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Light was mostly from a large window. Fill flash was just to take out a few shadows, and was actually the on board flash with some flash exposure compensation dialed down. I removed the highlights from the flash. The rectangle of paper was actually some artwork she was working on, but the white paper served nicely as a reflector in any case.
I usually shoot wider portraits too, especially of children, but I think that the tight shot can sometimes be dramatic. In any case, I liked this one.