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Therapist: ____________________ Date: ____________________ Session: _____________________

Please put a + or - after each statement worked on with _____ per day. Scores should be recorded in the narrow column directly to the right of each category.

Please use the following data codes: P = PreTest, TI = Independent Response during Teaching, TP = Prompted Response during Teaching,

PN = Novel Probe, PT = Teaching Materials Probe in conjunction with the simple + or -.