PBIS is a prevention-based whole-school approach to managing student behavior that is based on teaching behavior expectations, acknowledging students for appropriate behavior, consistent discipline, and team-managed data-based decision-making.
The following questions relate to your commitment to participate in PBIS-related activities and are rated on a scale of 0 to 10. For each item, please indicate your willingness to participate, current level of participation, and the value you place on these activities.
No personally identifiable information is being collected in this survey.

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* 1. District Name:

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* 2. School Name:

In regards to DIRECTLY TEACHING BEHAVIOR EXPECTATIONS TO STUDENTS.

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* 3. How willing are you to participate?

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* 4. How often do you currently do this?

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* 5. How much do you value this?

In regards to REMINDING STUDENTS OF BEHAVIOR EXPECTATIONS.

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* 6. How willing are you to participate?

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* 7. How often do you currently do this?

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* 8. How much do you value this?

In regards to ACKNOWLEDGING STUDENTS FOR APPROPRIATE BEHAVIOR WITH PRAISE.

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* 9. How willing are you to participate?

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* 10. How often do you currently do this?

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* 11. How much do you value this?

In regards to ACKNOWLEDGING STUDENTS FOR APPROPRIATE BEHAVIOR WITH TANGIBLE REWARDS.

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* 12. How willing are you to participate?

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* 13. How often do you currently do this?

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* 14. How much do you value this?

In regards to DOCUMENTING MAJOR BEHAVIOR VIOLATIONS ON A DISCIPLINE/REFERRAL FORM when major behavior violations occur.

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* 15. How willing are you to participate?

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* 16. How often do you currently do this?

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* 17. How much do you value this?

In regards to MANAGING MINOR BEHAVIOR VIOLATIONS IN YOUR CLASSROOM rather than referring them to the office.

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* 18. How willing are you to participate?

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* 19. How often do you currently do this?

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* 20. How much do you value this?

In regards to IMPLEMENTING PBIS STRATEGIES (e.g., teaching PBIS behavior expectations and acknowledging appropriate behavior) in CLASSROOM SETTINGS.

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* 21. How willing are you to participate?

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* 22. How often do you currently do this?

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* 23. How much do you value this?

In regards to IMPLEMENTING PBIS STRATEGIES (e.g., teaching PBIS behavior expectations and acknowledging appropriate behavior) in NON-CLASSROOM SETTINGS (e.g. hallways and lunchroom).

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* 24. How willing are you to participate?

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* 25. How often do you currently do this?

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* 26. How much do you value this?

Thank you for your participation in this survey.
A school summary report will be shared with your administrator.
Filter, K. J. (2015). Positive Behavior Interventions and Supports Assessment of Commitment Tool (PBIS-ACT). Mankato, MN: Minnesota State University, Mankato.
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