Santino arrived happily, and without hesitation walked right through the waiting area and directly into the office. He scanned the room once again and reached for a familiar toy, and mid reach he verbally labeled the item, indicating the differential between a verbal request and a verbal comment. Santino utilized single noun labels and/or attribute (color ) + noun label across 3 activities with noted spontaneous use 16/ 24 opportunities, and following a model 5/24 opportunities and within a Binary choice 3/24 opportunities. Social referencing was more frequent although transient. Support to request assistance with use of the sentence form "help me + action" was successful given via cues and verbal models across 6 opportunities.
Given a personal choice question to indicate a desire or decline for an item offered, Santino utilized a head shake to indicate "no" 3/3 opportunities. Santino happily participated in all tasks presented, and at times began laughing out loud and smiling as he anticipated a repeated cycle of an activity.
45-50 minutes of session time was ideal. Session close was supported with familiar verbalization as we greeted Ingrid. He happily replied "bye" in response to my social salutation, and reached out to touch hands, smiling just moments after I shared " Thank you for coming today Santino, It was a fun time, and I will see you again on Wednesday."
Briefly shared positive aspects of session with Ingrid. Wonderful Session !

Thank you once again to Nicole as Christopher was needing support to be timely to the session as well as logging into the session. Christopher was excited to share so much this session, however we were unable to establish a strong internet connection. Elise assisted, and although an alternate location which allowed for a strong connection last visit was provided, the connection remained challenging. Elise subsequently shared that it appeared to be an issue on site. We closed the session shy of 9:00 due to the technological challenges.

Santino was seen today in the office as sessions now resume. Return to on campus school visits is anticipated. Santino entered the waiting area with slight trepidation, briefly engaged in social reference and then immediately initiated the transition into the office, as Ingrid and Mom returned to the car. He happily scanned the room, and within 1-2 minutes reached for a familiar toy and sat right down on the floor. As we engaged with the activity he imitated the verbal model provided, and subsequently completed carrier phrase leads 6/8x within the activity. Three varied tasks were subsequently presented this session. Verbal imitation was noted on a variable basis, while strong periods of delayed echolalia was noted. Santino periodically paused and scanned the room. Joining his attentional shift allowed for periods of social reference as comments were provided. Session was extremely successful as he appeared most comfortable with the lights off, with the natural sunlight coning in from the window, while 432hz music was playing in the background.
Goals to be reviewed and updated as necessary. Such a pleasure to see Santino today. Session duration 45 minutes as per mom's request to best support the transition.

Thank you to Nicole as she ensured that Chris was set and ready to connect virtually this morning via Theraplatform. Chris was eager to begin our time together as he happily shared his current interests, explaining that he is "more into Mario now" and "not so much into Sonic" as he had been.
As conversation progressed, extensive opportunities presented themselves to re visit familiar strategies to support Christopher in the area of reciprocity, topic expansion, sequencing, topic shifting and the awareness of attentional shifts and the role of a "talking partner" within conversation. Chris expanded on the aspects of attention and thinking as we discussed "thinking together, finishing thoughts and taking your talking partner with you as you "jump" to another thought. He shared that he "was so excited" as well as stating that he was "feeling obsessed" and wanting to talk only about Mario today and "tell you/me stuff." Approximately 45 minutes into the session he clearly needed a break from the screen, as he began rubbing his eyes and shared that he only wanted talk about Mario today. We subsequently re- visited the important aspects of movement activities within sessions, and will once again integrate and embed various movement techniques throughout sessions. Wonderful to see Chris today !!

The session was anticipated, however, communication with mom confirmed that Chris had completed his last week of school.

Santino was once again seated, and "ready" as the session commenced. Use of quiet time preparation continues to be beneficial, supporting modulation and readiness. Santino presented with a softer affect today, much quieter and a significant decrease in unmitigated echolalia was observed. He appeared a bit fatigued and responses to varied cues was inconsistent and a soft vocal volume was utilized following cue supports. Periods of hyperemotionality were noted once more this session. Ingrid was supportive during these instances. Session was shortened due to Santino needing period of respite.

Christopher happily initiated conversation with a primary focus of sharing thoughts regarding that school is coming to a close, and his anticipated transition to the Stuart house. He was again brimming with ideas as he wanted to share thoughts about his numerous plush toys. Strong emphasis was placed on conversational reciprocity and the aspects of allowance for speaker -listener turn taking. Conversation was supported though direct question today, as topic shifting and varied responses were noted. Scaffolding supports to allow for increased use of cohesive ties and "connector" words was facilitative. Narrative expansion with use of plush toy props was supported with the emphasis on natural dialogue vs. "tv" dialogue, and the review of varied vocabulary within tv dialogue use .

Mom had once again supported Santino with"quiet time" activities just prior to session commencement, supporting sensory modulation and Santino's overall readiness. He was happily seared in front of the screen as the session commenced. Strong periods of unmitigated echolalia were frequent and accompanied by waves of hyperemotionality. Mom remained present for the duration of time that Santino remained in front of the screen. He initially engaged and requested favorite items as they were presented, however, attention to the screen was fleeting and interactions were limited this session. Conversation with mom subsequently followed as Santino left the room. Mom shared that Santino continues to be enjoying time home, engaging in swimming and play.

Chris happily greeted, and initiated conversation across numerous topics. Supports to connect ideas within a single context were facilitative. Expansion on the familiar concepts of reciprocity, and conversational turn taking were highlighted. Familiar cues of "thinking together" were supportive throughout the session as many ideas flourished today. Use of his plush characters again served as props within narrative generation. Focus on cohesive links and expanded dialogue to include more novel/natural dialogue versus "tv" talk. Shift into "prop" rough and tumble necessitated use of supports for redirection.

Standing appointment time was confirmed as per usual. As session was to commence, mom shared that Santino had been awake since early this morning and was now sleeping soundly.