Santino was seen for session 42 of 43 with this SLP in the individual classroom and appeared pleasant and calm upon transition between sessions. The daily, visual schedule was referenced and reviewed. Santino verbalized "Christina" and "Mom"! As noted in the previous session, 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", as in the previous session, 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 15 out of 15 opportunities. As noted previously, Santino 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 with minimal physical assistance to each element on the strip (i.e. I - Want - Yellow - Hamburger) for 4 out of 4 opportunities then requested a change in game procedure via gesture as he handed the die to this SLP. His request was validated and play continued 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 7 of 7 opportunities. (He gestured to "feed" the "hamburger" on each turn of this SLP.) Verbalization paired with communication intent was noted from time to time (i.e. "Red Hamburger, Purple Hamburger, Roll Die x 3, Feed Pig, Pick Green"). Santino responded to the question, "What Number?" x 2. In addition, "Did Pig/He Pop?" was posed after each turn as Santino was directed to the "Yes"/"No" pictures on the communication strip. This SLP referenced and modeled the response, "NO" x 14. Santino verbalized, "Yes!" and removed the corresponding picture from the strip in response to the final question!.."All Done" was referenced by this SLP and Santino assisted with clean-up upon verbal direction. He joined in singing all of the words of "The Clean-Up" song...Santino was directed to 3 novel and 1 familiar book choice. He requested
"A is for Apple", an interactive alphabet presentation with tracks to trace letters and flaps to flip. Hand-over-hand assistance was provided, initially, to trace the letters with his "Pointer" finger. Santino followed the predictable sequence and tracing pattern. Approximately half-way through the alphabet, he did so independent of assistance. Santino lifted flaps and verbalized the following: "Ant, Bee, Car, Dog, Duck, Elephant, Egg, Frog, Fish, Gate, Kite, Lamp, Pear, Queen, Ring, Shoes, Vase"...The session came to a close in the usual manner with the "Good-Bye" Song. The daily visual schedule was reviewed in preparation for the next session. Santino seemed to show some distress via teary eyes and verbal rehearsal of the ABCs. (He may have thought it was time for dismissal). His feelings were validated and the schedule was reviewed again...Continue as planned...