Santino was seen for session 47 of 48 with this SLP. He was met upon transition to the restroom with OT as a change of pull-up was required. Both this SLP and OT assisted with the procedure. Santino appeared fatigued throughout. He seemed calm upon transition back to the individual classroom where the visual schedule was referenced and reviewed...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...Consideration has been given to expand upon Goal 5 to include modifier + object/action in the phrase "I want..." via picture exchange and/or verbalization...Santino searched for and requested Pop! The Pig" via verbalization. He appeared upset when the preferred item was not available. His feelings were validated, followed by an introduction to 2 novel and 2 familiar activities. All were rejected. Subsequently, book choices were presented in an array of 2 novel and 2 familiar options. All were rejected. Santino continued to show signs of distress. A familiar book was presented by this SLP and read aloud. Santino lay on the pillows and fell asleep for 20-minutes. He awoke and appeared pleasant as the "Clean-Up" and "Good-Bye" songs were presented. Successful photo exchange on his daily, visual schedule followed in preparation for dismissal. Santino verbalized "Miss Sharon" and "Lunch Box" upon photo removal.
Additionally, he verbalized "Mom" to complete the "First/Then phrase initiated by this SLP (i.e. First..."Miss Ingrid", Then... "Mom")...Upon Miss Ingrid's arrival, Santino verbalized "Miss Ingrid is here!" in response to the question, "Who is here?"...Continue as planned with focus on use of communication book/photos across sessions/instructors and settings.