Wash. Admin. Code § 388-828-4380
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 self-neglect | 0 | 1 | 2 |
| 7. | Prevention of suicide attempts | 0 | 1 | 2 |
| 8. | Prevention of PICA (ingestion of inedible substances) | 0 | 1 | 2 |
| 9. | Prevention of nonaggressive but inappropriate behavior (e.g., exposes self in public, exhibitionism, inappropriate touching, gesturing, talk, or advances) | 0 | 1 | 2 |
| 10. | Prevention of sexual aggression | 0 | 1 | 2 |
| 11. | Prevention of substance abuse | 0 | 1 | 2 |
| 12. | Prevention of wandering | 0 | 1 | 2 |
| 13. | Maintenance of mental health treatments (e.g., prevent disruption of mental health care) | 0 | 1 | 2 |
| 14. | Managing attention-seeking behavior* | 0 | 1 | 2 |
| 15. | Managing uncooperative behavior* | 0 | 1 | 2 |
| 16. | Managing agitated/over reactive behavior* | 0 | 1 | 2 |
| 17. | Managing obsessive/repetitive behavior* | 0 | 1 | 2 |
| 18. | 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: | ||||
| * #14-17 are questions added by DDA. They are used as part of the DDA behavior acuity scale and are not used to calculate SIS percentiles. |
[Statutory Authority: RCW 71A.12.030 and 71A.16.050. WSR 24-23-058, s 388-828-4380, filed 11/15/24, effective 1/1/25. Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4380, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4380, filed 4/23/07, effective 6/1/07.]