DATE # OF OCCURRENCES

ADDITIONAL COMMENTS

Frequency Data Collection FormName: ____________________________________________Target Behavior: ____________________________________

04/20/23 1West Virginia Autism Training Center

04/20/23 West Virginia Autism Training Center 2

04/20/23 West Virginia Autism Training Center 3

Behavior CountingX out each time behavior occurs

Name _____________________________Week of ________________________

Behavior to be counted _____________________________________________

Monday 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29Tuesday1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29Wednesday1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29Thursday1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29Friday1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

Child’s Name: ______________ Week of: _________________Behavior:_______________________________________

Check the number of times the behavior occurs during the activity. .

Activity Mon. Tues. Wed. Thurs. Fri. Average

Arrival ___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___510times

___10-15

___15-20

___+20

Circle ___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

Lunch ___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

Average

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

___0 times

___1-5 times

___5-10times

___10-15

___15-20

___+20

04/20/23 5West Virginia Autism Training Center

04/20/23 West Virginia Autism Training Center 6

04/20/23 West Virginia Autism Training Center 7

04/20/23 West Virginia Autism Training Center 8

WV Autism Training Center

04/20/23 West Virginia Autism Training Center 10