Santino was seen for session 5 of 5 with this Speech-Language Pathologist (SLP) in the "East" Classroom. He appeared pleasant in demeanor and seemed to transition well between sessions as he exchanged photos successfully on his daily, visual schedule with both verbal and physical prompts by this SLP...
Goals for the session included the following...
1. to engage in forming a relationship with Santino that includes regulation, and shared attention and interest 2. to enter into two-way, purposeful interactions with gestures and intentional communication 3. to determine highly motivating/favorable, cause and effect activities, so that Santino may develop a feeling of control and predict/anticipate what will happen next 4. to imitate predictable action sequences and communication patterns through cause and effect activities 5. to develop single-word requesting via eye-gaze, picture exchange and/or verbalization...
As the session commenced, Santino was introduced to the therapy ball and the "Hello Song". He appeared regulated afterward and was directed to the large, middle table to choose from a field of 2 cause and effect activities. A one-step verbal direction to sit in the chair was not executed. Santino appeared to be "in search of" something and walked about the classroom. Attempts to engage him in his chosen pattern of movement and to enter into shared attention and interest were met with protest via a hand gesture. This was interpreted as "Give me space/step aside, Miss Sharon!". He then lay on the rug in the "circle-time" area where he rolled onto his back and rubbed his eyes. Attempts to engage Santino, as in previous sessions, were met with rejection. At one point, he rolled toward this SLP and seemed to be teary-eyed. His emotion was met with validation (i.e. "Oh my, Santino! I can see your teary eyes. You seem sad! Maybe you want Miss Sharon to move away/give you space."). This SLP obliged and he seemed to recover within seconds. Attempts to redirect Santino to the table were met with rejection, once again....
A cause and effect activity was brought to the "circle-time" carpet area to entice Santino. He appeared intrigued and engaged for approximately 15-minutes with eye-contact and intentional, two-way, purposeful interactions to complete three cycles of the patterned action sequence. Imitation of the communication pattern was not noted, however...
Santino stood, spontaneously, then traveled to his backpack, reached in, retrieved a container of strawberry-banana yogurt, and presented it to this SLP. His request was validated and another two-way, purposeful interaction with intentional communication was engineered to locate a spoon. He giggled and engaged in continuous eye contact between this SLP and the items from his backpack as each was removed one by one (i.e. shorts, shirts, socks, etc.) followed by, "Is this a spoon?...Nooooooo!". A trip to the kitchen was required to locate a spoon. Utensils were removed from the container on the counter in the same fashion as from his backpack. Some frustration was noted as the process continued, at which point a spoon suddenly appeared. The final question and affirmative response, "Is this a spoon?... Yeeeeeee...s!!!" were presented. Santino and this SLP returned to the East classroom. He followed a one-step verbal direction to sit and chose to do so on the carpet in the "circle-time" area. This SLP feigned ignorance and "needed" help to open the container of yogurt. With both visual and verbal cues, Santino obliged by reaching and grabbing the tab. Together the yogurt container was opened and a spoonful was presented along with the single-word, "Yogurt!" as he engaged in eye contact. Santino cleared the spoon with his lips. An expression of what appeared to be, "Oh! This is sour!", followed. Each spoonful was presented upon eye contact (interpreted as his request) and paired with the single-word, "Yogurt!". Part-word, verbal cues with vowel elongation (i.e.Yooooo....gurt) were introduced in an attempt to elicit a single-word request. Santino verbalized, "Yogurt!", paired with eye contact, once, after the third presentation. This two-way, purposeful interaction with intentional communication (requesting via eye contact) continued for approximately 20-minutes. Santino ate 2 containers of yogurt!...
Continue as planned for the next session and introduce a smaller classroom on the North side of the campus. Interacting with Santino is just wonderful!