot about your new client. Teachers, doctors, therapists, and earlier behavior analysts leave a paper trail. Reading it carefully at intake saves time, protects the client, and keeps you from repeating what has already failed.
Why it matters
A record review is often the first step of a behavior assessment. It tells you where the behavior has been, what has been tried, and what might be going on medically. Skipping it can lead to real harm: you might design a plan for "attention-seeking" head hitting that actually started with an untreated ear infection, or reintroduce a procedure that made things worse last year.
Practice scenarios on this task ask what to do with information found in records, what records can and cannot tell you, and what you need before you request them.
Key ideas
- Records are an indirect source. They summarize other people's reports and impressions. They help you form hypotheses and plan the rest of the assessment, but they cannot confirm the function of a behavior.
- Look in three broad places.
- Educational: IEPs or 504 plans, prior functional behavior assessments (FBAs) and behavior plans, progress reports, discipline and attendance records.
- Medical: diagnoses, current medications and recent changes, sleep, feeding, allergies, seizures, pain, vision or hearing concerns.
- Historical: developmental milestones, earlier assessments and services, past interventions and their results, major life events, and the family's goals and context.
- Watch for medical and biological variables. Sudden onset, a sudden change in intensity, or behavior directed at one body part (such as hitting one ear) can signal pain or illness. When there is a reasonable chance a medical variable is involved, recommend a medical evaluation and coordinate with the client's health care providers. Diagnosing or treating medical conditions is outside your scope.
- Learn from past interventions. Note what was tried, for how long, how it was measured, and how well it was carried out. "It didn't work" may mean the procedure didn't match the function, or that it was never implemented as written.
- Get permission first. Request records only with written authorization from the client or their legal guardian, and ask only for what is relevant to the referral.
- Flag safety and logistics. Records may reveal a history of severe injury, pica, elopement, or medical conditions that change how you will safely assess, or legal documents (such as guardianship) that tell you who can consent.
Definitions
- Indirect assessment: gathering information from sources other than direct observation of the behavior, such as records, interviews, rating scales, and checklists.
- Release of information: a signed authorization from the client or legal guardian that allows you to request or share specific records with specific people.
- Medical variables: physical or biological conditions, such as pain, illness, medication side effects, or poor sleep, that can change how often or how intensely behavior occurs, often by altering the value of reinforcers.
- Intervention history: the record of what procedures have been used for a behavior, by whom, for how long, and with what measured results.
Examples from a session
Record review across settings
- Clinic: Rafael, age 4, is referred for screaming. His pediatric record notes frequent constipation, and his parents say screaming spikes in the late afternoon. His BCBA lists this as a possible medical variable, asks the family to follow up with the pediatrician, and plans to track bowel movements alongside screaming.
- School: Hana, age 10, has an IEP and an FBA from two years ago that found task escape during writing. Her new BCBA treats that finding as a lead to check, not a conclusion, because her classroom, teacher, and skills have all changed since then.
- Home: Prior notes on Jordan, 15, say a response cost system "failed." Looking closer, the BCBA sees no data were collected and the plan was used only on weekends. That history shapes questions for the caregiver interview.
- Adult services: Denise, 42, lives in a group home. Her medication record shows a dose change three weeks before staff reported more property destruction. Her BCBA shares the timing with her prescriber and keeps collecting data rather than guessing at a cause.
- Non-example: A BCBA copies the escape function from a two-year-old FBA straight into a new plan without observing the client. That is reusing an old conclusion, not reviewing records.
Common mistakes / exam traps
- Accepting labels at face value. Words like "defiant," "manipulative," or "lazy" are not behaviors. Translate them into observable, measurable descriptions and check them yourself.
- Using a diagnosis as an explanation. "She bites because she has autism" is circular. A diagnosis describes a pattern; it does not identify the environmental variables maintaining behavior.
- Requesting records without consent, or requesting everything. Get written authorization and limit requests to what is relevant to the referral.
- Ignoring how old a record is. Skills, settings, and contingencies change. A three-year-old report may describe a different situation.
Record review vs. functional analysis
Both can point to a function, but only one tests it. Records are indirect: they report what someone else saw or believed, so a note that "he acts out to get attention" is a hypothesis. Descriptive assessment shows which events tend to go with the behavior; a functional analysis, when appropriate, manipulates those events and demonstrates function. An option that sets function from records alone skips that step.
Medical referral vs. medical advice
When records hint at pain, illness, or a medication change, the in-scope move is to recommend a medical evaluation, share your data and its timing with the provider, and keep measuring. Telling a family to start, stop, or change a medication, or deciding a condition is ruled out, is outside your scope even when the behavioral pattern looks clear.
Quick check
Tomás, a BCBA, reviews records for Lily, 7, who was referred for biting. Her school progress report says biting began suddenly last month, and a note from her pediatrician mentions two loose teeth and sore gums. What should Tomás do with this information?