Santino was seen for session 41 of 42 with this SLP in the individual classroom and appeared pleasant and calm upon transition between sessions. The daily, visual schedule was referenced and reviewed. The skin on Santino's lips was noticeably dry and peeling. Water from his bottle was applied with a tissue by this SLP to provide hydration...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 presented with 1 novel and 1 familiar activity. He requested, "Pop! The Pig" via photo exchange then entered into two-way, purposeful interaction with gestures and intentional communication to participate in an adapted, predictable version of the game for 14 out of 14 opportunities. As noted in the previous session, Santino requested Color + Object via photo exchange and located color choice independent of direction in his communication book then added it to the "Sentence" Strip. Minimal verbal and physical cues/prompts were required for removal of the strip. Santino handed the strip to this SLP independent of direction and pointed independently (3x) or with minimal physical assistance to each element on the strip (i.e. I - Want - Red - Hamburger). Verbalization paired with communication intent was noted from time to time (i.e. "Red Hamburger, Purple Hamburger")...A number from 1 to 4 is embossed on the bottom of each "hamburger bun" and indicates how many times the "chef's hat" is pushed. This action causes the "pig's belly" to grow. Santino is cued each time to..."watch the belly"...as he pushes in anticipation of the buckle to "pop" and the "pig's arms" to raise...A second round of the game was requested by Santino via photo exchange and a new version was introduced in a
"My Turn/Your Turn" sequence paired with a roll of the die to determine the color of the "hamburger" to "feed" the "pig". Santino participated in this manner with moderate to minimal physical assistance to roll the die. He selected the associated hamburger color from the "pile" independently for 12 of 12 opportunities..."All Done" was referenced by this SLP and Santino assisted with clean-up upon verbal direction...During the remaining 10-minutes of the session, the book, "Brown Bear, Brown Bear, What do You See?", was presented to Santino for the first time by this SLP. He appeared to show great interest as HE READ the predictable story sequence aloud with minimal assistance by this SLP. He tracked the words visually and with his "pointer" finger as he read, then referenced the simple illustrations and slid the panel to reveal the new animal on each page. Santino verbalized the following in response to "What is that?" for 3 of 3 opportunities:
"Green Frog, Purple Cat, White Dog"...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 verbal and minimal physical cues...Continue as planned with focus on intentional communication to request and initiate via social referencing paired with photo exchange and verbalization.