Santino happily entered the front desk area, established sustained reference, and shared a "hug." The "walking song" continues to be a familiar facilitative tool to transition to his room. He quickly scanned all picture choices that were set out on the table, and reached to place the desired item of choice in my hand. Gentle redirection to remove his backpack and then move forward with activities was encouraged. Subsequent redirection to place the picture of choice on the "picture strip" and exchange the "strip" for the desired item paired with verbal stating of his intention was facilitated through hand over hand assistance. 3 Cycles of 5 trials to remove and replace the picture of choice and exchange the entire strip, and allow for verbal stating of the intention was performed with full hand over hand assistance. Additional cycles of 5 trials across 3 different tasks were offered to allow for the transition of more independent removal and placement of selected pictures, subsequent exchange, and verbal imitation following the exchange with an average of 4/5 and verbal imitation with an average of 2/5 for the duration of the session.
Strong focus to be in the area of independent manipulation of the pictures, to segue into more independent use of the picture book, which includes scanning across pages, removal and replacement of pictures within the book, carrying the book (his lexicon) across environments to allow for successful initiation of communication across social contexts. Strong focus remains on the supporting of verbal stating intent within the exchange to anchor the intention of requesting vs verbalizing the labels upon receipt of the desired item. Use of the visual schedule continues to be a strong facilitative tool as Santino now "looks" to the schedule as session closure is indicated, to anticipate the arrival of the next teacher or transition.