Richard was in a great mood and was happy to have our session back in person. We focussed on /s/ and /s/ blends while navigating the new tooth loss with his top front teeth. He realized that adjusting the airflow helps make a strong /s/ that is not "too noisy" with extra air escaping. Richard was very talkative and his stories were out of sequence and hard to follow. Using story telling picture cards, Richard told and retold stories in sequence. We discussed the importance of order and knowing what is 1st, middle and last.

Richard was greeted by SLP in the hallway. Richard appeared tired in today's session as he continued to yawn and hold his head in his hands on the table. When asked, Richard denied being tired. Richard produced /s/ at conversational level at ~75% accuracy. Richard stated it's "tricky" since losing his top front teeth. He produced /s/ blends at conversational level at ~80% accuracy independently, and the errors required minimal cues to correct. Through informal assessment, Richard has been observed to make errors with past tense/irregular past tense, possessive verbs, and reduced vocabulary, all of which were targeted today. He achieved irregular past tense with 50% accuracy. He appeared to enjoy the vocabulary tasks. Although Richard appeared tired, it was a good speech therapy session overall.

Santino happily and rapidly entered the office today, as it had been 2 weeks since the last visit due to online classes for the week of 11/2, followed by the storm closure on the 9th and subsequent cancellation on the 11th. Support for verbal initiation to indicate request was provided for the initial 20 minutes of the session. Additional requests were subsequently noted with increased independence and frequency. Strong periods of echolalia and vocalization were noted this session. Verbalizations were shaped and directed to activities in context with noted increases in social reference. Requests for assistance were noted following carrier phoneme cue repetition for each opportunity presented 4/6 times. Response to personal choice yes /no question forms was noted with question repetition as well, with head shake "no' response x4. RMT strategies supported cycles of social reference within gross motor ball tasks. 432 HZ continues to be utilized.

Chris eagerly entered the office once again. He quickly shared that he had slept with his new sun glasses on last night and wanted to continue wearing them today. This afforded the wonderful opportunity to once again discuss the aspects of "whole body listening," the use of gestures, facial expression, intonation and eye gaze within successful communication. We further expanded this topic with a modified "eye spy" activity focusing on referencing, as well as broader semantic concepts. Cross pattern movement tasks supported more novel topic expansion. Additional tasks focusing on meta- linguistic aspects of communication were introduced today. Aspects of self awareness will continue to be support and highlighted.

Richard was excited to connect for an online session. To get used to the virtual format, Richard was given a choice of different scenes to manipulate and describe. He chose a pirate ship scene and created a story using all the characters. Using some of the descriptive vocabulary he has been learning, Richard described all the pirates and their actions in great detail. He was eager to show how he learned to play UNO virtually. He used excellent sequencing skills in describing each step by step. Using BOOM articulation cards, Richard produced /s/ in the initial position with 50% accuracy. In just the last couple of weeks, Richard lost more teeth in the front. He is very conscientious and adjusting the air flow and positioning as necessary. Looking forward to seeing Richard back in person at school.

Richard was greeted by therapist. He was very happy in today's session. He told me he lost his other front tooth however has been aware of keeping his tongue back with his /s/ sounds, indicating improved awareness. /s/ and /s/ blends at sentence level (self generated) were targeted with 90% accuracy. It was then targeted at conversational level with ~90% accuracy. Minimal verbal cues were beneficial in producing /s/ accurately. The only other error noted was /th/ and it is not appropriate to target /th/ until /s/ is completely mastered due to lingual placement required would contradict /s/. Auditory comprehension was fantastic today. He was focused throughout the session. Have a great weekend.

Santino was expected to arrive at the office as per scheduled confirmation. Mom phoned as session was to commence and shared that he would not be in today.

Chris eagerly entered the office this morning, again arriving at 7:45. He was however, a bit distraught about having lost his sunglasses. Support and subsequent strategies to shift attention were successful. It is truly significant to note that since office visits have commenced, Chris continues to demonstrate strong intent to sustain engagement, paired with a strong integration and presence of facial expression, body language, and increased attentiveness to social cues and perspective of his "communication partner." Chris shared today, "Ms Lynne, I really like it here, I feel happy and we can do so many different games and think together." Responding to such a delightful thought, we highlighted the dynamics of a "calm body and brain," how that feels, and how that helps us with thinking and learning and feeling happy. Conversational expansion was strong today, with broader detail and more lengthy cycles of exchange. Chris was able to observe this as well, as his attentiveness and periods of more lengthy sustained engagement allowed for expanded discussion.
Strong session today.

The session commenced once again via teletherapy upon Christopher's arrival at school. He arrived a bit late due to traffic as per mom. Christopher initiated conversation by sharing thoughts about the morning's unfolding. The majority of session time was utilized to support him, provide supportive strategies to assist with self calming and consolation. As the session progressed, Christopher shared that he was "feeling a little better." Familiar activities were presented, allowing for periods of increased success while being supported with tasks of decreased linguistic challenge for the duration of the session.

Session commenced on line this morning, as per School guidelines following notification via email last evening. Christopher was eagerly awaiting our "connection" as he had "entered "the virtual waiting room early. Session commenced with movement based activities, patterns of movement sequences and cross pattern tasks. Attention throughout the session was strong, and acknowledgement of attentional shift was again supported, as Christopher continues to demonstrate awareness of his communication partners perspective, and the "best" strategies to utilize in order to allow for the most successful conversational exchanges. Christopher was eager to share varied items that he had not shared over the last weeks. Stronger use of affirmation to indicate acknowledgment of comment rather than rapid topic shift as focus on expansion of cycles of exchange with provision of broader detail ( attributes, use of early inferences ) are encouraged. Positive session today.