Individual's Name:

Speaking Peer:

Observer:

Age:

Peer's Age:

Date:

Location/Setting:

Begin Time:

Activity:

Peer's Position(s)

List What the Peer Does . . .

List What Peer Says and to Whom

AAC User's Position(s)

List What AAC User Does . . .

List What AAC
User Communicates and How

Obstacles or Problems

End Time: