Santino was seen for session 31 of 31 with this SLP and appeared pleasant and calm as he transitioned between sessions...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...The daily, visual schedule was referenced and reviewed...Santino immediately searched the bag of materials and requested "Boo!...A Book of Spooky Surprises" from a field of 4 planned books. He requested the book 2 times then requested "Where is Santino's Pumpkin?" via photo exchange. The books were presented in the typical manner. Santino was presented with a novel book option, "Where's the Witch?". He lifted the felt flaps at the appropriate point as the predictable pattern of questions and answers was read aloud by this SLP. Verbalization of story content during predictable story patterns was not noted...In an attempt to engage Santino further, this SLP presented 2 novel activities and Play-Doh. He requested Play-Doh via photo exchange from a field of 3 options and stood to sit in the chair upon verbal direction. As in previous sessions, Santino immediately requested the Gingerbread Man and all items in the appropriate sequence via photo exchange to complete the activity 3 separate times (with use of "More" photo + "Play-Doh" photo). During this 35-minute activity, Santino, once again, appeared completely focused and engaged with shared attention and interest. He followed the established sequence for 3 out of 3 opportunities via photo exchange during this two-way, purposeful interaction with gestures and intentional communication. He continues to convey a sense of pride as he sits back and appears to admire his creations. Santino requested 3 different colors of Play-Doh, the Gingerbread Man cookie cutter, rolling pin, eyes, mouth, and buttons via photo exchange and requested "More" + Color + "Play-Doh, "More" + Eyes, and "More" + Buttons, when necessary...Santino verbalized the following: "Cookie, Cookie Cutter, Gingerbread Man, Gingerbread Man Cookie Cutter, I Want, More, Want More, Eyes, Buttons"...Santino 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 both verbal and minimal physical prompts from this SLP...Continue as planned with focus on intentional communication to request and initiate via social referencing paired with photo exchange and verbalization.

Christopher initiated conversation rapidly, and was eager to share the "mystery mini's " he had added to his collection of lego marvel figures. This afforded the opportunity to expand further into the concepts of "thinking together," and recognizing your talking partner's perspective.
Expansion into facilitating increased use of detail, use of more contingent responses within an
exchange, and decreased use of fillers and affirmations was a subsequent focus.
Supporting attentional focus this session was encouraged through the continued embedding of cross pattern movement sequences, as well as additional movement sequences adapted from Brain Gym.

Student was absent today.

Upon arrival, Santino was sound asleep in the car. Kim had shared the he had woken up in the late hours of last night and remained awake for the better portion of the early morning hours. Marcus assisted with getting Santino to his room where he slept soundly amongst the pillows and with the weighted blanket. This afforded a wonderful opportunity to speak with Kim. Conversation expanded across topics. Feeding remains a primary concern, and strategies to emulate as close as possible to the meal time experience he shares with Ingrid is vital. Dorothy was able to join in the conversation briefly and feels confident in taking the lead as the primary teacher involved in mealtime. Additional concerns that Kim shared fall in the scope of ADL skills.
The successful use of the visual schedule was discussed, highlighting that the components of sabotage are intentionally embedded. Use of picture exchange as a tool to communicate requests has continued to expand almost on a daily basis. The primary goals being that Santino will independently place pictures on the strip to create a sentence (" I want red triangle"), establish eye gaze in order to lead into the communication dynamic, reach to give the strip to the teacher, paired with the verbal accompaniment "I want red triangle", and subsequently receive the desired item.
The use of picture supports to facilitate increased verbalization has been extremely successful.

Santino was seen for session 30 of 30 with this SLP and appeared pleasant and calm as he transitioned between sessions...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...The daily, visual schedule was referenced and reviewed. As it was reported that Santino drank 2 beverages during the previous sessions, his
"Pull-Up" was checked and determined to be dry by this SLP...Santino immediately searched the bag of materials and requested
"Boo!...A Book of Spooky Surprises" from a field of 4 planned books. He requested the book 2 times via photo exchange. With minimal verbal prompts ("More?"/"Want more?"), Santino requested "More" via photo exchange. Santino turned the pages independently as the familiar predictable pattern was read aloud by this SLP. Santino verbalized "Boo!" once during this 10-minute segment..."All Done" was referenced by this SLP then selected by Santino who then requested "Where is Santino's Pumpkin?". The book was presented in the typical manner once. Verbalization of "ghost" was noted once during this 5-minute activity...In an attempt to engage Santino further, this SLP presented 2 novel activities and Play-Doh. He requested Play-Doh via photo exchange from a field of 3 options and stood to sit in the chair upon verbal direction. Santino immediately requested the Gingerbread Man and all items in the appropriate sequence via photo exchange to complete the activity 3 separate times (with use of "More" photo + "Play-Doh" photo). During this
35-minute activity, Santino, once again, appeared completely focused and engaged with shared attention and interest. He followed the established sequence for 3 out of 3 opportunities via photo exchange. As in the previous session with this SLP, the two-way, purposeful interaction with gestures and intentional communication appeared to result in a sense of pride as Santino seemed to sit back and admire his creations. Santino requested 3 different colors (yellow, red, and orange), the Gingerbread Man cookie cutter, rolling pin, eyes, mouth, and buttons via photo exchange and requested "More" + Color + "Play-Doh" when necessary...Santino verbalized the following: "Cookie, Cookie Cutter, Gingerbread Man, Gingerbread Man Cookie Cutter, I Want, More, Want More, Eyes, Buttons". "All Done" was referenced by this SLP and selected by Santino...He 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 both verbal and minimal physical prompts from this SLP..Continue as planned with focus on intentional communication to request and initiate via social referencing paired with photo exchange and verbalization.

Christopher rapidly engaged in conversation as he shared thoughts across multiple topics. Supports were provided in order to enhance "thinking together," and expand reciprocity within a specific topic. Use of strong scaffolding strategies facilitated increased use of detail, and cohesive responses within the exchange, and a decrease in use of non specific vocabulary, fillers and affirmations. Christopher was subsequently observed to self -redirect during a period of topic shift.
Cross pattern movement tasks embedded within expanded categorical inclusion and exclusion language activities was extremely facilitative once again. Wonderful session today.

Christopher was excited to share some new videos that he had made over the weekend, allowing for expanded conversation across varied topics. Supports for increased cycles of exchange with decreased questioning and use of comment/comment exchange were successful. Cross pattern movement cycles embedded within categorical inclusion tasks was a strong focus. Chris has demonstrated significant gains within inclusion/exclusion tasks. Narrative generation with use of a magnetic story board again facilitated use of expanded character trait discussion, use of increased cohesive ties and temporal links for increased linguistic organization. Strong session today.

Ben was immersed in viewing items on his laptop upon my arrival. A sign was posted on his door; "please do not ask me a lot of questions, it's Monday and I'm tired." He promptly closed his laptop and responded to my social greet, and my comment regarding his sign. Commenting strategies were employed as the session commenced as the most appropriate tools for facilitating optimal conversational exchange. Cross pattern movement tasks were then strongly encouraged, and Ben was amenable to transitioning outside in order to utilize bean bags as a tool to enhance cadence, and patterning embedded within reciprocal naming of expanded semantic categories, items within abstract categories, and descriptive concepts. The activity was abruptly shortened as students entered the back area. Ben's affect changed dramatically as he stated " please do not ask me to do this now." I acknowledged that it was getting busy, and he shared that he was "not comfortable with so many kids out here now." We returned to his room, and he requested to do some "quieter things."
Conversation expanded into perspective taking as in previous sessions, with a focus on conveying intention, and reading gestural cues.

Santino was seen for session 29 of 29 with this SLP and appeared pleasant and calm as he transitioned with Miss Janis back to the individual classroom...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 sat on the pillows, yawned and rubbed his eyes. He appeared fatigued, but immediately requested "Boo!...A Book of Spooky Surprises" from a field of 4 planned books. He requested the book 2 times via photo exchange. With minimal verbal prompts ("More?"/"Want more?") Santino requested "More" via photo exchange paired with verbalization. Santino turned the pages independently as the familiar predictable pattern was read aloud by this SLP. Santino verbalized "Boo!" once during this 10-minute segment..."All Done" was referenced by this SLP then selected by Santino who then requested "Where is Santino's Pumpkin?". The book was presented in the typical manner once. Verbalization was not noted during this
5-minute activity. Santino lay back on the pillow and selected "All Done" independent of prompts...In an attempt to engage Santino, this SLP presented 2 novel activities and Play-Doh. He requested Play-Doh via photo exchange from a field of 3 options and stood to sit in the chair upon verbal direction. Santino immediately requested the Gingerbread Man and all items via photo exchange to complete the activity 4 separate times (with use of "More" photo + "Play-Doh" photo). During this 35-minute activity, Santino appeared completely focused and engaged with shared attention and interest. He followed the established sequence for 4 out of 4 opportunities via photo exchange. This two-way, purposeful interactions with gestures and intentional communication appeared to result in a sense of pride as he appeared to sit back and admire his creations. Santino requested 4 different colors (blue, yellow, red, and orange), the Gingerbread Man cookie cutter, rolling pin, eyes, mouth, and buttons via photo exchange and requested "More" + Color + "Play-Doh" when necessary..."All Done" was referenced by this SLP and selected by Santino...He 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 both verbal and minimal physical prompts from this SLP...Continue as planned with focus on Santino's use of "All Done/Finished" and 'More" to indicate his intentions.

Santino was seen for session 28 of 28 in the individual classroom and appeared pleasant as he greeted this SLP with extended eye contact through the glass as if to say, "Why are you out there? Come on in!"...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 immediately requested "Boo!...A Book of Spooky Surprises" from a field of 4 books. He requested the book 5 times via photo exchange combined with the photo of "more" and verbalized "Wants Boo", "Wants More" upon selection. In addition, he verbalized the following during this 15-minute segment: "Wizard, Question, Ghost, Boo"...Additionally, with reminders to, "Wait, please", Santino turned the pages after each of the patterned, predictable questions were read aloud by this SLP. "All Done" was referenced by this SLP then selected by Santino who then requested "Where is Santino's Pumpkin" from a field of 3 books via the "more" photo + book title. This sequence was completed 3 times. Santino verbalized the following: window, ghost, open door, apples, 2 apples, candy apples, 1-2-3-4-candy apples, hat, pointy hat, pointy witch's hat, outside door. The sequence ended with reference to "All Done" by this SLP...Santino requested "Build and Play" Police Car via photo exchange from the array of 7 planned activities. He proceeded to request via photo exchange from a field of 9, the necessary items (i.e.Tires, Screws, Screwdriver) required to attach the siren, spoiler and front and back bumpers. These new items did not appear to be of interest to Santino as he requested the familiar front and back tires via photo exchange and followed the sequence for 8 out of 8 opportunities. He placed each item upon receipt in the correct location and independently manipulated the screwdriver correctly to tighten and remove the screws. It is important to note that "All Done" was referenced by this SLP upon noticeable fatigue.
Santino then requested "All Done" and assisted with clean-up upon verbal request by this SLP...Santino was enticed with a Play-Doh activity. He selected via photo exchange from a field of 2 options to create a Gingerbread Man. Santino requested all items via photo exchange to complete the activity 3 separate times (with use of "More" photo + "Play-Doh" photo) and verbalized the following: "Gingerbread Man, Orange, Eyes, One Eye, Two Eyes, Mouth, Button, One Button, Two Buttons, Three Buttons"..."All Done" was referenced by this SLP and selected by Santino. He 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 both verbal and minimal physical prompts from this SLP...Continue as planned with continued focus on Santino's use of "All Done/Finished" via photo exchange to indicate his intention to end an activity.