Santino was seen for session 9 of 9 with this Speech-Language Pathologist (SLP) in the "East" classroom. As usual, Santino 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
Mr. Marcus...Santino presented with milder cold symptoms and permitted wiping with a tissue as needed...Goals for the session remained consistent and 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...In keeping with the routine, the session commenced in the typical sequence. Attempts to introduce the sensory ball in order to assist with regulation and to engage in singing the "Hello" Song were met with rejection. Santino, instead, walked to and from the "letter" stamps located on the shelf. Verbal redirection was unsuccessful at first, but with persistence and increased affect, along with brief "joining" in his chosen activity, the regulation/greeting sequence was completed as planned...Subsequently, Santino walked to the table and chose the "Ball Catapult/Launcher" displayed in a field of two planned activities on the center table. He selected the green ball and ran to the carpet in the "circle-time" area in anticipation of the activity. Santino followed the established action sequence, which initiated only upon eye contact prior to each step of the process. As in the previous session, Santino searched for and located the ball then ran and/or skipped joyfully back to this SLP while engaging in eye contact. Once the ball was returned to the "Launcher", this sequence of purposeful/positive interaction repeated successfully for 15 out of 15 opportunities...Upon completion, Santino selected blocks he had "eyed" but not reached for in previous sessions. He seemed hyper-focused on the block with the letter "P" and repeated "Penguin" (pictured on one side of the block) several times. Attempts to engage in and extend his chosen activity were presented with increased affect and momentarily welcomed by Santino as block "L" and the "lion" depicted, "growled" and "chased" block "P" and the "penguin" back into the box which was promptly returned to the shelf. Santino seemed interested in letters and puzzles for the remainder of the session. He selected 2 letter puzzles and brought each to the carpet one-by-one. Santino immediately removed the letters "R-E-D", returned each to the frame then pushed it away. Efforts to redirect and engage Santino in the remaining planned, preferred activity, Who Lives in This House?" were rejected. Santino returned to the alphabet puzzle. In an effort to engage and extend his chosen activity, the letters were removed by this SLP and a choice of 2 letters was provided. Santino gestured for both then followed a one-step verbal direction to return the letter designated by this SLP into the frame. He was successful in this regard for approximately 5 out of 10 opportunities. Attempts to insert the remainder of the letters in a "My turn/Your turn" sequence were met with some protest, but were tolerated from time to time. Upon completion, Santino returned the puzzles successfully to the shelf with both verbal and physical prompts. The session came to a close in the usual sequence with the "Good-Bye" Song. He removed the photo successfully from his daily, visual schedule with both verbal and fading physical prompts by this SLP. Continue as planned with a focus on single-word requesting via eye gaze, gesture and/or picture exchange during familiar, preferred cause and effect activities. Have a lovely weekend!!!