Santino was seen for session 3 of 3 with this Speech-Language Pathologist (SLP). He was greeted in the "East" classroom and appeared to transition easily and calmly from Mr. Marcus as he exchanged photographs successfully on his daily schedule with both verbal and physical prompts from this SLP.

Goals for the session remained consistent and were evaluative in nature with an additional focus on building rapport and developing a relationship with Santino.


Santino presented with a pleasant demeanor as he transitioned to the "middle" classroom where the therapy ball and "Hello" song were introduced in order to maintain regulation and to develop a routine. Santino obliged, then followed a one-step verbal direction successfully to sit in the chair at the table. Assistance for proper position and comfort was provided.

Santino was introduced to the activity, "Who is in the House?". He was able to maintain focus, organization and continuous attention to the task for 20-minutes. Santino participated in a predictable sequence of verbal and action patterns within the activity. He requested objects via gestural reach and eye gaze. Attempts to elicit yes/no verbal or gestural responses were unsuccessful. Santino executed the action sequence successfully, labeled objects (name and color), and action words within the sequence.

Santino sought the sensory ball for 1-2 minutes with support from this SLP at his hips.

Attempts to engage Santino in a gross-motor, back and forth, turn-taking activity involving pushing/driving cars and trucks through a tunnel proved unsuccessful. Santino did crawl through the tunnel once when enticed by a vehicle on the opposite side.

Santino was directed back to the table and followed a one-step verbal direction successfully to sit in the chair. Assistance was provided for proper position and comfort.

Santino participated in a fine-motor magnetic puzzle activity at the table for approximately 10-minutes. Attempts to elicit yes/no verbal or gestural responses to indicate the desired puzzle pieces were unsuccessful. He did request via reaching gestures and eye gaze.

For the last 15-20 minutes of the session, this SLP followed Santino's lead in an attempt to form a stronger relationship and to enter into a two-way, purposeful interaction with gestures and intentional communication with him. He transitioned to the "East" classroom and lay on the carpet in the "circle-time" area while rubbing his eyes. This SLP sat beside him and commented that he looked tired. Santino grabbed my hands and placed them on his head. This SLP began to sing "Head, Shoulders, Knees, and Toes" repeatedly along with the actions. Santino grabbed my hands, placed them over his eyes and held them in place. "Santino! Where are you?", I asked. He responded by removing my hands to reveal, not only, extended eye-contact, but also, a "gleam in his eyes", accompanied by smiles, and deep giggles! This exchange occurred repeatedly over a 15-minute period!



The session came to a close with side to side rocking, in-time with the "Good-Bye" song, followed by removal of the photo successfully from his daily schedule with both verbal and physical prompts.

Continue as planned for the next session and incorporate "cause and effect" play to assist Santino to develop a feeling of control and to predict and anticipate what will happen next.

It was heartwarming to make a stronger connection with Santino today! I look forward to working with him next week!