Santino was seen for session 17 of 17 with this Speech-Language Pathologist (SLP). He transitioned from the "East" classroom into the lobby via Mr. Marcus where he was met by this SLP...Santino lay on the black sofa and appeared fatigued. The daily, visual schedule was reviewed as it was received with the sequence intact. Attempts to redirect Santino were successful after a few minutes and he proceeded into the individual classroom without protest...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...Upon entry to the classroom, Classical Music for Attention and Focus was played in the background...Santino referenced the "Snake" alphabet puzzle arranged in a field of 2 planned activities displayed on the table. He followed the one-step verbal direction successfully to sit in the chair. Each puzzle piece was presented individually upon request via gesture and/or eye gaze for 26 of 26 opportunities. Attempts to elicit the letter names by pausing and waiting throughout the familiar "Alphabet" Song as each piece was connected to form the "snake" were unsuccessful. This SLP requested "help" from Santino. Hand-over-hand assistance was provided over 3 opportunities to guide Santino to point to each letter (with his "pointer" finger) as the song was repeated with each new letter added to the "snake's" body. Santino repeated the pointing sequence independently from letters "G" to "Z" (20 of 20 opportunities). He appeared interested, focused and engaged as he kept in time with the song (except for the prolongation of "P") while tracking each letter visually as he pointed...The second 20-minute planned activity,
Bob Books First! Level A: Book 1, "Mat", was introduced to Santino. (As the books progress, this series uses all the letters of the alphabet, except "Q", with consistent sounds and patterns of three-letter words and short sentences throughout.) Santino looked at the cover briefly then turned to retrieve "Farm Memory Match Up" from the bag of materials (kept in reserve by this SLP) situated near the door behind the desk...In an attempt to "join" in his chosen activity, the segment continued as Santino engaged in a purposeful, two-way interaction with gestures and intentional communication to play a modified version of the "Match Up" game...Santino was presented with each of 10 small, plastic farm animals individually. He followed one-step verbal directions (i.e. "Pull the...apart.", "Put the top of the...down.", "Put the bottom of the...down.") to set-up the game for 10 out of 10 opportunities each. This SLP would then hide 4 pieces under "haystacks". Santino participated in the game for 25 out of 25 opportunities as he was instructed to "Pick one!" from a field of 4 "haystacks" until he found a matching pair. He reassembled each correctly and required assistance to turn and line up the nose and tail details, only. Santino placed each animal back on the floor upon each one-step, verbal direction with the positional modifier, "next to" (i.e. "Put the sheep next to the horse.") for 10 out of 10 opportunities. He seemed to show interest, intense focus, task persistence and engagement for approximately 25-minutes. Santino appeared to look to this SLP for reassurance that he was proceeding correctly. He was reinforced and praised for his efforts throughout the activity...Santino assisted with clean-up by placing the animal requested (from a declining field of 10) into the box for 10 out of 10 opportunities. He closed the flaps independently upon request...Santino rubbed his eyes and lay on the floor. This SLP lay beside him and presented the book "Mat" referenced earlier. Santino tracked the short sentences with his "pointer" finger and turned each page with moderate "hand-over-hand" assistance from this SLP...The session came to a close in the routine manner with the "Good-Bye" Song and successful photo exchange on his daily, visual schedule given verbal and moderate physical prompts from this SLP...Continue as planned with focus on functional, single-word requesting via eye-gaze, photo exchange, and/or verbalization. Santino continues to be a joy to work with!