Santino arrived to program in good spirits but slightly tired from an active morning and the car ride to school - as per mom's comments. He complied with my request to follow me to the classroom, accompanied by the dancing musical reindeer which he enjoyed interacting with during the last session. Santino experimented by placing the reindeer in several positions and locations in the room, table, and floor, and viewing it from different angles and vantage points. When encouraged, to replicate the movements,via teacher demonstration, Santino did make an effort to follow the verbal and physical prompts afforded him. He pressed the reindeer's paw repeatedly to activate the song and dance and, at one point, held its legs and moved them in the correct corresponding manner in which it was programmed. Santino enjoyed this activity and came to me on three separate occasions, pulled himself close to me to increase contact, while maintaining eye contact. This is not a common behavior for Santino, but I was delighted to see him initiate it and recipricated an appropriate affective response in turn. It may be indicative of a heightened level of comfort and and contentedness in Santino, commensurate with a greater feeling of safety and/or trust, and increased familiarity/adjustment to program and expectations; however, as mentioned, the behavior was reciprocated with a smile and a hug to reinforce the positive connection. The next activity involved listening to a song about colors and fruits while pairing them up with corresponding plastic colored fruit item equivalents (yellow pineapple, for example). The objective here was to have Santino listen to, retrieve, and imitate speech and spoken language (Florida State Standard SP.PK12.SA.7.1). While outcomes on this activity were not as successful as having him repeat the movements in the earlier activity with the toy reindeer, both will continue to be addressed in future sessions. Santino did not show any indication that he wanted to eat any of the snacks I had left out for him today. However, he did make correct motions to bring a cup of water to his lips and drank a sip, but he then brought the cup to his upper lip to drink and in so doing spilled some and was not able to drink more. Efforts to model appropriate drinking techniques will be addressed in future sessions.

Santino arrived in a sleepy mood having just woken up from his car ride to the program. He initially stretched out on the couch and grabbed my hand towards his for contact, which indicates a measure of comfort and familiarity, but after he was introduced to a dancing and singing musical stuffed animal Santino grew more animated, responsive, and began vocalizing in a happy fashion. Santino was encouraged to replicate the motions of the reindeer and did so, along with the teacher. We placed objects around the reindeer to contain him from falling off the table, but when he did fall off, Santino knew where to place him and how to re-activate the switch by pushing on a paw. He made similar vocalizations, but they did not approximate the words I was attempting to elicit that were familiar to him and relevant to the activity at hand. When another teacher and student joined us for a few minutes, we tried to engage Santino in a game of catch with the reindeer. Santino was able to catch him 2 or three times after a few attempts, and he was afforded a great deal of praise - in the form of high fives and verbal 'hoorahs' when he did so. We next worked on shape identification and discrimination, and Santino repeated the word 'circle' after being shown a hula hoop, following verbal prompting techniques. He was permitted to take the reindeer outdoor to the playground and it accompanied him on some equipment, which he clearly enjoyed very much. Ten minutes before the end of the session, Santino was prompted to turn on the water faucet in the kitchen, which he did, with hand-over-hand assistance. He also passively complied with physical directives to push on the soap (a first), and to dry his hands with towel; the latter two skill sets required physical and verbal prompts for successful attainment. He appears to have become increasingly familiar with expectations, acquiring more practiced skills and abilities with daily exposure. Santino drank from the faucet for three minutes after a few drops of water were placed on his lips during the hand-washing activity. This has proven to be a helpful way to keep him hydrated, and has also been requested by his mother. At the very end of the session, I took out a balloon, which has proven to pique Santino's interest, engagement, ability to sustain attention to task, and maintain eye-contact. I placed it by my eyes and mouth as I encouraged him to replicate the 'M' sound. When he did so, I gave him the balloon. I hope to use this technique as a means by which to elicit and shape vocalizations to better approximate letters and words upon request. I was pleased with Santino's responsiveness, compliance with directives, and his overall engagement today.

Santino was less tired today than than earlier in the week. His nose was not running as much as it was the other day, however he sneezed three times in my presence. I have been showing him the box of Kleenex in efforts to increase his awareness and expectations regarding healthy practices, and prompting him to take one as needed, using hand-over-hand techniques (Florida State Standard HE.K.C.1.1). It is hoped that in time and with practice, Santino will acquire the skill sets to increase independence in such areas as self care and feeding. Santino was visually prompted using the communication book but remained uninterested in identifying me as his teacher. We moved onto a tracing activity and Santino was more receptive to tracing the letters of his name on a balloon I had blown up. Next, we used plastic foods items in efforts to have him identify the ones in which he seemed interested and selected to examine; but he did not repeat my verbalizations and did not sustain attention for long. He was more interested in removing placards on the wall of the classroom that named the months of the year, but he did not repeat them when prompted, and protested a bit, with increased vocalizations, when these were placed back in their proper place on the wall. We finished the session listening and moving to music; the Coco-melon 'Popsicle' song is his current favorite, and Santino enjoyed skipping and hopping after me to the music, replicating my actions. I poured him some water in a cup hoping I could get him to drink - as hydration has been raised as a concern for Santino by his mom. Although he initially seemed interested and took the cup from my hand, he began transferring it to another cup that he found nearby and enjoyed observing and listening to the feel and sounds the liquid made as it passed from one cup to the other. As we were proceeding to the kitchen, Ingrid, Santino's babysitter, arrived to take him home. As Santino's book bag had been left in a different classroom today, Ingrid went to take his hand so he would accompany her to retrieve it, but he pulled away, vocalized disapproval, and refused to follow. He remained with me as his book bag was handed over to Ingrid and left without incident.

Santino was tired again today; he had a runny nose, requiring the use of tissues with which to help him wipe it, and he sneezed a few times during our session. It seems he has a cold, which may explain his fatigue in class the last few days, in addition to some disrupted sleeping habits of late, which was relayed by his mom. Santino did not want to eat any of his snacks and was not pressed to do so; they are displayed on the table in his class and Santino directs this teacher to the item if he desires to eat. I assisted him physically and verbally in hand-washing and Santino maintained the gains previously noted. Today, however, he initiated a good grip on the paper towels handed to him and hesitated, which may be an indicative precursor to the acquisition of skillsets required to dry them. Santino worked on object identification and verbalization skills, repeating the word 'stop' when holding the octagonal plastic sign from a miniature traffic sign set. He also worked on completing an alphabet tower on which he had begun to work in a prior session. He assembled 8 blocks vertically atop a cabinet, but when the tower became too high for him to continue and toppled even after diligent attempts to align them on his tip toes, Santino intentionally toppled the rest onto the floor. He was then able to complete his alphabet assembly horizontally and creatively used different set of cubes with which to do so. We finished up the session with me reading a book that seemed to capture his attention ('Little Dinosaurs'). Santino relaxed comfortably in an arm chair in the classroom and looked at the pictures as I read him the book and he repeated two words when verbally prompted.

Santino and I used a puzzle to work on shapes and colors. He did well putting the individual shapes back in their corresponding spots. We made a tower with the blocks. Santino made a tower with alphabet letters putting the letters in the correct sequence until it toppled at 'I'.

Santino arrived to the program in a timely fashion, as usual, but his mother explained that he was tired following a very active morning and the car ride to the program. She also requested that I continue to make every effort to have him remain hydrated, and drink water, if at all possible during the after session. Santino was brought to the classroom to put away his book bag, but he was initially not happy with this plan and threw a tray of coins on the floor. He was spoken to in a firm but gentle fashion and afforded hand-over-hand assistance to pick up the pieces and place them back in their rightful compartments on the tray. I attempted to work with the communication book, but Santino showed little interest. He did approximate this teacher's name after it was repeatedly spoken to him while showing him her picture and via pointing, gestures, and verbal promoting techniques. Santino did appear a bit tired but he was not interested in lying down to rest or being read a story. We worked on some pattern replication and visual-motor tasks before going outdoors for a brief time.
Santino's behavior perked up outdoors and he enjoyed the slide and jumping up and down the bridge, replicating this teacher's movements and giggling. He added mulch to the slide as he went down it, which increased his velocity, and he clearly loved the increased speed, landing on his feet each time. We practiced hand-washing two times during the hour, and Santino followed physical directives that were accompanied with verbal prompts to perform the steps involved; improvement was noted in the speed and accuracy of performance (Florida Standard SP.PK12.10.1b). While Santino did not want to drink from the fountain, a cup or his bottle, he did drink from the water faucet during hand-washing. Santino did not express interest in eating during my time with him; however he did enjoy playing with some mini marshmallows that were shown to him and enjoyed the textured taste when he put them to his mouth. Santino is interested exploring and examining objects with different feels and surfaces, so it was not surprising that he enjoyed working with the mini marshmallows, which we also counted aloud together while he experienced their smell, taste, and texture.

Efforts have been ongoing to facilitate Santino's adjustment to routine and to expectations regarding behavior. His routine is kept as consistent as possible so that skills commensurate with expectations may be acquired. Today, Santino was shown where to put his book bag and where to find his communication book. Although he as yet does not identify his teacher by pointing to her picture, he has become more familiar with it and will watch as I point to myself and my picture while saying and showing him my name. We spent the first hour working on activities that tapped upon gross motor skill development. Santino was shown basic movements on short beams, and encouraged to replicate the teacher's movements, placing one foot directly in front of the other. Santino understood what was expected in this activity and demonstrated good gross motor skills and the ability to imitate my movements. He has gotten more comfortable on the playground and has become more skilled and adept at using the equipment, trying different ways to engage with different recreational apparatus and exploring the terrain and grounds. He enjoys letting the mulch slip through his fingers and will often play and examine it from different angles and heights. We then proceeded indoors to the kitchen and washed our hands. Santino was afforded hand-over-hand assistance to turn on the faucets, and he lathered his hands independently. Today, he held the paper towel handed to him and was shown how to us it properly. He especially enjoyed the water today; he leaned his head down to feel it splash on his face and even drank some. When shown different snack items, Santino brought my hand to his yogurt snack, indicating he wished to eat it. He was afforded hand-over-hand prompts initially, but required physical assistance to feed himself. For the remainder of the session, Santino was given opportunities to engage in activities to develop fine motor skills and eye-hand coordination (for example; he was helped to align a variety of different objects with their beginning letter equivalents). He was assisted in carrying out personal care and hygiene routines, such as keeping his hands clean by washing them frequently, in order to guard against illness, remove germs from his hands, and prevent infections -as Santino frequently touches his eyes, nose and mouth. It is also a beneficial means by which to reinforce and consolidate emergent gains noted in self-care skills. (Note: this aligns with Common Core: SP.PK12.US.8.1)

Santino arrived with his mom today, and she mentioned he might need a nap as he was tired and not yet adjusted to the new routine following break. I allowed Santino to place his book-bag in one of the classrooms and arranged some pillows on the floor on which he could relax. He did lie down in the darkened room and it appeared as if he might doze off; however he was distracted by sounds outside so I allowed him to trace his finger along some touch and trace letter cards to reinforce letter recognition and writing skills. He did not opt to eat any of the snacks provided and shown to him. I allowed him to use technology for 15 minutes; he was clear he knew what programs he wished to operate and enjoyed listening to music. He was vocalizing in a happy way and appeared to grow a bit restless in the classroom so I afforded him the opportunity to go outside. He did seize this opportunity and got a second wind. He was absolutely jubilant as he played on playground equipment and particularly fancied going up and down the big twisty slide. I reinforced the concepts of up down, fast and slow,
and over and under as he did so. Two students, within a year or two of his age, joined him on the slide and he seemed amused by their antics, giggling animatedly as they slid down after him. He was so happy outside that he was initially resistant to return indoors, but he did take my outstretched hand and we proceeded to perform our daily hand-washing activity. Santino continues to make incremental gains performing this daily living skill and we will continue practicing it in order to to reinforce, generalize, refine and consolidate emergent advances.

Santino appeared a bit tired today. He was observed laying his head down in the crook of his arm as he explored some plastic objects on which we were working to identify. He showed no interest in working with the communication book today, however, and pushed it away with his hand. I thought he might want to lie down, but when he showed some interest in a letters and numbers activity, we worked to reinforce and consolidate prior gains noted in that area. Santino was afforded hand-over hand assistance to put away the activities on which he worked. He showed no interest in eating or drinking while with me. I updated his babysitter on all when she arrived to pick him up at 2:00PM as Thursdays he has an earlier day.

We began the session by having Santino place his book-bag below the sink, where it is usually kept. He required physical prompts to do so but was cooperative and complied with expectations when afforded prompts. We then took out the communication book and Santino was afforded hand-over-hand assistance to identify his teacher by pointing to her picture and name, the latter of which is affixed to the book with velcro. He was more receptive to working with the communication book today, but his attention span was limited to approximately 5 minutes, with frequent re-focusing and prompts required. The velcro component did seem to add a spark of interest, contributing to his engagement. It should be noted that Santino appeared tired today. After working with his communication book, he laid down on the floor and appeared to be closing his eyes and yawning a lot. I shut off the light and read him two stories, 'Eating the Alphabet' book and 'Counting cats'. While he appeared initially interested in following along with the former, his interest turned to a puzzle and we worked on assembling it together, with hand-over-hand prompts. Santino vacillated amongst a few sensory-tactile activities before returning his attention to the magnetic alphabet board. He enjoyed configuring the pieces in a special arrangement and was less resistant when this teacher intervened, allowing her to re-arrange them in a horizontal line. He also went head-to-head with me at one point when I mimicked his vocalizations, giggling and maintaining eye-contact for several seconds. We ended the session with Santino following actions demonstrated for him and pairing the foods we reviewed in the 'Eating the Alphabet' book with their felt counterparts from a toy bin. Santino did not show any interest in eating the snacks provided by his mother today although she said he would probably be hungry; however, they were were left out for the duration of the session in the event he changed his mind.