Santino was seen for session 24 of 24 and appeared pleasant as he was met by this SLP in the East classroom for transition to the individual classroom. The visual schedule was referenced and reviewed. Initial attempts to transition to the individual classroom were met with rejection as he appeared teary-eyed and lay on the carpet in the "Circle-Time" area. After a few minutes, successful transition commenced without further rejection...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 requested
"Where is Santino's Pumpkin?", 4 times consecutively via photo exchange, from a field of 3 planned activities. Santino appeared less engaged than in previous sessions as he turned the pages independently. Delayed echolalia of unknown context was observed. In an attempt to enter into a two-way, purposeful interaction, a tissue ghost was created by this SLP. Fleeting moments of eye contact and interest were noted as the ghost "flew" and landed nearby during this 15-minute segment...Santino stood and reached for his green bottle on the table and selected the Pediasure Vanilla Shake. Santino followed one step verbal directions (i.e. "Pull the tab., Turn the cap., Throw it in the trash can., Pour., etc.) to complete the transfer of the beverage into the green container. Santino seemed interested and willing to assist. Maximum physical assistance was provided throughout the process to complete each direction successfully. Eye contact, focus and task persistence were noted throughout...Santino sat and reclined slightly, but did not drink the beverage as the "The Gingerbread Man" storybook was presented by this SLP. With minimal assistance, he turned the pages and tracked selected portions as an abbreviated story was read aloud by is SLP. During this 10-minute activity, Santino verbalized "Gingerbread Man" several times as he referenced the illustrations...Santino appeared sleepy, rubbed his eyes and yawned frequently, then stood and lay on the pillows where he drank all but a few drops of the shake...Santino was directed to his communication book and requested 1 of 8 puzzles from the "Mickey Mouse Pattern Tiles Set", 3 times consecutively via photo exchange. Additionally, Santino requested shapes, via photo exchange, from a field of 4 for 15 out of 15 opportunities to complete the puzzles. Verbalization of color + shape upon receipt of the item requested, as in the previous session, was not observed. He verbalized "Daisy Duck!" when presented with the "Daisy Duck" puzzle requested via photo exchange.. Although he appeared fatigued, Santino showed excellent task persistence throughout this 15-minute activity...The session came to a close in the usual manner with the "Good-Bye" Song and successful photo exchange on his daily, visual schedule given both verbal and minimal physical prompts from this SLP...Continue as planned. Once again, Santino seemed very confident and consistent with photo exchange today!