This worksheet is designed for you to fill in with your own rules and agreements. Since there are no "right" or "wrong" answers, I cannot solve it for you directly. However, I can provide
examples of how to fill it out so you can create your own.
Here are four common examples of behaviors and consequences that students often use:
Row 1:
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If I do this...: Leave my toys or books on the floor after playing.
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My consequence will be...: I have to pick them up before I can watch TV or play video games.
Row 2:
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If I do this...: Finish all my homework before dinner time.
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My consequence will be...: I get to choose what movie we watch on Friday night.
Row 3:
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If I do this...: Yell or speak rudely to my parents or siblings.
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My consequence will be...: I lose 30 minutes of screen time for the day.
Row 4:
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If I do this...: Help set the table for dinner without being asked.
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My consequence will be...: I get to pick a special dessert for the weekend.
How to write your own:
1. Think of something you do (good or bad).
2. Think of what should happen because of that action.
3. Write the action in the left box and the result in the right box.
Final Answer:
The worksheet requires personal input based on your own behavior goals. You can use the examples above as a guide to fill in the four rows with your own agreed-upon rules.
Parent Tip: Review the logic above to help your child master the concept of behavior worksheet for elementary students.