Santino established brief reference upon social greet. Support to enter the numeric code on the keypad for entry was presented in a fading cue hierarchy to facilitate independence. Presentation of pictured activity options facilitated immediate requesting via picture placement and subsequent verbalization of desired items upon entry into Santino's room. Subsequent verbal requests within the established activity were facilitated via phonemic cue with decreased need for picture manipulation 7/8 trials ( I want+color+shape). Additional activities focused on action regulation with support to encode Agent+Action, Action + object (+preposition). Initial models paired with sentence strip use x3 , followed by phonemic cues only, facilitated verbalization to indicate intent
7/8, 6/8, 7/8 opportunities across 3 tasks. Use of "Help me" sentence form was strongly encouraged via use of picture point paired with gesture for 3 initial presentations and subsequently with phonemic cues across 9 additional opportunities to request assistance. Use of "help me" allows for further sentence expansion (help me + verb form ) rather than encouraging use of the structure "I want help," which limits sentence expansion. Santino was happily engaged for the majority of the session today and responded well to all activities presented. Use of "all done+task name" continues to be facilitated as decreased interest and /or attention indicate the need for
activity transition.

Santino was seen for session 6 of 6 in Term 3 with this SLP and transitioned calmly between sessions. The daily, visual schedule was referenced and reviewed...Goals for the session remained consistent and included the following...1. to engage in forming a relationship with Santino that includes regulation, and shared attention and interest 2. to enter into two-way, purposeful interactions with gestures and intentional communication 3. to determine highly motivating/favorable, cause and effect activities, so that Santino may develop a feeling of control and predict/anticipate what will happen next 4. to imitate predictable action sequences and communication patterns through cause and effect activities. 5. to develop single-word requesting via eye gaze, picture exchange and/or verbalization...Consideration has been given to expand upon Goal 5 to include modifier + object/action in the phrase "I want..." via picture exchange and/or verbalization...Santino was directed to an array of 4 planned activities. He referenced the photos, selected one, then requested a novel activity via verbalization paired with photo exchange, "I want opposites!". The "Opposites Puzzle Pairs" activity was presented and the sequence was established...Santino assembled each 2-piece puzzle and verbalized the following upon presentation: "On/Off, Above/Below, Low/High, Up/Down, Left/Right, Inside/Outside, Open/Closed, Long/Short, Front/Back, Empty/Full, Exit/Enter, Hot/Cold, Wet/Dry, Sunny/Cloudy, Night/Day, Small/Big, Fat/Thin, Light/Heavy, Quiet/Loud, Fast/Slow, Stop/Go, Asleep/Awake, Happy/Sad...After appropriate wait-time, verbal prompts and redirection to the communication book, Santino neither indicated a desire to complete the activity a second time nor chose another activity. The "Do-A Dot" markers were selected and presented by this SLP. Santino participated independently, minimally, over the 15-minute segment. He responded to verbal prompts/requests from this SLP to, "Help Me/Miss Sharon" and provided hand-over-hand assistance to create the color patterns. Verbal prompts paired with redirection to communication photos for activity selection (i.e. "More Dots?/All Done Dots? were unsuccessful. Santino assisted with clean-up upon verbal direction...The session came to a close in the typical manner with the "Good-Bye Song" and reference to the daily, visual schedule in preparation for dismissal. Santino verbalized "Miss Ingrid" upon her arrival..Continue as planned with focus on use of communication book/photos across sessions/instructors and settings...

Chris was engaged in imaginative play with the plush toys from "Sonic" as the session commenced.
Support to scaffold the play and expand into character similarities and differences, and sequential linear play schemas was provided. Provision of temporal cues and use of "connectors" facilitated a stronger linear play sequence across 3 themes. Expanded vocabulary use within the aforementioned tasks as well as "Barrier" language activities was a strong focus. Use of expanded vocabulary and a framework for novel sentence generation vs. "previously heard phrases" within conversation and play schema generation was a strong focus this session.

The session commenced as Ben returned from the brief morning break where he was engaging with peers out side in a "tag" activity. He extended social greeting and subsequently expressed frustration regarding the peer dynamics of the outside play. Supports were provided, and he calmed shortly thereafter. Initiation of conversation was responded to with minimal reciprocal engagement even with multiple topics of familiar interest being introduced within a natural exchange This afforded the opportunity to review and support the dynamics of reciprocity, perspective taking and further expanding into the area of presupposition. Discussion into the abstract components of language including higher level inferences and use of abstract language (idioms, similes and metaphors ) was also focused upon.

Santino was greeted by the SLP as he completed his previous session. He transitioned nicely to the chair at the table. He assisted with closing the computer and putting away his iPad. When given a choice of bubbles and train set, he verbally requested trains. An oral motor tool (Z-vibe) was introduced without vibration initially and then turned on. Santino turned to the vibration on his cheek showing interest. When SLP tapped to his lips, he opened for it to be put in his mouth however quickly closed his lips after a few seconds of intra oral stimulation. He independently rubbed on his lips and began to laugh. With the blue chewy tube, he was bending it and visually interested, he did not place it in his mouth despite visual models and prompting. Santino and SLP began building train track as he assisted with taking the crackers out of the package with ease. He immediately tapped to his lips and put them in the "all done bowl". He refused further interaction (i.e. tapping to teeth, pretend brushing teeth, licking, tapping to tongue, or licking crumbs off his lips). With Veggie Straws, he watched SLP play with the straw, placing it between lips and blowing air/napkin across the table. He crushed into crumbs with his fingers, immediately wiping off the crumbs. While placing the trains on the track (requesting each one verbally - "I want yellow train"), SLP tapped crumbs of Veggie Straws on his lips with vibration on and Santino demonstrated reduced aversion. He began to rub his lips together and eventually lick the crumbs off with his tongue tip. He did not grimace nor show signs of distress. We did this 10x. This is improvement, as Santino appeared to stop and consciously decide to lick his lips despite possible anxiety about the food being on his lips. Overall, his interaction with the food was less aversive today. He was happy throughout the session. Santino assisted in clean up and at that time, Mom picked Santino up from the classroom. Session was briefly discussed with Mom. Great session, I will see him Monday!

Santino was seen for session 5 of 5 in Term 3 with this SLP and transitioned calmly between sessions. The daily, visual schedule was referenced and reviewed...Goals for the session remained consistent and included the following...1. to engage in forming a relationship with Santino that includes regulation, and shared attention and interest 2. to enter into two-way, purposeful interactions with gestures and intentional communication 3. to determine highly motivating/favorable, cause and effect activities, so that Santino may develop a feeling of control and predict/anticipate what will happen next 4. to imitate predictable action sequences and communication patterns through cause and effect activities. 5. to develop single-word requesting via eye gaze, picture exchange and/or verbalization...Consideration has been given to expand upon Goal 5 to include modifier + object/action in the phrase "I want..." via picture exchange and/or verbalization...Santino was directed to an array of 4 planned activities. He referenced the photos, selected one, then requested a novel yet similar activity via verbalization paired with photo exchange, "I want dinosaur!". The "Stegosaurus-Build and Play Dinosaur" was presented...A battery-powered "drill" option was labeled and demonstrated by this SLP. Santino verbalized immediately, "I want drill". He appeared intrigued by the tool. Maximum hand-over-hand assistance was provided to operate it throughout the activity. Santino disassembled and reassembled the dinosaur with maximum assistance and appeared frustrated by the minor changes in the process and function of the tool. He requested via photo reference/exchange paired with verbalization x 5: "I want...+ the following: dino head, tail, plates, front leg, back leg"...Santino assisted with clean-up, but appeared fatigued and possibly distressed due to the change of activity/routine. He lay on the pillows and fell fast asleep immediately. Attempts to wake him after 15 minutes in preparation for the next session were unsuccessful...Continue as planned with focus on use of communication book/photos across sessions/instructors and settings...

Santino was seen for session 4 of 4 in Term 3 with this SLP. The daily, visual schedule was referenced and reviewed...Goals for the session remained consistent and included the following...1. to engage in forming a relationship with Santino that includes regulation, and shared attention and interest 2. to enter into two-way, purposeful interactions with gestures and intentional communication 3. to determine highly motivating/favorable, cause and effect activities, so that Santino may develop a feeling of control and predict/anticipate what will happen next 4. to imitate predictable action sequences and communication patterns through cause and effect activities. 5. to develop single-word requesting via eye gaze, picture exchange and/or verbalization...Consideration has been given to expand upon Goal 5 to include modifier + object/action in the phrase "I want..." via picture exchange and/or verbalization...Santino was directed to an array of 4 planned activities. He referenced the photos, selected one, then requested a familiar activity via verbalization paired with photo exchange, "I want police car!". The "Build and Play Police Car" was presented. Santino was encouraged x 10 to push the police car and engage in a my turn/your turn, back and forth exchange. Verbalization of "Ready, Set, Go" was noted x 5 as he participated in the routine...It is important to note that Santino noticed loose screws on the car and requested the screwdriver to tighten them via spontaneous verbalization, "I want screwdriver" x 5...Santino requested "Farm Animal Puzzles" from and array of 3 remaining planned activities via photo exchange paired with the verbalization, "I want farm puzzles"...Santino requested each 4-piece animal puzzle spontaneously x 8, "I want..." + the following: horse, chicken, donkey, sheep, cow, dog, cat, bunny"...He was prompted verbally ("head-tail-front legs-back legs") as he assembled each successfully x 8. Verbalization of this sequence was noted from time to time throughout the activity...The session came to a close in the typical manner with the "Good-Bye Song" and reference to the daily, visual schedule...Continue as planned with focus on use of communication book/photos across sessions/instructors and settings...

Team conference scheduled for the time window typically slotted for speech.
Wonderful opportunity to discuss Santino's nice progress and additional focus of intervention.
New communication book was shared and discussed at length, with mom to utilize pages in the book for "home "vocabulary. Additional vocabulary include expanded verb repertoire, as well as increased abstract concepts and modifiers. Mom indicated support of using Mayor Johnson pictures for the purposes of this expanded vocabulary. Goal expansion into increased sentence variation and length was highlighted as well. Discussion also included feeding and bathroom use as ongoing priorities for mom. Use of visual scheduling with embedded sabotage, and ongoing team collaboration remain vital.

The session commenced as Christopher was speaking with a peer during the teacher transition.
This allowed for discussion regarding "friend vocabulary," the various terms utilized in casual conversation. Supports and cues were provided as discussion expanded into exploring the meaning of varied vocabulary, and the use of "phrases," vs self generated sentences.
Structured activities focusing on categorical inclusion, exclusion, use of expanded semantic relationships and broader scope of attributes were targeted this session. In addition supports to expand conversational reciprocity, focusing on contingent responses, using the familiar strategies of "thinking together," paired with use of scaffolding to increase use of cohesive ties was also a focus. Movement patterns were once more embedded as attentional shifting was significant this session.

Santino established brief reference upon social greet, he was encouraged to carry his lunch box and once again, guided to push the keypad to allow entry to the main area. Support to direct placement of his lunch box was provided. Santino appeared a bit tired this session, as he immediately sat and rubbed his eyes. Presentation of activities displayed within a binary choice facilitated picture placement on the 'I want" strip and subsequent verbalization across 6 tasks.
Action regulation within tasks was encoded following models, with use of anticipatory cues , and spontaneously (ie: "Push mickey down"). with 4/8, 2/8,2/8 respectively across 3 tasks. Increased response to anticipatory cues across additional 3 activities for 8 trials resulted in 2/8 model, 4/6 cues, 2/8 spontaneously. Periods of eye rubbing and postural shifting remained throughout the session. He responded well to Handle activities and RMT strategies as his arousal and engagement, referencing and overall verbalizations subsequently increased.