Santino arrived a bit teary eyed, however, upon establishing social reference and responding to social greet, he smiled and rapidly entered the room, clearly seeking a preferred item. He continues to request desired items throughout the session, both to request a change in activity as well as to repeat and/or acquire specific items needed in order to complete an activity. Spontaneous use of where question form "where is ...?" is now noted with increased frequency in order to acquire an item that is not within his visual field. Cues provided as needed. Periods of joint engagement and social reference were strong today, with sustained eye gaze within vocal overlap during singing activities. Strong session.
Chris arrived today presenting with a rather somber affect. He was eager however, to participate in the tasks provided. He rather quickly shifted into a more positive affect as conversation and participation in activities progressed. Conversational expansion was strong today with increased cycles of reciprocity and topic maintenance with use of increased comment /comment exchanges was noted. Enthusiasm to venture into more unfamiliar tasks with inherent increased linguistic load embedded within movement/balance board patterning sequences was strong as well. Increased aspects of sustained attention though task completion was noted this session. Strong session.
Richard was greeted in the lobby. He walked to his room very slowly, requiring verbal cues to keep walking forward. SLP initiated the session with enthusiasm as usual however Richard was sluggish in the beginning of the session. With time, he warmed up. Since last week, I have noticed a difference in attention and impulsivity. Told he was asked 5x to please set the object in his hand on the table. After completing the orientation/date task, he was given the choice of a book or /s/ sounds. He chose to do a book activity. During the book activity, he interrupted 4 times (which he does not usually do). He did well answering questions regarding what was read aloud. He did well with inferencing, sequencing, and understanding more prediction/abstract concepts. Speech intelligibility was fair today. RIchard's speech was "muffled" at times, requiring cues to reduce rate. He often did not respond to those cues and continued to speak at a rapid/muffled rate. However, his /s/ in conversation was great. He made 3 errors in the entire session, which is significant progress. At the end of session, we targeted social skills - responding to scenerios with peers, turn taking, feeling and emotions. Overall, Richard required more cues to remain on agenda/task at hand but still was considered productive.
During the initial session with Jonathan, articulation was assessed to see which sounds we needed to focus on in therapy. Jonathan presents with a moderate lisp affecting his /s/ and some /s/ blends. He has self awareness of that sound sometimes being challenging and he said he is trying to make it better. With his love of snakes(he showed a recent picture with a snake) and animals, we used the analogy of keeping his snake"tongue" behind the cage "teeth" to produce a smooth strong /s/ sound. We also reviewed that a strong skinny stream of air needs to move forward, not escape out the side of the mouth. That is what contributes to a noisy /s/ sound. He was a star student and demonstrated understanding and immediate improvement when he produced the /s/ sound with correct positioning, using a mirror, visual and verbal cues.
Richard was still home due to allergies so virtual session was done online from the Batt school. He was happy to be in session and said he wished we were together in person. To make it fun, we loaded an online library of fun books to read and discuss while focussing on our /s/ blends and target language goals of vocabulary and story sequencing and retelling. We chose a fun story about a snowball that grew and caused problems for a group of animals. It was a great read with lessons of cause and effect and consequences. Richard was really engaged and answered all problem solving questions with creative and thoughtful answers. He had strategies for each animal and how they could have made better choices and not had all the problems.
Marcel is motivated to improve his sounds. To keep it fun and motivating, we've been using text from books he is reading or song lyrics from entertaining songs. Using song lyrics, Marcel was able to slow his pace of speech, pause to get his tongue in position for all R sounds in all positions with 50% accuracy. That is actually a huge accomplishment for being new to speech therapy. He has great self awareness and is already self correcting when he does not produce a strong R. Marcel has created a list of challenging words and asked that we prioritize that list rather than breaking our practice into focussed sounds. He is responding well to this approach. For motivation, videos of the poet Amanda Gorman were shared of her two years ago (while still in speech therapy) to present day when she performed at the presidential inauguration.
Christopher was in a great mood. He did not have concerns about others not being kind to him so he was more relaxed being in a group situation at lunch. However, he was frustrated that he could not restart his computer and had forgotten his password. He had a hard time slowing down to problem solve and instead of pausing, he continued to enter the wrong password which set his computer into lockdown mode. He finally agreed to some of the problem solving suggestions of asking his sister for help with the password. She figured it out and he was relieved to have a working computer. Once outside for recess, he was too tired from the computer situation to run around and play. During our "pow wow," he admitted to getting himself too worked up and it just wasn't necessary. We reflected on how pausing and using our problem solving skills helps us from having big reactions, which often make it difficult to stay calm and find a resolution. He agreed and said, "I get it now."
Richard was greeted in his room happily. He was on time and excited to share his Valentines with teachers and students. Richard was in a great mood all session, with excitement to participate. We began the session with date/orientation followed by a Valentine's Day craft which targeted cutting, writing, /s/ in conversation, rate of speech, and following directives. Richard enjoyed this activity. While choosing a book, Richard wanted to read about Christmas therefore - today, we did an auditory reading task about Christmas. Richard stated he "loved" the book. He sure does enjoy reading!! We targeted possessives in structured and unstructured tasks, which appears to be more difficult. Upon speaking to his reading/writing teacher, she stated they are working on blends - I will continue to target phonemic and phonological awareness with these sounds. Richard did very well today! Rate of speech was improved.
Richard was seen on time, greeted in the lobby. He was happy upon arrival. We began the session with orientation/date/days of week. He did well with this today. We spoke about working on /s/ in structured task today and he was very willing. We did /s/ and /s/ blends in structured task (self generate sentences) and during conversational level. Verbal cues were utilized more during conversational tasks. /s/ accuracy during sentence was 90%, and conversation was at 80%. Rate of speech required verbal and visual faded cues. He continues to demonstrate difficulty with self monitoring of appropriate rate of speech however does respond well to prompting. We also targeted possessives in structured tasks, achieving 4/6 correctly (independently). Lastly, we read a book aloud about Valentine's Day at school. Richard answered simple "wh" questions with 100% accuracy. Well done!
Santino happily entered the office following social reference and response to social greet. He rapidly scanned the room for items of interest and reached for a desired item while simultaneously verbalizing via noun label. He responded 'yes" to "should we put our music on?" He did not respond to the familiar question "Should we leave the light turned on, or turn it off today?? ( He typically prefers the light off, allowing for the natural sunlight to illuminate the room). Repetition of the question was not facilitative as he was actively engaged with exploring the task he had acquired. Opting to leave the light on, and joining him on the floor, he quickly initiated " Light off" paired with social reference. Use of 'where is....?" to locate needed /desired items within sabotage framework continues to increase in frequency. Requests for desired items continues to be consistent throughout the session. Strong session and increased periods of social reference.
