Santino continues to happily enter the office, respond to social greet and Ingrid's salutation. Santino visually scanned the office clearly searching for a specific item. He then requested "Open closet door please" to search inside. He happily commented "rainbow colors" as he reached for the activity. Requests via single noun label predominated for the duration of the session, with noted strong periods of scripting and singing this session. Requests for assistance continue to increase within appropriate context via "help me" x3 and "help me +action " x5. Use of the form
"where is ...? " continues to be facilitated within sabotage tasks 3-4 times per session. 432 hz continues to be utilized with noted spontaneous request "music on" today as we entered the office. Strong session.

Marcel was a pleasure to meet and work with. During our initial conversation, we discovered that we had a lot in common, especially our love of the game of tennis. Tennis and sports provide a lot of good metaphors for improving our speech. As explained to Marcel, just as we breakdown a forehand step by step when we are learning how to play tennis, we need to break down the movement of our challenging sounds. L and R in various positions are difficult for Marcel in connected speech. In just the first lesson, Marcel was able to adjust position and produce the target R sounds. During the assessment, we broke down all the different kinds of R's (ar, or, er, ir, air, ire, our) and how subtle tongue positions and lip position shape the sounds. We also discussed the foundations of clear speech which include our posture, our breathing, pace of speech, articulation/coarticulation, and how we project our voice. Marcel is a bright, mature, and motivated young man. Through weekly speech therapy and practice (like he does on the tennis court), Marcel should be able to master and produce the target sounds. 2 sessions per week for 30 minutes are recommended.

Richard was so excited to jump back to outside time for the obstacle course. It was a huge success and he said he showed his friends. Teachers also reported back that it was a great activity for the kids to work collaboratively. Before heading outside, we targeted speech practice with the bingo app and Richard got his highest score yet of 75% accuracy independently. Once outside, Richard was excited to show how he expanded our sidewalk chalk obstacle course and where friends added other "levels." They demonstrated great imagination and creativity designing the sidewalk chalk obstacle course on the playground to have "levels" like a video game. Richard enjoys social encounters to exchange ideas, work as a group, problem solve, and connect with others.

Richard was excited to play some new games while practicing his /s/ and /s/ blend sounds. Using an iPad app, Richard was able to produce sounds in sentences while working on descriptive vocabulary. He found the silly sentences to be very funny and it maintained his attention for a couple rounds of practice. It was a beautiful day so we headed outside to create an obstacle course while working on our vocabulary and executive functioning skills required to plan such an activity. We also practiced how to present it to his peers during recess. The kids have struggled to find appropriate games during recess that are fun, engaging, motivating, and don't result in conflict. Richard was excited to show his friends a "non-tag" kind of game.

Chris happily initiated conversation by eagerly sharing the new comic book that he had spoken about during our last visit. Conversation was well paced with increased allowance for comment interjection. Topic shift was noted frequently, and supported with scaffolds and familiar facultative tools to sustain instances of "thinking together." Expanded use of comment/comment cycles across varied topics this session was noted with increased use of cohesive ties. Topic shift into the "situation at school" was noted near the session close.Strategies focusing on positive aspects were highlighted, and successful at redirecting his observable concerns.
Brief sharing with Dad that the session was positive.

Santino continues to happily enter the office and respond to social greet. He had clear intention of what he was looking to engage with as he arrived. He proceeded immediately to the closet reached to the door and stated "Ms. Lynne open closet door." The verbalization was rapid and soft in volume, however strong and clear. Additional requests via use of noun label/attribute +noun label continue to be noted throughout the session consistently. Increased response to Yes/No personal choice continues to increase with verbal "yes" responses noted with decreased need to repeat the stimulus question. Continued use of the "where Is...?" question form within contextual sabotage given phonemic cues is noted. Use of " What" question forms to ascertain the name of an unfamiliar item is noted following initial model, and subsequent use of carrier and phonemic cue. Spontaneous requests for assistance continue to be noted with use of "help me" and expanded form "help me+action" given phonemic cue. 432 music continues to be utilized. Shared session success with Ingrid as is routine. Strong session once again.

Chris was seen in the office today, as Mom messaged early that they were en route. Chris was eager to begin the session today as he had new "things" to share. He proudly shared the comic book that he had written. Review of each component of the sequence of events with the "story" was a strong focus. Expansion into aspects of character traits/ name choices and support to link the events within the sequence was also a focus. Further discussion allowing for increased reciprocity focused on his skateboard. He has detailed his skateboard with sayings, pictures etc. This afforded an excellent opportunity to facilitate comment /comment exchange. An additional topic for conversation today was his new mini video projector. Strong attentional focus and regard for conversation expansion today. Great session !

Richard arrived around 8:40 today. He was happy upon arrival. We started the session with a recall task - which appeared difficult to him. He was asked to explain in detail 3 fun things he did this past weekend. He began to explain that him and his mother went to the science museum followed by "but I don't know who won, it was a long time ago" , given no other context. He required maximal cues to explain with appropriate sequencing what he was referring to. Unfortunately, I'm still not entirely sure what he was referring to however he did explain that he had gone to the science museum previously and there was a contest. He was not able to elaborate on what kind of contest or when that was. He also required cues to talk about the sequence of his gold tournament. Moderate verbal cues were provided to slow speech and over articulate in efforts for his connected speech to be more intelligible. In addition, orientation was covered in today's session (name, date, year, etc.). /s/ was dropped at the final position in many words during conversational tasks - especially with plurals and possessives. During a social activity, Richard presented with improved situational awareness. Great work today, Richard.

As per Andrea, allowance for a session was noted, although it was a school holiday. Scheduled appointments were slotted in office today. Santino happily entered the office as he typically does following natural salutation with Ingrid. He quickly reached for what he thought was a preferred item only to realize that although it was similar, was not the item he was intending it to be. He
then requested the desired item via use of attribute +noun label. Opportunity to expand sentence form to encode where question form given phonemic cues was successful. Continued use of noun label/attribute +noun label to request desired items is noted throughout session across activities. Support with phonemic cues as needed. Spontaneous requests for assistance via use of expanded form "help me+action" was noted across 8 opportunities today. Spontaneous request for "music" was noted today as the 432 hz music had not yet been started. Such a strong session!

Richard was greeted in his room. He used the restroom for the first 10 minutes of the session. Richard appeared well rested and focused during today's session. After going over the orientation task (date/month/year), Richard requested to start the session with a "Llama Llama" book, which is the series we have been working on the last two weeks. Following the book being read aloud, Richard answered simple "wh" questions about what was read to him which he answered with 80% accuracy. In addition to auditory comprehension, Richard demonstrated difficulty with awareness of appropriate rate of speech, requiring moderate cues. We discussed topic maintenance and initiation as Richard has a tendency to frequently start conversation with "except" (i.e. "except I have this book at home"). Both /s/ and /s/ blends in all positions were targeted in connected speech. We went back to discussing placement of tongue and where the air should be escaping and there were a few instances of lateral /s/ noted (air escaping the side of his mouth, rather than the front). /s/ at the final position of words is continuing to be dropped in situations where possessives and plurals are used.