Upon arrival, Santino was sound asleep in the car. Kim had shared the he had woken up in the late hours of last night and remained awake for the better portion of the early morning hours. Marcus assisted with getting Santino to his room where he slept soundly amongst the pillows and with the weighted blanket. This afforded a wonderful opportunity to speak with Kim. Conversation expanded across topics. Feeding remains a primary concern, and strategies to emulate as close as possible to the meal time experience he shares with Ingrid is vital. Dorothy was able to join in the conversation briefly and feels confident in taking the lead as the primary teacher involved in mealtime. Additional concerns that Kim shared fall in the scope of ADL skills.
The successful use of the visual schedule was discussed, highlighting that the components of sabotage are intentionally embedded. Use of picture exchange as a tool to communicate requests has continued to expand almost on a daily basis. The primary goals being that Santino will independently place pictures on the strip to create a sentence (" I want red triangle"), establish eye gaze in order to lead into the communication dynamic, reach to give the strip to the teacher, paired with the verbal accompaniment "I want red triangle", and subsequently receive the desired item.
The use of picture supports to facilitate increased verbalization has been extremely successful.