Santino was seen for session 39 of 40 with this SLP in the individual classroom and appeared pleasant and calm upon transition 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...Santino was presented with 2 novel and 2 familiar activities. Santino appeared to be in search of "The Little Old Lady..." which was not an option. His frustration was validated and alternate options were presented once again. Santino selected each activity in succession, but did not appear interested or engaged in any of the options requested via photo exchange. He participated in the action sequences for a few turns, only. With each activity, upon noticeable disinterest, "All Done?" was referenced by this SLP then selected and verbalized by Santino who assisted with clean-up upon verbal direction...This SLP stated, "Oh MY, Santino! What are we going to do? Nothing Miss Sharon brought today seems interesting to you."...Independent of direction, Santino approached, reached for my arms, wrapped them around him and put his head on my shoulder then looked up at me. He seemed to want to provide comfort or offer a solution to the situation... The session came to a close in the usual manner with the "Good-Bye" Song and successful photo exchange on his daily visual schedule given verbal and minimal physical cues. Santino verbalized, "Sharon"...Continue as planned with focus on intentional communication to request and initiate via social referencing paired with photo exchange and verbalization.

Ben responded to social greeting, however, neglected to socially reference and maintained posturing such as that his back remained facing me. He engaged in conversation while continuing this posture. This was approached, discussed and subsequently respected, as he clearly needed a few moments to modulate. As conversation was facilitated, and expanded, the use of photos allowed for increasing joint focus and more cohesive conversation. Ben was subsequently extremely motivated to participate in the "thinking game " challenge which involved recall of facts, use of comparisons, trivia etc. Game play allowed for subtle cues to support awareness of gestural and facial cues as well as expanded use of intonation to indicate intentionality within a conversational exchange.

Santino continues to demonstrate strong social referencing upon social greet, and initiate "hugs" as he approaches. Transition continues to be facilitated through use of familiar song, as well as recent assistance to push the key pad numeric sequence to enter the main area. Santino continues to rapidly scan picture choices presented on the table with the actual items remaining out of sight. He quickly places the item of choice on the strip, reaches to place the strip in my hand and now allows for isolated distal point to each picture/word on the strip while sustaining gaze across all 24 trials this session.
"Mouthing" the words paired with my verbalization was noted on 3/6, 4/6, 5/6 x2.
Additional picture placement on the strip to include color+object , size +object was facilitated with hand over hand assistance x12. Spontaneous point to "all done" paired with verbal was noted x2 across 2 tasks. Santino was often focused on singing the ABC song this session. Periods of joint singing allowed for increased periods of reference during these instances. Session closure continues to be facilitated through the use of familiar song, independent picture removal and observable anticipation of the next teacher's arrival.

Santino was seen for session 39 of 40 with this SLP in the individual classroom and appeared pleasant and calm upon transition between sessions. The daily, visual schedule was referenced and reviewed. Santino verbalized "Sharon"...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...Santino was presented with 2 novel and 2 familiar activities. All were met with rejection as Santino appeared to search for another option. Redirection to presented options was rejected once again. Another option was presented ("The Little Old Lady...") and immediately requested via photo exchange paired with reference. Once more, Santino appeared to take immediate interest in the text and illustrations. During a 30-minute period, Santino requested the book twice via photo exchange and engaged in two-way, purposeful interaction with gestures, shared interest, and intentional communication. He pointed to text as if decoding whole words (paired with reference to illustrations) and verbalized the following, expanding his utterances throughout, as an adapted version of the story was presented by this SLP: "Once Upon a Time, Old, Little Old Lady, Cottage, Walk, Moon, Stopped, She Stopped, Shoes Went CLOMP! CLOMP!, Two Big Shoes, Pants, Pants WIGGLE! WIGGLE!, Bumped, Shirt, Shirt SHAKE! SHAKE!, Two White Gloves, White Gloves Go CLAP! CLAP!, Hat, Tall Black Hat, Faster, Scary Pumpkin Head, Boo! Boo!, Ran Fast, Door, Locked Door, Rocked, Knock-Knock-Knock, Open, Open Door, Bravely, Bed, Good Night...Santino was encouraged to use the action sequences of the Shoes, Pants, etc. and did so with moderate to minimal verbal and/or physical assistance and model by this SLP...During the next 10-minute segment, Santino completed 3 Comprehension activities related to the story. He sat at the table and appeared to reference the 4 photo choices presented as possible answer choices. Maximum hand-over-hand assistance was provided to complete all paper/pencil tasks..."All Done" was referenced by this SLP then selected and verbalized by Santino who appeared tired and teary-eyed. He stood independent of direction and lay on the pillows. Attempts to entice and redirect were met with rejection. Santino fell asleep within minutes and slept for the remaining 20-minutes of the session...Continue as planned with focus on intentional communication to request and initiate via social referencing paired with photo exchange and verbalization.

Santino was seen for session 38 of 39 with this SLP in the individual classroom and appeared pleasant and calm upon transition 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...Santino was presented with 2 novel and 2 familiar activities, and 1 familiar book option. Santino requested "The Little Old Woman Who Was Not Afraid of Antyhing" via photo exchange. As in previous sessions, Santino appeared to take immediate interest in the text and illustrations. During a 30-minute period, Santino requested the book twice via photo exchange and engaged in two-way, purposeful interaction with gestures, shared interest, and intentional communication. He pointed to text as if decoding whole words (paired with reference to illustrations) and verbalized the following, expanding his utterances throughout, as an adapted version of the story with props was presented by this SLP: "Once Upon a Time, Old, Little Old Lady, Cottage, Walk, Seeds, Moon, Moon Shining, Stopped, She Stopped, Shoes Went CLOMP! CLOMP!, Two Big Shoes, Pants, Pants WIGGLE! WIGGLE!, Bumped, Shirt, Shirt SHAKE! SHAKE!, White Gloves, Two White Gloves, White Gloves Go CLAP! CLAP!, Hat, Tall Black Hat, Faster, Quite Fast, Scary Pumpkin Head, Boo! Boo!, Ran Fast, Stop, Didn't Stop, Door, Locked Door, Rocked, Quiet, Knock, Knock-Knock-Knock, Open, Open Door, Brave, Bravely, Happy, Good Night, Up, Garden, Scarecrow...Santino was encouraged to use props to imitate the action sequences of the Shoes, Pants, etc. and did so with moderate to minimal verbal and/or physical assistance by this SLP. Santino seemed to enjoy wearing the gloves and hat. All components were gathered to assemble a scarecrow (as in the story) while Santino observed and referenced the completed creation...During the final 20-minute segment, Santino was enticed to "Dress the Scarecrow" by requesting then gluing the pants, shirt, shoes gloves, and hat on the scarecrow cut-out. He did so for 5 of 5 opportunities and verbalized, "Scarecrow"..."All Done" was referenced by this SLP then selected and verbalized by Santino who assisted with clean-up upon verbal direction...The session came to a close in the usual manner with the "Good-Bye" Song and successful photo exchange on his daily visual schedule given verbal and minimal physical cues. Santino verbalized, "Mom"!...Continue as planned with focus on intentional communication to request and initiate via social referencing paired with photo exchange and verbalization.

Christopher was excited to share his "ideas" for our time together today. Topics and ideas encompassed a fairly wide range with rapid shifts as he shared his thoughts. He was extremely excited to share the news of his presentation and video as well. Scaffolding and supports were provided to assist Christopher with sequential recall of the details of the project, and the videos themselves. Denys joined the session to share the video with us. This afforded the opportunity to formulate more facilitative leading questions and cues to assist Christopher with successful organization of the thoughts he was wanting to share. It also allowed for discussion into expanded concepts of recognizing emotions and self modulation as we explored the concepts of "nervousness, embarrassment, frustration, and creativity." As the session progressed Christopher was continuing to share additional thoughts, prefacing his utterances with "guess what?"
Supports for "connecting thoughts, closing thoughts and shifting thoughts were strong today as Christopher was rapidly shifting attentional focus today.

Christopher was excited to discuss the many Marvel mini characters that he had with him once again. He shared the idea that "we could organize and create a story just like you like to Mrs. Lynne." This idea again afforded an excellent opportunity to expand into strategies for sentence organization and use of scaffolds to support linear thinking, cohesive ties and links to support the sequentiality of the play story schema. Embedding of cross pattern movement sequences, visual patterns and left/right collaborative movements were extremely facilitative in supporting sustained attention and modulation.

Ben quickly engaged in conversation as the session commenced. Strong session focus on expanded strategies to increase conversational reciprocity, with increased emphasis on perspective taking and effective topic shifting. Additional focus was placed on increased attention to personal space boundaries, and " recognizing" gestural and facial cues and body language within a conversational exchange. Topic discussion crossed a wide array of subjects this session and Ben exhibited a wider range of affect to support his conversational intentionality.

Santino once again happily entered the front desk area, established sustained reference, and shared 3 "hugs." Gentle redirection to assist with placement of his back pack in its designated place prior to initiating activities was encouraged. Santino rapidly scanned items being offered and quickly placed the picture of the item of choice on the picture strip, and reached to exchange the strip for the desired item. Sustained attention to the strip as hand over hand facilitation was provided to isolate pointing to each word on the strip as the words were modeled. Santino "mouthed " the words as the words were modeled on 1/6 , 4/6, 6/6 X 3) trials provided. Verbal label of the noun label following receipt of the item was noted 50 % of the time this session. He spontaneously pointed to the "all done" picture and verbalized " all -done" x3 across 3 tasks today.
Santino was often focused this session on singing the "ABC " song, and often demonstrated instances of delayed echolalia. Use of classical music continued .
Session closure was again facilitated through the use of the familiar song, picture removal and observable anticipation of the next teacher's arrival.

Christopher arrived late for school today.