Revised 07/01/2024 Interventionist must maintain a copy of this assessment for a minimum of five years after the training and supervision is complete. Page 1 of 5
HEALTH LICENSING OFFICE
Behavior Analysis Regulatory Board
1430 Tandem Ave. NE, Suite 180, Salem, OR 97301-2192
Phone: (503) 378-8667 | Email: hlo.info@odhsoha.oregon.gov
Web: www.oregon.gov/oha/ph/hlo
Behavior Analysis Interventionist Competency Assessment (initial and ongoing)
This form identifies the initial, and at least once a year thereafter, competency assessment of the Behavior Analysis Interventionist as provided by the
supervising Licensed Behavior Analyst, Licensed Assistant Behavior Analyst, or Licensed Health Care Professional. In addition to any other competency
assessment that may be provided by the supervisor, this “General Observation Competency Assessment” must be completed for each interventionist prior to
independent client service. A copy of this assessment must be maintained by the Registered Behavior Analysis Interventionist for a period of at least five years
after the last day of training and supervision. NOTE: A competency assessment must be provided prior to the Registered Behavior Analysis Interventionist
providing any independent service delivery to clients, and at least once a year after the initial assessment.
Interventionist Information
LAST NAME: FIRST NAME: MIDDLE INITIAL: BARB REGISTRATION #:
Supervisor Information
LAST NAME:
FIRST NAME:
MIDDLE INITIAL:
BARB REGISTRATION #:
Assessment
( Initial or Ongoing)
DATE OF ASSEMSSMENT: DATE OF LAST ASSESSMENT: NUMBER OF MONTHS SINCE LAST ASSESSMENT:
I. Professional and Ethical Issues
All areas of competency must be provided through direct observation, role play, or interview as identified below:
Task: Description:
Direct
Observation:
Role Play: Interview:
I-1
Describe employer, state and federal regulations regarding procedures for storing, transporting and
sharing confidential electronic or paper documents or files with client identifying information.
N/A N/A
Describe examples of employer, state and federal reporting regulations (i.e., mandatory reporting laws).
N/A
N/A
Describe the role of the registered interventionist based on BARB requirements.
N/A
N/A
I-4
Describe how to communicate with colleagues, caregivers, other stakeholders as indicated by
supervisor.
N/A N/A
Give examples of professional behavior in family homes, schools, and community environments.
N/A N/A
I-6
Give examples of, and procedures for, preventing perceived or actual conflicts of interest or dual
relationships.
N/A N/A
I-7
Identify and describe examples of situations requiring additional supervision and request in appropriate
timeframe.
N/A N/A
Identify and describe characteristics of populations served (i.e., autism, intellectual disability, etc.).
N/A
N/A
I-9
Identify methods to protect rights of consumers (i.e., using evidence-based practices, right to effective
treatment, and applicable state and federal laws.
N/A N/A
Accept (and apply) performance feedback on maintenance or improvement of skills.
N/A
N/A
Print Form
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Section (I) Notes: Professional and Ethical Issues (continued)
II. Foundational Knowledge of Behavior Change Principles
All areas of competency must be provided through direct observation, role play, or interview as identified below:
Task: Description:
Direct
Observation:
Role Play: Interview:
II-1
Define Applied Behavior Analysis (ABA).
N/A N/A
II-2
Define behavior and provide operational definitions.
N/A N/A
Demonstrate stimulus control transfer procedures.
N/A
Discuss functions of behavior (i.e., socially mediated, automatic).
N/A
N/A
Section (
II
) Notes: Foundational Knowledge of Behavior Change Principles
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III.
Assessment
All areas of competency must be provided through direct observation, role play, or interview as identified below:
Task: Description:
Direct
Observation:
Role Play: Interview:
III-1
Describe how you would contribute to conducting standardized or curriculum-based language, play,
academic, or adaptive behavior assessment as trained and indicated by supervisor.
N/A N/A
III-2
Demonstrate how you would assist with functional behavior assessment methods (indirect vs. direct
methods; collect ABC data, functional analysis etc.).
N/A
Implement systematic preference assessments to identify potential reinforcers.
N/A
Section (III) Notes: Assessment
IV. Implementation of Prescribed Intervention Plans
All areas of competency must be provided through direct observation, role play, or interview as identified below:
Task: Description:
Direct
Observation:
Role Play: Interview:
Implement continuous and intermittent schedules of reinforcement.
N/A
Implement antecedent-based interventions (i.e., motivating operations, choice, etc.).
N/A
IV-3
Implement differential reinforcement procedures.
N/A
IV-4
Implement extinction procedures.
N/A
IV-5
Implement positive and negative punishment procedures.
N/A
Describe procedures that address generalization and maintenance.
N/A N/A
Implement prompts and use prompting hierarchies.
N/A
Implement prompt fading.
N/A
Implement error correction procedures.
N/A
Implement discrete trial teaching procedures.
N/A
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IV. Implementation of Prescribed Intervention Plans (continued)
All areas of competency must be provided through direct observation, role play, or interview as identified below:
Task: Description:
Direct
Observation:
Role Play: Interview:
IV-11
Implement task analyses (chaining).
N/A
IV-12
Implement shaping procedures.
N/A
IV-13
Implement naturalistic teaching strategies (i.e., incidental teaching).
N/A
Describe how you would assist with caregiver/stakeholder training as authorized by supervisor.
N/A
N/A
Implement prescribed crisis or emergency management procedures.
N/A
Section (
IV
) Notes: Implementation of Prescribed Intervention Plans
V.
Data Collection and Documentation
All areas of competency must be provided through direct observation, role play, or interview as identified below:
Task: Description:
Direct
Observation:
Role Play: Interview:
Describe how to prepare for session (i.e., data collection, materials, etc.).
N/A
N/A
Collect data using continuous recording methods (i.e., frequency, duration, latency, IRT).
N/A
Collect data using discontinuous recording methods (i.e., interval recording procedures).
N/A
Collect data using permanent product methods.
N/A
Graph collected data.
N/A
Write objective and specific session notes (i.e., mastery of skills, difficulties, illness, etc.).
N/A
V-7
Give examples of how to communicate with supervisor.
N/A N/A
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Section (V) Notes: Data Collection and Documentation (continued)
Supervisor Feedback –
List their strengths and the skills they need to maintain below:
Supervisor Feedback – List what they need to improve upon and the skills they need to target below:
Signatures
Supervisor - By signing below, I attest that a competency assessment has been provided to the Registered Behavior Analysis Interventionist prior to providing
any independent service delivery to clients, and an assessment will be provided at least once a year after the initial assessment. I also attest to having
examined the information provided on this Behavior Analysis Interventionist Competency Assessment and certify by my signature below that it is true, correct,
and complete.
Supervisor Signature: Date:
Interventionist - By signing below, I attest that I have received a competency assessment prior to providing any independent service delivery to clients and
have or will receive an assessment at least once a year after my initial assessment. I also attest to having examined the information provided on this
Behavior Analysis Interventionist Competency Assessment and certify by my signature below that it is true, correct, and complete.
Interventionist Signature:
Date: