Santino was seen for session 16 of 16 with this Speech-Language Pathologist (SLP). He transitioned from the "East" classroom into the individual classroom via Miss Christina. Santino appeared teary-eyed and fatigued. He was greeted with the "Hello" Song in an attempt to help soothe and calm him. The photo exchange on his daily, visual schedule was completed successfully with both verbal and physical assistance, then arranged to display the remainder of his schedule sequence (i.e. Backpack, Mom, and Ingrid) by this SLP. The schedule was reviewed with Santino...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...Santino was offered food and beverage choices which were both met with rejection. He stood independent of direction and selected the bag of 26 colored balls and requested via gesture for assistance to open the bag which was closed tightly with a clasp. Hand-over-hand assistance was provided and Santino showed what appeared to be intense concentration and task persistence to remove the clasp and the balls from the mesh bag. He looked up and engaged with eye-contact from time to time, especially when little fingers were "stuck" in the mesh. Assistance and encouragement were offered with intense affect by this SLP throughout the task to provide reinforcement for his focus and efforts...Santino was observed to verbalize color words and
"Hey! You come back here!" as some balls rolled out of his reach. Additionally, it should be noted that he added what sounded like, "I'm gonna tell Mamma!"...Santino seemed to show signs of fatigue once again and completed only 2 opportunities to toss the balls into the large basket. Attempts to engage were rejected as he lay on the pillows and rubbed his eyes...A short predictable storybook was presented and read aloud as Santino fell asleep quickly...After
15-minutes, the "Good-Bye" Song was presented. Santino woke slowly then completed the photo removal successfully both in the classroom and lobby with verbal and physical prompts from this SLP. Santino opened the door with assistance and greeted Mom happily!..Continue as planned.