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DATE # OF OCCURRENCES
ADDITIONAL COMMENTS
Frequency Data Collection FormName: ____________________________________________Target Behavior: ____________________________________
04/20/23 1West Virginia Autism Training Center
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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
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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
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04/20/23 5West Virginia Autism Training Center
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WV Autism Training Center
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04/20/23 West Virginia Autism Training Center 10