Supervisor Observation Feedback Report
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Supervisor Name
First Name
Last Name
Student Clinician
First Name
Last Name
Email
example@example.com
Client Name
First Name
Last Name
Behavior Modification
Appropriate type of reinforcement used
Client behavior managed consistently in a firm yet non-threatening manner
Session structured in an organized manner (visual schedule,rules reviewed, etc.)
Comments
Key Teaching Strategies
Target behaviors modeled accurately
Target-specific feedback provided consistently
Therapy techniques appropriate for client’s age/developmental level & disorder
Appropriate home assignments given with written instructions and demonstration
Comments
Session Design
Clear pre-instruction given for each target behavior and/or appropriate modeling provided
Communication style adapted to needs of the client (vocabulary, language level, non-verbal communication)
Appropriately following written objectives (do statement, condition, criterion)
Data from previous session used to determine next step with current goals andobjectives
Appropriate interpersonal skills; establishing rapport,motivating client, poised, confident demeanor
Comments
Data Collection
Ability to judge responses accurately
Implemented consistent form of accurate data collection
Session plan was written behaviorally and descriptively, using previous data to guide session and goals/objectives
Comments
Final Comments
Submit
Should be Empty: