Santino once again entered the office smiling happily, responded to social greet and to Ingrid's salutation. Santino once again requested a desired item not within his visual field. Additional requests for desired items within tasks themselves and to request a change of task continues to increase in frequency and expanded sentence form. Regulation of action events continue to increase as well via use of "action + object" sentence forms. Spontaneous requests for assistance were noted today within 6 opportunities via "help me"x4 and "help me +action " x2. Use of the form "where is ...?" continues to be facilitated within sabotage tasks3-4x/session. 432 hz music continues to be utilized. Strong session once again.

Richard was greeted at the front when he was dropped off, and we walked back to his room together talking about his evening. He does not recall recent events often without cues. We targeted orientation tasks in the beginning of the session - watching a video on months of the year/holidays (sing along) which Richard really enjoyed! We targeted /s/ blends, while using stories/descriptions of each word provided. RIchard did relatively well with this task, however speech intelligibility decreased with excitement. Richard was prompted to slow his rate of speech approximately 10x this session. He stated "my dad tells me to slow down too", therefore his awareness appears to be carrying over. He dropped /s/ in the final position of words with plurals/possessives only (ie. it's my mom bike, dropping 's on mom). A model is provided, and Richard will produce the word correctly. Vocabulary enrichment activity concluded the session with a book read aloud, followed by auditory processing tasks/answering "wh" questions.

After the break, we took a look at Richard's articulation inventory. He still has difficulty with s blends at work and sentence level, and s at the sentence and conversation level. Although he has shown great gains, he still speaks quickly at times and drops sounds and syllables in multisyllabic words. It should be noted that these errors are inconsistent which shows improvement in hitting the target sound more frequently. During the recess, we went outside so Richard could socialize with his peers. He benefits from guidance on interacting and problem solving with the group. The group can sometimes be rigid with choice of games. To empower Richard with problem solving skills, we brainstormed some new fun outdoor activities to introduce to the group.

Chistopher was online and waiting for our session time to begin as the clock read 7:30. He was eager to talk, although he clearly was not feeling well. He shared how difficult and upsetting it was to take the test for the illness. He quickly shifted topics and allowance for increased conversational reciprocity was stronger today. Comment/comment cycles were noted with increased frequency of 2-3 exchanges and increased use of cohesive ties within topic shifts. Familiar strategies were utilized to support the use of ongoing linear sequential linking. As the session neared the 45-50 minute mark his cough began to irritate him and attention subsequently drifted, as his overall affect appeared fatigued. We closed the session at 50 minutes. Hope he's feeling better soon.

Today was a good day! Richard was focused and appeared well rested. He arrived to school at 8:40am. We started the session with orientation tasks including date, month, and he brought up his name which we discussed his "full name" as he could not recall his last name correctly as he was inconsistently substituting letters/sounds. SLP explained to him the importance of knowing his full name for safety purposes. With cues, he was able to name the month, day and year. Following that tasks, Richard chose to complete a game that targeted asking/answering questions, word finding tasks, vocabulary enrichment, and social skills. Throughout the activity, "Headbands Jr.", Richard did well asking and answering questions to figure out the character on his headband. He often required cues to ask sequential questions about the character. We also worked on speech intelligibility in connected speech during this tasks. As stated before, Richard continues to require cues to slow his rate of speech & over articulate his sounds. /th/ errors are still consistent however is age appropriate at this time. /s/ blends in conversation was targeted during a book activity, which Richard enjoyed and was very involved with asking and answering questions about the book about winter (which goes along with seasons/holidays we have been targeting in recent sessions). Overall, Richard did well this session. SLP will continue to target overall speech and language skills that appear to fall below average via continuous informal assessment. Well done, Richard!

Santino happily responded to social greet and initiated transition into the office following spontaneous verbal "bye" paired with reference to Ingrid. Santino once again spontaneously requested a desired item not within his visual field. Spontaneous requests via use of single noun/ attribute + noun continue to increase in frequency throughout each session. Requests for assistance (help me) continue to increase following use of single initial phonemic cue within context. Use of expanded sentence form to include attribute+ noun +locative phrase is noted within tasks following carrier phrase and phonemic cue. Use of the form "where is ...?" continues to be facilitated within sabotage activities 3-4 x per session. Introduction of use of
"what" question forms for the purpose of obtaining a label for an unfamiliar noun continues to emerge within cue contexts. Social reference within communication exchanges remains variable, however, intentionality has notably increased. 432 Hz continues to be utilized. Strong session once again .

Chris participated in our session virtually this morning. Mom shared last evening that both Chris and his younger brother were not feeling well, and would be home for 2 weeks under quarantine to be in accordance with protocol. Chris initiated conversation by sharing that his throat was really hurting today and that he "did not feel good." Although not feeling well, Chris was eager to share some of the Christmas gifts that he had received. Opportunity to expand into comparisons and contrasts of the various "plush " characters was utilized. Conversational reciprocity was supported this session with familiar cues and prompts. Attentional focus weaned as the session progressed and although Chris acknowledged his focus shifting, his stamina was not at its usual place. We closed the session at 50 minutes, to allow Chris to finish his breakfast that he had with him as we were together.

Richard was greeted in his room by SLP. Richard appeared tired throughout today's session as he was frequently yawning, rubbing his eyes, and resting his head on the table. At approximately 30 minutes into the session, we went outside to "wake our bodies up". We did a race around the play ground and completed some speech/articulation tasks using descriptors of the scene, which he enjoyed. After coming inside, Richard appeared to be more focused and less tired. We followed our daily routine of going over our month calendar & days of the week. Richard continues to demonstrate increased understanding in this area. We targeted intelligibility in connected speech, which was certainly affected while feeling tired. HIs speech was considered to be more "muffled" and "slurred" in the beginning of the session however improved with cues & waking his body up. Final consonant /s/ appeared to be the biggest error noted, he was omitting many /s/ sounds, requiring cues. We also completed possessive verbs at structured tasks in addition to unstructured tasks. Language enrichment activities were provided and completed throughout the session. I have spoken to Ms. Andrea (Richard's other SLP) and we have collaborated on progress and future goals as Richard continues to improve in the area of speech and language.

Richard was greeted in the lobby on time. He was happy today. First, we started by conversing about our day yesterday, requiring some cues to assist with sequencing tasks. He was trying to explain a game to me that he and other classmates play on the play ground however had difficulty expressing his thoughts. He left out important information, therefore we targeted sequencing tasks with verbal cues which appeared to help. We will continue to target this in therapy. In addition, we worked on simple date concepts - days of the week and months of the year. While doing these activities, we targeted speech intelligibility in connected speech. As stated many times before, Richard's articulation at the word, phrase and sentence level has significantly improved however continues to require assistance at the connected speech level. Over articulation and decreasing rate of speech significantly improves his articulation. We read a book together followed by answering "wh" questions based on auditory comprehension, targeted vocabulary enhancement, and using possessives. There were a lot of goals targeted today and Richard did very well. I will see him tomorrow.

Santino happily entered the offie, quickly reaching upward to direct attention to the top of the cabinet and requested desired activity. Spontaneous verbalization to request desired items was noted throughout session. Expansion of utterance length continues to include attribute +object.
Social reference was strong today, as cycles of interaction and joint play was increased. Response to rising intonational inflection within phonemic cue presentation to encode target vocabulary within tasks of joint/collaborative play was significant this session. Use of "where is... ?" to locate items not within visual field was noted 4x given initial model. 432Hz continues to be utilized. Strong session today.