Santino was seen for session 27 of 27 with this SLP in the individual classroom and appeared pleasant yet focused on an activity from the previous session...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...Upon removal of the stimulus, Santino immediately requested "Where is Santino's Pumpkin?" from a field of 4 planned activities. He requested the book 5 times via photo exchange and verbalized the following during this 15-minute segment: pumpkin, Halloween, cat, window, ghost, open door, apples, 2 apples, candy apples, 1-2-3-4-candy apples, Mommy's bowls, behind Mommy's bowls, hat, pointy hat, pointy witch's hat, outside door, Trick-or Treat...Both the book and associated photo were removed from the choices much to Santino's protest. He stood independent of direction and searched for the desired items. Upon redirection, Santino chose "Boo!...A Book of Spooky Surprises" and verbalized the following: Boo, Cat, Black Cat, Wizard, Ghost....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, remove, then reattach the front and back tires of the vehicle 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 Santino appeared less focused overall than in previous sessions with this SLP in the individual classroom. He appeared to rush through the activity as he reached for items and required moderate verbal and physical prompts to request via photo exchange to complete the activity. At one point, Santino abandoned his chosen activity and lay on the pillows. Attempts to redirect and assist with clean-up were met with rejection...The session came to a close in the usual manner with the "Good-Bye" Song. Santino verbalized the following during planned pause-time within the song: "Santino", "Good-Bye, "So-Long". Successful photo exchange was noted on his daily, visual schedule given both verbal and minimal physical prompts from this SLP...Continue as planned with a focus on Santino's use of
"All Done/Finished" via photo exchange to indicate his intention to end an activity.

Santino was seen for session 26 of 26 with this SLP in the individual classroom and appeared pleasant and focused as he transitioned between sessions. The visual schedule was referenced and reviewed with this SLP...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 "Where is Santino's Pumpkin?", from a field of 4 planned activities. He requested the book 5 times via photo exchange and verbalized the following during this 15-minute segment: pumpkin, Halloween, cat, window, ghost, open door, apples, 2 apples, candy apples, 1-2-3-4-candy apples, Mommy's bowls, behind Mommy's bowls, hat, pointy hat, pointy witch's hat, outside door...Santino requested the "Spiral Maze Tower" 5 separate times via photo exchange from an array of 7 planned activities. Additionally, he requested each of 4 colored "rings" via photo exchange to construct the tower with maximum hand-over-hand assistance. The ball was also selected via photo exchange then released to spiral through his creation during the 10-minute activity...Santino referenced and requested the Mickey Mouse "Deck the Halls" Big Fun Book to Color via photo exchange from the array of 7 activities and proceeded to turn the pages and verbalize the following during the 10-minute segment: Mickey Mouse, Lollipop, Party Time, Presents, Hat, Candy Cane, Minnie Mouse, Cookie, Delicious, Donald Duck, Oh Boy, Surprise, Jingle Bells, Merry Christmas, Hooray, Oooooooo, and Gingerbread Man. Santino referenced the pictures hanging on the wall each time he encountered the same in the book...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, remove, then reattach the front and back tires of the vehicle for 15 out of 15 opportunities. He placed each item upon receipt in the correct location. It is important to note that Santino answered questions correctly for 7 of 7 opportunities via photo exchange to complete the process (i.e. What is missing from the car?, What do we need to hold the tire in place?, What do we need to turn the screw?, What do we need to take the screw out?). Santino required fading maximum to minimum hand-over hand assistance to turn the screwdriver over 4 of 6 opportunities. He independently manipulated the screwdriver correctly to tighten the screws during the remaining 2 opportunities. Santino appeared completely engaged and showed excellent task persistence throughout this 20-minute activity...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. Once again, Santino seemed very confident and consistent with photo exchange today! It was wonderful to engage with him during his requested activities!

Team meeting: Establish room allocation and times of transition throughout the day. The smaller room on the north side of the building will be consistently utilized for the initial window of time (M,T, TH, F beginning at 11, Wed beginning at 10) through approximately 11;45. Partitioned area in the pre-K classroom will be allocated for the remaining portion of the day. Visual schedule picture repertoire will expand to include more specific daily transitional changes (playground, cafeteria area , restroom etc.) Further development of the PECS system as Santino has responded amazingly well to this tool, and is now more consistently independently requesting desired items across activities and teachers via picture exchange paired with increased use of verbalization following a model, and with the emergence of more spontaneous verbal label use as well. Acquisition of a newer binder book with a handle to allow for color coding of pages to support categorical organization of the repertoire of pictures to be used across environments.
Continued use of therapeutic listening within sessions, and expanded use to be recommended for home carryover. Continued expanded curriculum development.

Santino was seen for session 25 of 25 with this SLP. He was transitioned from the East classroom by Miss Janis to meet this SLP in the individual classroom. Miss Janis reported that Santino verbalized "Miss Sharon" upon referencing the visual schedule with her. Santino appeared pleasant and calm as the visual schedule was referenced and reviewed with this SLP...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 entered the room and immediately requested "Where is Santino's Pumpkin?", from a field of 4 planned activities. He requested the book 4 times via photo exchange and verbalized the following during this 15-minute segment: pumpkin, window, ghost, open door, apples, 2 apples...Santino was presented with a new book, "BOO! A Book of Spooky Surprises", which follows a predictable, rhyming story pattern of questions and answers to learn who shouted, "BOO!". Santino seemed interested in the illustrations and finger-holes which created the characters' eyes as the story was read aloud by this SLP. Verbalization was not noted during this 5-minute activity...Santino stood independent of direction and removed his green bottle from his backpack then handed it to this SLP. His request was validated as he was directed to an array of 7 food and beverage photo choices displayed on the table. Santino requested the Pediasure Vanilla Shake and his green bottle via photo exchange. Santino followed the familiar sequence of one-step verbal directions (i.e. "Pull the tab., Turn the cap., Throw it in the trash can., Pour., etc.) to complete the transfer of the beverage into the green container. Once again, Santino seemed engaged, interested and willing to assist. Maximum physical assistance was provided throughout the process to complete each direction successfully. Eye contact, focus and task persistence were noted throughout...Santino selected "The Gingerbread Man" storybook and handed it to this SLP then verbalized, "You can't catch me, I'm the gingerbread man." He sat and reclined slightly with the bottle in his mouth. Santino did not drink the beverage as the "The Gingerbread Man" storybook was presented by this SLP. With minimal assistance, he turned the pages and tracked selected portions as an abbreviated story was read aloud. Verbalizations were not noted during this 10-minute activity as Santino held the bottle in his mouth...Santino stood and lay on the pillows where he drank about one-half of the shake...Santino followed the one-step verbal direction to sit in his chair. His communication book was referenced. Santino requested 1 of 8 puzzles from the "Mickey Mouse Pattern Tiles Set" via photo exchange. Additionally, Santino requested shapes, via photo exchange, from a field of 4, for 4 out of 4 opportunities to complete the puzzle. Verbalization of color + shape upon receipt of the item requested was observed for 3 out of 4 opportunities...Santino appeared fatigued and showed less task persistence throughout this 10-minute activity...He stood independent of direction, reached for an activity book (perhaps from a session with another teacher) and verbalized the title, "A Pig Can Jig". Santino brought the book to the pillows and began to turn the pages. In an attempt to engage and extend his chosen activity, Santino was guided through a picture/word matching activity with maximum hand-over-hand assistance. He showed attention, focus and eye-contact throughout this 5- minute activity...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. Once again, Santino seemed very confident and consistent with photo exchange today!

Ben initiated social greeting this session with extended social referencing. He once again inquired if he could share something on his laptop, which subsequently expanded into additional topics allowing for increased contingent conversational turns. Ben appeared tired today however, and did express that he was indeed feeling tired. He subsequently initiated an indirect request to participate in a "test." As I inquired he rapidly repeated that he "had a test,' and began to read from a script. This afforded an ideal opportunity to address the familiar concepts of perspective taking, body language and a newer discussion of topic/conversational approach strategies. Ben's affect was variable as the concepts of topic approach, and listener perspective were discussed specific to the "survey "that he had wanted me to participate in. Additional activities focused on use of expanded descriptive concepts, associations and semantic relationships within collaborative "like-minded" brainstorming.

Christopher's birthday excitement was bubbling over as he was waiting in his doorway anticipating my arrival. He jumped right into sharing thoughts across a few different topics. Together we ordered the topics for discussion based on his priorities. Sharing the new Lego Marvel characters purchased in New York was the priority. He initiated use of the familiar strategies that we have used for effective categorical organization in order to arrange, group and discuss them based on similarities and differences. He was quite proud as he said "I remember this Ms. Lynne."
Sharing information about Comic Con and the trip to New York was a subsequent focus. Initial itemization and listing the specific thoughts, events and details that he rapidly recalled about the trip served as a foundation to allow for more successful organization and temporal sequencing of the events and activities. Strong supports were provided as the task was challenging. Familiar cues and supports were facilitative. Movement sequences were embedded in greater scope this session in order to support attention to task, as Birthday excitement was encompassing today.

Santino was seen for session 24 of 24 and appeared pleasant as he was met by this SLP in the East classroom for transition to the individual classroom. The visual schedule was referenced and reviewed. Initial attempts to transition to the individual classroom were met with rejection as he appeared teary-eyed and lay on the carpet in the "Circle-Time" area. After a few minutes, successful transition commenced without further rejection...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 requested
"Where is Santino's Pumpkin?", 4 times consecutively via photo exchange, from a field of 3 planned activities. Santino appeared less engaged than in previous sessions as he turned the pages independently. Delayed echolalia of unknown context was observed. In an attempt to enter into a two-way, purposeful interaction, a tissue ghost was created by this SLP. Fleeting moments of eye contact and interest were noted as the ghost "flew" and landed nearby during this 15-minute segment...Santino stood and reached for his green bottle on the table and selected the Pediasure Vanilla Shake. Santino followed one step verbal directions (i.e. "Pull the tab., Turn the cap., Throw it in the trash can., Pour., etc.) to complete the transfer of the beverage into the green container. Santino seemed interested and willing to assist. Maximum physical assistance was provided throughout the process to complete each direction successfully. Eye contact, focus and task persistence were noted throughout...Santino sat and reclined slightly, but did not drink the beverage as the "The Gingerbread Man" storybook was presented by this SLP. With minimal assistance, he turned the pages and tracked selected portions as an abbreviated story was read aloud by is SLP. During this 10-minute activity, Santino verbalized "Gingerbread Man" several times as he referenced the illustrations...Santino appeared sleepy, rubbed his eyes and yawned frequently, then stood and lay on the pillows where he drank all but a few drops of the shake...Santino was directed to his communication book and requested 1 of 8 puzzles from the "Mickey Mouse Pattern Tiles Set", 3 times consecutively via photo exchange. Additionally, Santino requested shapes, via photo exchange, from a field of 4 for 15 out of 15 opportunities to complete the puzzles. Verbalization of color + shape upon receipt of the item requested, as in the previous session, was not observed. He verbalized "Daisy Duck!" when presented with the "Daisy Duck" puzzle requested via photo exchange.. Although he appeared fatigued, Santino showed excellent task persistence throughout this 15-minute activity...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. Once again, Santino seemed very confident and consistent with photo exchange today!

Santino was seen for session 23 of 23 with this SLP in the individual classroom. He appeared pleasant and regulated as he transitioned between sessions. The 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 referenced "The Gingerbread Man" storybook presented by this SLP. With minimal assistance, he turned the pages and tracked selected portions of the text both visually and physically, via his "pointer" finger, as an abbreviated story was read aloud by is SLP. During this 15-minute activity, Santino verbalized "Gingerbread Man" several times as he referenced the illustrations and completed the familiar rhyme, "Run, run as fast as you can. You can't catch me, I'm......the gingerbread man!"...Santino was presented with a choice of 3 books via photo exchange. He selected "Where is Santino's Pumpkin?". He turned the pages and lifted the flaps to locate the missing pumpkin throughout the story as it was read aloud by this SLP. Throughout this
20-minute activity, Santino verbalized the following: orange leaf, red, yellow, window, ghost, candy apple, open door...Santino was directed to the "Mickey Mouse Pattern Tiles Set" and followed the
one-step verbal direction to sit in the chair. Santino selected the shape, via photo exchange, from a field of 4 for 18 out of 18 opportunities. He verbalized color + shape (i.e. green diamond, yellow trapezoid, brown triangle, etc.) upon receipt of the item requested to complete 3 Disney-themed shape puzzles (i.e. a hexagon or any combination of a triangle, diamond and/or trapezoid to "fill-in" Mickey's ears, the sail of Donald Duck's boat, and the roof of Pluto's doghouse). He showed excellent focus, engagement and task persistence throughout this 15-minute activity...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 prompts from this SLP. Santino verbalized "Ingrid" upon reference to her photo...Continue as planned. Santino seemed very confident and consistent with photo exchange today!

Santino was seen for session 22 of 22 with this SLP in the individual classroom. He appeared pleasant and regulated as he transitioned between sessions. The 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's "Pull-Up" was checked and judged to be very wet. Santino appeared pleasant and calm as he transitioned to the restroom and assisted with the familiar process. Once back in the individual classroom, Santino followed the one-step verbal direction to sit in the chair at the table. In an attempt to extend his interest and interaction with Mickey Mouse "Deck the Halls!" Big Fun Book to Color, (referenced during two consecutive sessions), Santino was directed to and presented with a "Gingerbread Man" cookie activity...With hand-over-hand assistance, Santino applied icing (spread with a spoon and squeezed from a bag) then added chocolate chips, independently, to decorate the "Gingerbread Man" cookie. Santino selected the icing color, only, via photo exchange. Eye contact, focus, and engagement were noted throughout the 10- minute activity. He verbalized "Gingerbread Man" approximately 3-5 times. Santino ran his finger through the icing, but refused a taste it...Santino referenced "The Gingerbread Man" storybook presented by this SLP. With minimal assistance, he turned the pages and tracked selected portions of the text both visually and physically, via his "pointer" finger, as an abbreviated story was read aloud by is SLP. During this 15-minute activity, Santino verbalized "Gingerbread Man" several times as he referenced the illustrations and completed the familiar rhyme, "Run, run as fast as you can. You can't catch me, I'm......the gingerbread man!"...During the remaining 5-minutes of the session, Santino and this SLP sat facing one another on the floor with Mickey Mouse "Deck the Halls" Big Fun Book To Color situated between us. Santino was prompted to tell this SLP about the pictures as he turned the pages independently. Santino engaged and entered into a two-way, purposeful interaction with gestures and intentional communication via spontaneous verbalization and reading of both single and multi-syllabic words, and two-word phrases printed or pictured on the pages. Continuous back and forth engagement via eye contact, smiles, laughter, gestures and facial expressions of what appeared to be excitement and pride in his verbalizations were noted once again throughout this portion of the session. Santino verbalized and/or read the following during the aforementioned interaction: Holidays, Mickey Mouse, Lollipop, Party Time!, Candy Cane, Minnie Mouse, Fun, Delicious, Ho-Ho-Ho-!, Donald Duck, Oh, boy!, Day, Play, Surprise!, Jingle Bells,
Merry Christmas!, Write, "Oooooooo!", Fa-la-la la la, M-m-m-m-m-m, Daisy Duck, Gingerbread Man, Horray!...The session came to a close in the routine manner with the "Good-Bye" Song. Santino appeared to transition easily from the Mickey Mouse book and successfully completed the photo exchange on his visual schedule within the classroom given verbal and minimal physical prompts from this SLP. Santino verbalized "Ingrid" 3 times upon referencing her photograph on the schedule!...Continue as planned with a focus on activities to build and expand upon functional communication via photo exchange, verbalization and written words.

Santino was seen for session 21 of 21 with this SLP in the individual classroom. He appeared pleasant and regulated 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...Santino was directed to sit in the chair at the table. In an attempt to extend his interest and interaction with Mickey Mouse "Deck the Halls!" Big Fun Coloring Book which he referenced during the prior session with both Miss Christina and this SLP, Santino was directed to and presented with a "Gingerbread Man" craft. With hand-over-hand assistance, Santino added the basic parts to assemble the Gingerbread Man. Eye contact, focus and engagement were noted throughout the 10 minute activity, He verbalized "Gingerbread Man" twice. Santino referenced the Gingerbread Man Storybook presented by this SLP. With minimal assistance, he turned the pages and tracked selected portions of the text both visually and physically, via his "pointer" finger, as an abbreviated story was read aloud by is SLP. Santino verbalized "Gingerbread Man" twice more during this 10 minute activity. For the following 20-minutes, Santino and this SLP sat facing one another on the floor with Mickey Mouse "Deck the Halls" Big Fun Book To Color situated between us. Santino was prompted to tell this SLP about the pictures as he turned the pages independently. Santino engaged and entered into a two-way, purposeful interaction with gestures and intentional communication via spontaneous verbalization and reading of both single and multi-syllabic words, and two-word phrases printed or pictured on the pages. Continuous back and forth engagement via eye contact, smiles, laughter, gestures and facial expressions of what appeared to be excitement and pride in his verbalizations were noted throughout this 20-minute portion of the session. Santino verbalized and/or read the following during the aforementioned interaction: Holidays, Mickey Mouse, Lollipop, Party Time!, Presents, Present, Hat, Candy Cane, Minnie Mouse, Fun, Eating Cookie, Delicious, Ho-Ho-Ho-!, Pluto, Donald Duck, Oh, boy!, Goofy, Day, Play, Surprise!, Jingle Bells, Merry Christmas!, Write, "Oooooooo!", Happy Holidays!, Accordian, Tuxedo, Daisy Duck, Gingerbread Man, Horray!...The session came to a close in the routine manner with the "Good-Bye" Song. Santino appeared to transition easily from the Mickey Mouse book and successfully completed the photo exchange within the classroom and the lobby given verbal and minimal physical prompts from this SLP...Continue as planned with a focus on activities to build and expand upon functional communication via photo exchange, verbalization and written words.