Santino was introduced to his communication book in which several pictures are used to enable him to communicate more effectively by pointing, matching, and verbalizing responses. I showed Santino the book which had letters and names attached by velcro. Santino showed some initial interest and pulled a few letters off one of the pages - the 'a' and the 's' in his last name, but he did not sustain his attention when shown how to re-attach the letters in correct order. He did, however, make repeated eye contact with this teacher when she showed him her picture and her name - and approximated the beginning and end sounds of her name after it was repeated to him several times. This book will continue to be used by Santino's teachers so that he grows more familiar with associating their picture(s) and their name(s) in the hopes of improving his communicative abilities and verbal skills. Santino was also introduced to a marching song and enjoyed marching in a circle with this teacher. The song, 'The Ants go Marching' also served to reinforce his counting skills. We concluded our session using wooden and magnetized alphabet blocks. Santino placed 7 of the wooden blocks in various spots in the room and then took delight placing them back in their correct order. While he did not permit this teacher to intervene in the process, actively preventing her from retrieving any blocks, he did clearly and correctly verbalize the letters as he picked them up, and he enjoyed placing them in a tower configuration. We finished the session touching various sensory objects and manipulating each to hear and feel their different sounds and textures. Santino enjoys and is responsive and perceptive to sensory stimulation - particularly observant with the tactile and spatial properties of objects.

We read the book titled, "Apple, Banana , Cherry" by Joy Crowley. As I read Santino walked on the alphabet carpet and tapped letters repeating ' X, y, z ." After that he ordered some of the block letters and then looked at his book titled',Kindergarten Skills". He turned the pages very nicely and matched the pictures to the letters. Great job,Santino!!!! He moved on to working with the numbers and ended the day with the magnetic letters. When it was time to clean up he did put the magnetic letters away.

Santino was in good spirits today and transitioned easily from his previous teacher. We began the session singing some common nursery songs and Santino finished the words to the song, Twinkle, Twinkle Little Star, and the Alphabet Song. Of interest was that Santino was able to pick up where I stopped and did not need to start from A to recite the alphabet. He then paired block letters with their magnetic counterparts, remaining fastidious and exacting when placing the letters alongside one another in sequential order. We finished the session playing with an assortment of felt fruit items. Santino repeated one or two fruits after this teacher first said them aloud, and correctly identified a slice of watermelon from the assortment. He also said apples and bananas after selecting these two items out of the assortment. Santino was shown some snacks but did not wish to eat anything. We ended the session skipping around the alphabet rug, with Santino giggling whenever I turned direction.

Santino was permitted 5 minutes of outdoor play before working on academics. We reinforced the concept of up down using a jump rope and Santino enjoyed holding one end of it. Hand-washing was done once inside the facility in efforts to reinforce and consolidate prior gains that have been made. Next, we utilized wooden blocks and Santino spelled out three 3-letter words correctly: cow, car, and cap. He did not verbally identify the words when this teacher pointed to them, but he arranged the letters quickly and in the correct sequence. Santino brought a banana pudding from the snack options left out for him on the table. He did not wish to eat a banana or any of the dry cereal that were offered subsequently. After eating, this teacher read him the story 'Cat Count,’ by Betsy Lewin, to reinforce counting skills and word identification by Betsy Lewin. Santino followed along with his eyes as this teacher was reading but did not sustain attention for longer than 5-6 minutes. This reading activity is recommended and beneficial to facilitate Santino's ability to follow words from left to right, top to bottom, and page by page and to recognize that spoken words are represented in written language by specific sequences of letters and to become familiar with the organization and basic features of print. (Common Core Standard LAFS.K.RF.1.1). Santino finished the session utilizing a magnetic letter board to sequence the letters of the alphabet. This teacher introduced the word 'pattern,' and Santino was shown how there were 5 colors repeated in the same order when the alphabet was arranged alphabetically from A - Z. Santino was prompted to repeat the colors to reinforce his color identification skills upon request, as he has demonstrated the ability to name all the letters of the alphabet, but did not do so upon request during today’s session. This will continue to be addressed in subsequent sessions to strengthen gains and reinforce letter, color, and word recognition and identification skills.

When this tutor arrived, Santino was walking in the hallways around the classrooms and did not want to be -rerouted to a different area of the facility. This teacher took his free hand (the other one was clutching his tablet and he often is fearful it will be taken away from him) and began skipping down the hallway, which successfully broke the perseverating pattern and redirected him successfully. Santino began giggling, grew more relaxed, and we proceeded outdoors. Once Santino realized his tablet would not be taken, he grew more comfortable and let it rest alongside the equipment which he was using. He grabbed this teacher's hand to lead her to different areas in the playground and classrooms and enjoyed the sensory stimulation afforded him by jumping on the bridge, running back and forth, twirling in circles, and assisting him physically with some of the more challenging exercises he was attempting. His actions were accompanied with verbalizations identifying the motion or activity in which he was engaged (i.e.; up/down; around; on top; below, circles etc.) Such word pairings are hoped to facilitate his association between the word and the action or activity. Santino greatly enjoyed it when this teacher whirled him in circles, giggling animatedly and communicating that he wanted more with his eyes and physical posturing. He would occasionally look over his shoulder when this teacher pretended to run after him, which indicates he was aware and anticipatory of antecedent and consequential actions. Santino observed as this teacher retrieved a ball with a stick that had fallen outside the gate; he grabbed onto it, held it with both hands, smelled it and rubbed his hands across it - gaining information about it as he is wanting to do with many objects. Santino was asked to point to the colors on the ball, but did not do so, although this teacher observed his eyes glancing at the different colored stripes. He repeated one color after it was verbalized but did not maintain the desired response task when prompted a second time. When we came indoors, Santino walked over to the sink with this teacher and placed his hands under the faucet. He washed his hands well using circular motions with minimal prompts once the soap was applied. He was afforded hand-over-hand modeling to turn off the faucets but has yet to take the paper towel when this is handed to him and dry his hands independently. It seems that engaging Santino in this routine hand-washing activity following play is proving beneficial; it has contributed to his understanding of expectations and helped improve his self-care skills (in hand-washing) In light of these gains, it will continue to be addressed here at our program.

Santino appeared tired today. He expressed his preference to go outside and led this tutor to the door by her hand. It was the first day back after a week following Thanksgiving break, and Santino had his first soccer lesson prior to meeting this teacher. Santino has made more eye contact with this tutor than previously and it is hoped that this will facilitate his ability to express his needs for social and instructional purposes within the school setting. Santino enjoyed playing on his favorite playground equipment - the large slide, and understood when this teacher demonstrated that he stand up when he reached the bottom to avoid dirtying his pants from some damp leaves that had accumulated at the bottom of the slide. He enjoyed jumping at the count of three when assisted by this teacher, expressing his delight with squeals and giggles. Santino would have enjoyed staying out longer, but this teacher verbally and physically prompted him to join her inside to do some academic work. First, however, he was brought over to the sink where he was assisted in a hand-washing demonstration. Santino washed his hands correctly after initially prompted by this teacher, washing in a circular motion. He seemed to enjoy this activity more than in the past and seemed to be more familiar with the sequence of necessary steps involved in washing his hands. He as yet was unable to turn the faucet on or off but allowed this teacher to do so with him using hand-over-hand modeling techniques. He was a also a passive participant in hand-drying, but was excited to play with soap bubbles in the cold water. Again, Santino is responsive to sensory and tactile techniques, so these have been beneficial to sustain his attention to tasks. After hand-washing, Santino was engaged in picking up letters to a puzzle but did not identify the letters from an assortment upon request. We will continue to practice this skill in future sessions.

Santino was especially interactive today, making and sustaining eye contact for longer durations and following verbal accompanied by physical directives with greater successful outcomes. Additionally, he was more physically demonstrative and affectionate. This is often the case with Santino so it was met with enthusiasm, verbal reinforcement and physical reciprocation. Santino enjoyed spending time outdoors today very much and was animated and involved. He went on every piece of equipment and has become more confident and competent with increased exposure and usage. Today, for example, he went down the biggest slide, repeatedly, and followed this tutor's prompts to stand up just as he reached the bottom to avoid a bit of water that had pooled at the base. He also requested to go on the see-saw, via handholding and by leading this tutor to the equipment, and he was delighted when he was treated to several bumps, giggling and squealing in delight. Santino was afforded verbal directives and a physical prompt to show him how to hold onto the see-saw handlebar and he correctly followed the directives as the desired follow-up action was contingent upon compliance. At one point, other students came outside and became involved in a game of tag. Santino sat on the bridge and observed the kids playing, smiling and giggling at their antics and shrieks. One or two invited him to join, but Santino preferred to remain a passive participant. When we moved back indoors, Santino proceeded to the sink following 2 verbal and physical prompts. He observed this tutor dispense and apply soap and followed her instructions. With hand-over-hand assistance, Santino correctly washed his hands thoroughly. His mother had mentioned that Santino has recently developed a habit of putting his fingers in his mouth and today, this tutor did observe him playing with his lip. He was discouraged from doing so, but the hand-washing goal will be beneficial to both teach him more independent self-help skills as well as to minimize germs and catching colds. Santino concluded the session by using the letter and tracing cards used the other day. He independently chose to work on the letters 'B' and 'b' today, following the letters 'A' and 'a' on which he worked yesterday. Santino traced the letters correctly using his fingertip and was awarded a great deal of verbal praise for doing so. He also observed this tutor using a crayon to trace the letters. With hand-over-hand prompts, Santino used the blue crayon to trace both the upper and lower case letter 'B's. He also picked up the crayon of his own volition; he appeared more interested in holding it than in the past, and less resistant to receiving and following instruction. Today proved to be another productive session. Santino appeared comfortable, happy, cooperative and more bonded to this tutor. He continues to demonstrate academic and social competence gains and is a happy and sweet child with whom to work.

11-14-18
Santino was in usual good spirits today and was very active around the classroom during transition time, exploring toys and trying to remove a wall chart. As he seemed a bit ready to expend some physical energy, and in efforts to redirect him in more purposeful activity, this tutor accompanied Santino outdoors to the play area. Santino was excited to go outdoors and vocalized in an overtly happy, animated, and excited manner when we first entered the play arena. He is becoming more familiar with the equipment and increasingly confident of his skills and ability. Santino stood up going down one slide, and then proceeded to the next, where he examined the structure prior to going down it, laughing upon landing. He also enjoyed going up and down the rungs on the ladder and did so with greater confidence, speed, and dexterity. After a brief 10 - 15 minutes of physical activity, we went inside the facility where Santino was shown to the sink. He motioned towards the faucet, and when afforded hand-over-hand modelling and support, Santino used soap and washed his hands. However, when the towel was given to him, Santino made no effort to dry his hands with it – so this tutor assisted him, showing him how he needed to complete the task. Following this, we returned to the classroom where Santino was tasked with a letter identification goal. With prompting and support, he was asked to pick out the upper and lower case letters ‘A’/'a" from an assortment of peel and stick letters. Santino was happy to work with letters, but needed an initial prompt to demonstrate what was expected. He was shown a card on which the letter 'A' was shown with tracing guidelines on it. The same was shown for a card showing a lower case 'a.' With his finger, Santino traced the letters in the correct direction, and he also put a smaller lower-case letter on top of the card showing a lower case 'a'. This tutor afforded him a great deal of verbal praise and high fives for tracing the letters. He did so one other time after this tutor began the tracing motion with her finger. He appeared to understand what was expected and proceeded to trace the shape of the letters himself. Santino remained engaged in this activity for at least 20 minutes. He greatly enjoyed it when this tutor placed the letters in random spots on his face. He repeatedly touched them as if to gain information about the texture and placement of the letters from his tactile sensory modality. When another tutor passed by and took a video, another sensory component was added – that of sight. When shown a picture of how he looked, Santino giggled and laughed at himself, peering and observing his face from a variety of different angles, which afforded him an opportunity to gain different perspectives about his appearance. This card and letter activity was handed over to Santino's subsequent tutor so that the great positive reaction it elicited could be reinforced and gains consolidated. Today proved to be a most enjoyable, rewarding, and engaging one for Santino.

This tutor arrived at program the same time as Santino and his mother, so we walked in together. Santino was dressed in neat attire and was sporting a book-bag on his back. His mother, Kim, showed me two activity purchases she made - one was a book to facilitate reading and visual perceptual skills, and the other was a set with crayons with which to color different words such as alpaca, on cards. Santino was first shown where to place his book-bag in a cubby. This will be the procedure upon entering the classroom so that he may, in time and with repeated practice, place it in his cubby independently. Next, we got right down to opening the activity sets. While Santino showed initial interest, it was not sustained. This tutor attempted to assist him in tracing a line, beginning with holding a crayon and placing its point at the beginning of the line; however, Santino did not want to participate in this activity and vocalized his displeasure. We shifted attention to the coloring set and this tutor began demonstrating how to hold a crayon and color the card with the alpaca word and drawing on it. Again, Santino showed initial interest; however, it did not sufficiently engage him enough to sustain his attention to the task for longer than a few seconds. Instead, he became absorbed with magnetized alphabet blocks and exploring various different objects in the room, moving to the hay stack and pulling out several hay needles and examining them via different sensory modalities. He enjoyed strewing them about the room; however, this activity was redirected to a more purposeful academic identification exercise. Santino was shown 5 different colored crayons and asked to select the red crayon from the bunch. When he was observed looking at the color red and appeared to bring his hand towards it, this tutor afforded him a great deal of verbal reinforcement and encouragement - via clapping and high fives. He was able to verbalize the word 'orange' after this tutor showed it to him and said the color, which was met with a repeat of enthusiastic high fives, claps, and positive verbal praise. By affording Santino such affirmations when he approximates a desired verbal or motor response, it is hoped to facilitate his ability to discriminate, identify, and produce suprasegmental elements of speech. (Florida academic standard: SP.PK12.SA.1.1). We went outdoors after a bit more than an hour in the classroom, and Santino enjoyed running on the bridge and climbing up and down the equipment. When it began drizzling after about 10 minutes, we returned to the classroom where Santino enjoyed peeling off the backing to letters and sticking them on paper, objects in his immediate surroundings, and the table at which we were working. He remained engaged in this activity for about ten minutes and also enjoyed stacking boxes from largest to smallest, showing good awareness of size perception. As the time neared the end of the session, this tutor modeled a clean up task for Santino and prompted him to participate; however, Santino remained a passive participant in this activity and returned his attention to another box containing alphabet letters. This box accompanied him back into his classroom where his next tutor was waiting for him. He was invited him to see a new circular alphabet rug purchased for the classroom. Santino appeared interested in observing the letters on the rug, easily transitioned to this next activity, and remained in a compliant and jovial mood for the duration of the two hour session.

Santino was happily ordering alphabet blocks when this tutor arrived to greet him at the onset of today's session. He is responsive to structure and consistency of routine so it was helpful in terms of adjustment and expectations to have him continue the activity he began yesterday. It is interesting to note that Santino effectively uses tactile discrimination skills to interpret objects, symbols, obtaining a lot of information through different sensory modes. He will examine objects from all angles and use his different senses to process information about its properties and broaden his understanding of the world around him. Santino matched the letter on the blocks with another set of letters, placing one atop the other with precision and accuracy. Santino indicated he wished to go outside after the first hour in the classroom and enjoyed playing on the equipment that was accessible to him. He enjoyed running up and down the bridge and demonstrated a few attempts to mimic the tutor performing motor activities when prompted. Santino demonstrates good coordination and balance but chooses to do what he elects to rather than participate with others in organized activities. It was good for him to get a bit of a break today and he seemed to enjoy playing on the playground equipment with which he was familiar from his participation at Batt over the summer. Santino did not indicate he wished to eat or drink any of the options presented to him upon his return to the classroom, choosing instead to resume playing with his blocks. It should be noted that he did fine without the use of technology today as his mother took his tablet and phone with her when she left. He also no longer needs to carry around the security blanket on which he had been dependent over the summer, so gains in his overall performance and daily functioning are evidenced. Santino enjoyed singing songs as he arranged the blocks in correct sequence. He satisfactorily and seamlessly transitioned to his next teacher when the session was over.