Title Page

  • Document No.

  • Assessment Title

  • Staff Assessed

  • Client Initials / Site

  • Assessed On

  • Prepared by (Name & Title)

  • Location
  • Disclaimer: Competencies assessing skills based on the principles of ABA should be conducted by BCBAs and BCaBAs.

  • Being Prepared for Session. Check all items that were observed. If did not observe mandatory checklist items, STOP assessing, provide feedback & training.

  • Has materials ready

  • Has data collection materials

  • Has reinforcers available

  • Is prepared for session? (Must have all 3 checkboxes checked)


  • Follows child's motivation?

  • Provides contingent reinforcement

  • Conducts (informal) preference assessment?

  • Appropriate schedule of reinforcement?

  • Reinforcement schedule used:


  • NET & DTT Ratio

  • Appropriate ratio of DTT and NET?

  • All components of 3-term contingency are present in DTT? (Observe at least 3 trials)

  • All components of 3-term contingency are present in NET (Observe at least 3 trials)

Data Collection

  • Records data in the moment

  • Records correct data

  • Trials observed

  • Check all observed client responses

  • Correct (+)

  • Incorrect (-)

  • Prompted (P)

  • No Response


  • We have reviewed the results of the assessment.

  • Assessor:

  • Assessed Staff:

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