Chris had once again logged in and was "waiting" in the virtual waiting room by just prior to 7:30. He quickly intimated conversation by sharing that he was retuning to school tomorrow. He shared a great deal of "thoughts " regarding school and the scenarios that had played out from his perspective. Support was provided as he continued to share a great deal of information. Opportunity then allowed for expanded discussion into social dynamics and perspective. Chris preferred to share details with brief allowance for acknowledgement of his comments and then subsequent continuation. Rapid topic shifting followed as the session progressed. Movement based activities were guided and shaped in response to support attention and modulation. Familiar cross pattern sequences and " Brain Gym " techniques were presented, and Chris actively engaged for intermittent periods. He gravitated to his plush toys near the close of the session, and requesting to share "stories" and "episodes" that he'd created. The session closed with Chris creating new storylines.
Santino once again happily entered the office and responded to social greet with strong reference and verbal greet. Upon entrance, Santino positioned himself in front of the cabinet and requested "open closet door." He had a specific idea about the item he was hoping to retrieve. Spontaneous verbalizations followed in rapid succession for the duration of the activity. He spontaneously requested assistance via "help me" 6 times during the session. Expansion into increased sentence structure was once again supported to include size concepts and additional descriptors. Carrier phrase and phonemic cue were facilitative. Response to yes/no question forms was strong and consistent with notable response of head shake +verbal "no" at session close as Santino was told this is the last time, its time to clean up "! Strong session once again.
Chris was eagerly awaiting to begin the session as he was 'in the waiting room" at 7:20! Session commenced with strong conversational expansion into topics of interest. Reciprocity was supported with single question/comment and responded to with affirmation, and allowance for additional comment approximately 60 % of the time within a given topic. Opportunity to once more expand upon perspective taking, and topic shifting as scaffolds were provided supporting "thinking together' and strategies to "lead" to a new topic . Chris demonstrated strong use of cohesive ties within brief narrative sequences. Strong session today.
Richard was feeling better and back in school but the therapist was home so session was done virtually. Richard was happy to be back in school. He was feeling better and no longer had a cold impacting speech production. Using silly sentence cards, Richard practiced his articulation with /S/ and /S/ blends. While targeting some of the language goals of expanding vocabulary and descriptive language, Richard then added on another part to the story. He was distracted when he saw his peers heading outside for recess, so we finished one last activity with a strong effort and Ms. Elise was called to escort him outside for the last few minutes of recess.
11/30/2020 was an online session. Richard was feeling under the weather with congestion. He kept insisting that he was fine and wanted to do our work together. With the congestion, it was not ideal to work on articulation so lessons were focused on language and vocabulary. Using card games, Richard was motivated to tell stories and make them really silly. Focus was on sequencing and using describing words (adjectives). Richard was an enthusiastic participant. He benefitted from switching up activities every 10 minutes to keep it motivating and engaging.
Today was a great session for Richard. He was focused and motivated. We began the session with going over the December calendar (days of week, days of months, months, etc). Richard continues to demonstrate increased knowledge in this area. We also worked on a phonemic awareness task, in addition to fine motor/writing while writing a wish list for Christmas. During this task, we targeted /s/ and /s/ blends in conversation. Following this activity, we targeted possessive nouns as Richard tends to drop the "s" when using possessives. For example, he was talking about a game on his mother's phone and said "I play that on my mom phone". During the structured activity, he achieved 80% accuracy however it decreases during unstructured settings. To complete the session, we targeted all articulation including rate of speech and vocabulary enrichment during a craft. We made a snowman out of construction paper, scissors, tape, and markers. This provided many opportunities for /s/ and/ s/ blends. Richard's speech was ~90% intelligible, however required cues to slow rate of speech - which then improved all productions of phonemes being targeted during this session. Overall, it was a great session targeting articulation, vocabulary, word finding, grammar, fine motor tasks, social interactions, problem solving and rate of speech.l Well done, Richard, have a great weekend.
Richard was greeted in his classroom by SLP. He was happy upon arrival. First, we started with his December calendar activity (writing, days of week, month/year). This activity was followed up a vocabulary enrichment and grammar activity. Richard did quite well recalling words/vocabulary we have recently been targeting. There appeared to be some difficulty with word finding/retrieving however moderate verbal cues were effective with assisting him during this task. Articulation was targeted at sentence and conversational level. /s/ at final position was more difficult and less accurate. Cues to slow rate of speech were helpful with increasing intelligibility. /s/ at initial position in conversation was 90%, medial 85%, final 80%. He continues to demonstrate improvement. He is not demonstrating self awareness of errors without cues. During the auditory comprehension task today, Richard answered 7/12 questions correctly after being read a short 4-5 sentence passage. Overall, Richard had a great day in therapy.
Santino established reference with a smile as he hurriedly entered the office. Gentle redirection once again was provided to retrieve his backpack and say "bye" to Ingrid. He scanned the room quickly today and requested a familiar item that was not in his visual field. Cue to support Action regulation with Agent +Action sentence structure was successful x3 to chain the event in order to locate the preferred item. Subsequent spontaneous requests were frequent and embedded throughout the session. Santino consistently responded to personal choice yes/no question forms with use of verbal "yes' x8 and head shake "no x2. Request for assistance via use of "help me" paired with subtle reference was noted 6 times spontaneously following an initial opportunity when supported with a phonemic cue. Strong Session today ! Periods of social reference were noted throughout the session. 432 HZ continues to be utilized within each session.
Chris happily initiated conversation today as we once again connected online. Conversational exchange was contextually strong as the session commenced. Attention and intention to support a lengthy exchange and allow for increased cycles of reciprocity was noted this session. Opportunities to expand discussion regarding "whole body listening," the use of gestures, intonation, eye gaze and the awareness of your communication partners "perspective" were highlighted. Chris was subsequently eager to share "scripts"he's created for his many "you tube" ideas. Focus centered on content, linguistic organization, use of detail to support the "antics" and rough housing that were portrayed among the characters chosen. Direct question and subtle inquiry were utilized to assist with dialogue expansion as it related to clarity of intended story line.
Richard was greeted by SLP on time in the lobby. He reported to be happy, being back to school. Richard was slightly congested, yet in good spirits. The session began with discussing/working on the December calendar. We targeted days of the week, vocabulary enrichment, and completed a craft that also assisted with fine motor skills. We transitioned to the articulation portion of the therapy session with ease. Richard self generated sentences/few sentences of /s/ in all positions of the word in addition to /s/ blends (which tends to be more difficult for Richard). Richard's adult top two teeth are mostly grown in which helps with /s/ production in this case. He claims that /s/ is hard but he continues to show significant improvement despite the lapse in therapy. He produced /s/ at the sentence level with 90% accuracy, and conversational level at 75% accuracy. Intelligibility most definitely improves with cues to slow rate of speech. We continue to work on self monitoring rate of speech. Overall, Richard was focused and cooperative during today's speech therapy session. Well done, Richard.
