Excellent session. Richard was excited for Halloween and talking very quickly about all the fun things planned. Worked on slowing down pace of speech, as Richard tends to drop sounds when he is speaking quickly in connected speech. Using the same silly Halloween prompts, practiced pace of speech telling silly Halloween stories. With verbal cues reminded him to slow down, Richard improved speech errors tremendously in connected speech. Moving on to a rematch of UNO, Richard used the slower pace while practicing /S/ sounds and demonstrated an increase in accuracy from the previous session (70% accuracy). Richard played fair during UNO and was looking forward to recess with his friends so he could play fair with them. Richard is very bright and makes great connections of previous sessions and previous conversations. He is motivated by the positive peer interaction and enjoys the feedback especially from the older kids including him in the game. He said "it's because he plays by the rules." Proud of this kid!

Christopher was in a great mood and excited to be with his friends at lunch. They started the time together playing a game of Among Us on the phone. Although the kids were using technology, the game called for a lot of interaction and sharing information. They were trying to figure out who the "Imposter" was so they were problem solving out loud in a collaborative way. Christopher shared that even though he likes to figure it out by himself, the group playing today "is working together" so that makes it more fun. A student who is not always so inclusive with Christopher was absent so he was more at ease with the group setting. They all took turns and were considerate if each other's comments and observations during the game. Commenting was competitive but expected without any "mean" comments as Christopher said. The group moved outside to play their favorite game of "Groundies." Some of the younger kids were unsure of the rules so Christopher was patient helping them understand what was happening. In the pow-wow after outdoor recess, Christopher disclosed that today was so much fun without the other kid. It was an opportunity to discuss "group dynamics" and how that changes at times. Connections one on one can be different when others are in the mix. Christopher was getting upset about that and personalizing the fact that group dynamics change. Problem solving included: take a break to observe the group and figure out a way to participate, discussed ways to enter into a group already in play, talk privately to the person about your feelings, ways to compromise in group scenarios, ways to share ideas and problem solve as a group. Christopher also shared that he is not sleeping well. Discussed some ways to unwind before bed: think about happy/positive thoughts (best part of the day, favorite vacation), listen to music, take some deep breaths and use positive self talk. "My brain and body worked hard at school today. It is time to relax and rest. I will get a good night's sleep to help recharge my body and brain for tomorrow."

Richard was in a great mood and excited to talk about his Halloween costume. While practicing /S/ sounds (60% accuracy with verbal and visual prompts), Richard also demonstrated his describing skills and told silly Halloween stories using pictures. While playing UNO, Richard switched out a couple of cards to get "better cards." We discussed playing fair and how it makes people feel when we don't follow the rules and play fair. It was a productive session with a long game of UNO that just wouldn't end. It was a good example of why cheating/sneaky play is not necessary because the leader changes so often. If one focuses on enjoying the game and learning new honest/fair strategies, things end up working out and being more fun for everyone. If everyone has fun, then friends will want to play with you again. This lesson was carried over nicely into recess while SLP was working with another student, Richard and 5 peers played a game. Richard did not like when someone was playing unfair.

Richard was greeted by SLP at entrance. He was happy upon arrival. We started the session with a conversational task targeting /s/, /z/ and /s/ blends. Richard achieved 90% accuracy when answering and asking questions. When telling stories and rate of speech became more rapid, Richard was noted to make more errors. With verbal cues, his speech intelligibility improved. Speech intelligibility is judged to be ~90% (significant improvement). Between structured tasks we did books to target auditory comprehension and Play-doh to target /s/ blends. /s/ blends appear to be the most difficult for Richard at this time. Richard created self generated sentences with /s/ blends and independently produced them at 85% accuracy. Social interactions/pragmatics were appropriate today.

Santino continues to happily and eagerly enter the office. Natural comment "psst.... Santino, you forgot your backpack" facilitated his retrieving his bag from Ingrid and initiating "bye." Santino rapidly reached for a desired item on the table while simultaneously providing a noun label, indicating a request. Additional requests for desired items was noted across 6 tasks. Requests within activities were noted with 36/40 opportunities, and with a carrier cue four times, characterized by use of single noun label, attribute +label and use of increased form "I want +label."( 22/40, 12/40, 6/40 respectively). Santino regulated action via use of action + object/adverb(down/up following carrier phrase twice and in response to context anticipation 4 additional times. Santino responded "yes" in response to the use of enticement to repeat an activity with phonemic cue twice and independently three times this session. Presentation of 4 unfamiliar items provided the opportunity to encode "what's that?" following carrier phrase presentation. Periods of delayed echolalia were observed with increased frequency this session as well, leading to periods of decreased response question/comment etc. Moments of sharing "Santino, I see that you are thinking about Super Why today," / " Santino, your remembering the song about ....." "and I'd like it if we could think together and you would answer" facilitated a strong social reference and subsequent verbal response 6 times this session. 432 Hz continues to be utilized each session. Session performance continues to be strong.

Christopher arrived for his session once again at 7:45, eager and happy to begin. I had shared with Jamie on Monday, as they had arrived 15 minutes early as well, that I'm able to accommodate the 15 minute early arrival as I typically arrive at just past 7AM each morning. This window of flexibility will assist with their morning drop off routine. Christopher was eager to share a video that he had made, as he narrated a listing of all of the "plush" toys in his room. We reviewed the video together as it progressed through, highlighting the wonderful aspects of categorization, description and strong linear cohesiveness that "connected" each transition to a new "group/category" and "brought his listener with him'" as he narrated. As session activities progressed today, Christopher continued to maintain a strong integration and presence of facial expression, body language, attention and intentionality once again. Encouragement to share verbally when attention to task begins to shift remains a strong focus. Enabling Christopher to self reflect, share with family and teachers when his attention shifts in a positive constructive way, allows stronger communication of intentionality, and opportunities for facilitating the shaping of task transition and closure in more proactive and constructive ways. Wonderful opportunity to share with mom success across goal targets and strategies for success in school. Cross pattern movement continues to be embedded across language activities. Strong session!

Today's session was great! Richard was very happy, focused and involved in all tasks. Richard and SLP discussed weekend activities which also targeted /s/ in conversation. He continues to require minimal verbal cues to produce the correct production of /s/ and /z/ however he also continues to be producing /s/ and /z/ at ~75% accuracy independently at the conversational level. Following the unstructured task, we read a book together about "The Biggest Pumpkin" to target /s/ blends in conversation at all positions of the word in addition to auditory comprehension. Richard loved this activity! He answered questions regarding the story with 80% accuracy. He produced /s/ blends with ~70% accuracy during this task. We targeted /s/ blends at sentence level with Richard generating his own sentences. He achieved 90% accuracy! Way to go! Richard's speech intelligibility continues to improve significantly!

Santino entered the office so rapidly and excitedly that natural comments to retrieve his backpack from Ingrid required repetition this morning. Santino quickly requested desired item within his visual field. Subsequent requests across 4 additional activities was noted all via single noun label.
Requests within the activities were noted with 28/30 with use of attribute +object form including varied shapes (octagon, parallelogram etc.). Two noun labels which appeared unfamiliar provided opportunity to introduce use of "what " question form to ascertain the label for an unfamiliar item.
Response to yes/no personal choice questions was facilitated strongly through use of enticement and intention to repeat a familiar activity with noted "yes" via verbal x6 opportunities. Familiar RMT techniques( backsliding, lateral rocking) were revisited today, with noted increase in periods of social reference following.
432 Hz music continues to be utilized. Carrier phrase response at session close was strong ( we are.... "all done," It's time to ... "go get Ingrid," we need to ...... "open the door" ).
Strong session once again.

Christopher was seen in the office today for the first time as per his request. Nicole had shared on Friday via telephone that she had spoken to Jamie, as Christopher had inquired about working at the office rather than at school via teletherapy. Jamie had followed up with the inquiry and confirmed to have services commence at the office beginning today, until the time deemed appropriate to resume face to face at school. Christopher was so incredibly happy and excited as he arrived at the office. It was so wonderful to see such genuine happy affect and sincere sense of calm and happiness exude from him throughout the session. Facial expression, body language, attention and intention were strongly integrated this morning. Conversational reciprocity was strong today, as Chris even shared " I remembered to "think together" today Ms. Lynne." Twice during the session he clearly was eager to share and interject a rapid topic change, and although the attentional shift was evident, he remained in his "listener role" without sudden shift and interjection. Strong acknowledgement was shared, in conjunction with validation of his intent to suddenly shift, and the success he demonstrated with reading the cues, and allowing for the more appropriate timing to shift, relying on awareness of pause and partner's perspective. Lots of exploration of the various materials, toys etc. that he had not seen, as expansion into the familiar language concepts was presented across activities of his choice. Such a strong session today !

Richard was greeted at the front with his father. He was happy upon arrival. He was approximately 10 minutes late. Initially, /s/ blends were targeted in a structured setting at the phrase level. He achieved 75% accuracy, requiring verbal cues 25%. /st/ and /sk/ appeared to be more difficult. We followed the structured task with an unstructured task targeting /s/ blends. SLP and Richard made snakes with play doh. During the task, we targeted "snake", "slither", "sly", "slimy", "snake skin", "scary", "spooky". He did quite well with this task. Following /s/ blend task, /z/ was targeted at sentence level with 90% accuracy! Richard produced /s/ in all positions at conversational level with ~75% accuracy. Well done, Richard! Have a great weekend.