The SIS exceptional behavioral support needs scale measures your personal support needs for the following behaviors:
# | Behavioral supports needed | No support needed | Some support Needed | Extensive support needed | |
1. | Prevention of emotional outbursts | 0 | 1 | 2 | |
2. | Prevention of assault or injury to others | 0 | 1 | 2 | |
3. | Prevention of property destruction (e.g. fire setting, breaking furniture) | 0 | 1 | 2 | |
4. | Prevention of stealing | 0 | 1 | 2 | |
5. | Prevention of self-injury | 0 | 1 | 2 | |
6. | Prevention of suicide attempts | 0 | 1 | 2 | |
7. | Prevention of PICA (inges-tion of inedible substances) | 0 | 1 | 2 | |
8. | Prevention of nonaggressive but inappropriate behavior (e.g., exposes self in public, exhibitionism, inappropriate touching or gesturing) | 0 | 1 | 2 | |
9. | Prevention of sexual aggression | 0 | 1 | 2 | |
10. | Prevention of substance abuse | 0 | 1 | 2 | |
11. | Prevention of wandering | 0 | 1 | 2 | |
12. | Maintenance of mental health treatments | 0 | 1 | 2 | |
13. | Managing attention-seeking behavior* | 0 | 1 | 2 | |
14. | Managing uncooperative behavior* | 0 | 1 | 2 | |
15. | Managing agitated/over reactive behavior* | 0 | 1 | 2 | |
16. | Managing obsessive/repetitive behavior* | 0 | 1 | 2 | |
17. | Prevention of other serious behavior problem(s) -Specify: | 0 | 1 | 2 | |
Subtotal scores of 1s and 2s: | |||||
Add subtotals scores for 1s and 2s for total exceptional behavioral support needs scores: | |||||
* #13-16 are questions added by DDA. They are used as part of the DDA behavior acuity scale and are not used to calculate SIS percentiles. |
Wash. Admin. Code § 388-828-4380
Statutory Authority: RCW 71A.12.030 and Title 71A RCW. 07-10-029, § 388-828-4380, filed 4/23/07, effective 6/1/07.