Santino was seen for session 12 of 12 with this Speech-Language Pathologist (SLP)...The daily, visual schedule was presented via his Occupational Therapist (OT), Miss Christina, in the "middle" classroom...Information was exchanged, briefly, between the OT and the SLP regarding Santino's productive, positive session completed with the OT...Attempts to transition Santino into the "East" classroom were met with rejection. It appeared that Santino thought it was time for dismissal. He brought his backpack to this SLP repeatedly and turned toward the door to the inner hallway. His feelings were acknowledged and validated as Santino sat and rocked side to side with this SLP...With assistance from Miss Christina, Santino did choose to enter the "East" classroom. The remainder of the session focused on continuing to soothe and calm Santino. Each attempt to engage him in planned activities was met with rejection. Both food and drink were offered. Santino did not seem interested. During the last 15 minutes of the session, Santino stood up, walked to the pretend food storage bin, selected a slice of pizza and verbalized, "Pizza!". He brought it to the "kitchen" area and sat on the floor. In an attempt to engage and extend his chosen activity, Santino was asked to "feed" each of two stuffed animals who were "hungry" and who "asked" for a bite of his "pizza". Santino complied with each "request" by "feeding" the "pizza" to them. At that point, the session came to a close in the routine manner...Continue as planned with the recommendation to display all photos of the teachers as well as those of Mom and Ingrid upon the start of his first session. The sequence may then be reviewed and referenced throughout the day as Santino transitions from session to session.

Santino was seen for session 11 of 11 with this Speech-Language Pathologist (SLP). He exchanged photos successfully on his daily, visual schedule with prompts from Miss Dorothy and transitioned calmly from the "middle" classroom to the "East" 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 was directed to the sensory ball and sat with support at his hips. The "Hello" Song was introduced. Eye contact was fleeting. Upon the presence of visitors to the classroom and independent of direction, Santino walked to the shelf, removed the alphabet stamps, returned to the "circle-time" area and spelled "pigy" and "yelow". Attempts to "join" Santino in his chosen activity were met with more tolerance than in the session prior. Initially, he did protest and remove the "g" and "l" added to his words, but with persistence and increased affect by this SLP, Santino eventually permitted the additional letters to remain and spell the words "piggy" and "yellow"...The second 20-minute session commenced as Santino selected "Water Wow" from a field of two activities presented. He imitated the action required to mainpulate a "water pen" and "paint" 4 separate farm scenes to reveal hidden objects. Santino maintained focus for 15-minutes. Delayed echolalia was noted intermittently as objects were revealed and named...Santino was easily enticed into an engaging, predictable interaction via the "Ball-Launcher" for the final segment of the session. As noted previously, each action in the sequence was initiated upon request (via eye-contact). Santino engaged in the typical manner by standing in anticipation, locating, retrieving and returning the ball to the "launcher" for 5 out of 5 opportunities. When the roles reversed, Santino launched the ball independently for 5 out of 5 opportunities. He giggled throughout and responded via eye contact when his name was called to "help" this SLP "find" the ball. Santino "came to the rescue" following appropriate wait-time and increased affect by this SLP who "stretched" but "could not" reach the ball...The session came to a close in the routine manner with side-to-side rocking in time to the "Good-Bye" Song followed by successful photo exchange on his daily, visual schedule with both visual and verbal prompts from this SLP...It should be noted that Santino brought his backpack to this SLP in anticipation of dismissal. He appeared upset and was redirected to the visual schedule to show Miss Christina NEXT...THEN Mom or Ingrid. Santino seemed to remain upset and even teary-eyed throughout the transition process given validation of his feelings, and attempts to distract, calm and soothe.

The session commenced once again with Christopher excitedly sharing "Marvel news." Christopher continues to happily want to share action figure characters, ideas, and "theories" about future movies as the session begins. This continues to afford the consistent opportunity to focus on the concepts of "thinking together", and the allowance of reciprocity, and acknowledgement of your communication partner's gestures, facial expressions and non verbal feedback.
Continued focus, and use of varied facilitation strategies to support increased topic cohesiveness and use of specific links to support linguistic organization remain a primary goal. Further expansion into the concepts of character and personality traits was facilitated with strong cue supports, embedded within the activities of story grammar generation and narrative development.
Christopher was once again highly motivated.

Upon arrival to Ben's room, he was actively engaged in viewing items of interest on his laptop.
Social greet was happily verbal, however, body language was inconsistent with the verbal as he remained facing his laptop. This afforded an excellent opportunity to indirectly discuss the "perception of a communication partner" based on body language, gestures and visual referencing. Ben engaged rapidly and shared 3 poignant observations regarding social greetings.
Focus of the session expanded into the dynamics of perspective taking within reciprocal language activities highlighting use of expanded descriptive concepts, varied semantic categories, and associative concepts. Ben expressed strong enjoyment, and actively participated. Use of embedded cross pattern sequences adapted from Brain Gym, Handle, and RMT continues to be a strong component within sessions as well.

Santino was seen for session 10 of 10 with this Speech-Language Pathologist (SLP) in the "East" classroom. He exchanged photos successfully on his daily, visual schedule with prompts from
Miss Janis, but appeared visibly upset as he transitioned away from what appeared to be an iPad...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...Bubbles were presented immediately upon the start of the first 20-minute session as a means to redirect Santino from the device. Shared attention and interest were fleeting. Santino selected an alphabet puzzle from a shelf independent of direction, then sat on the carpet in the "circle-time" area and spelled, "pigy" and "yelow". In an attempt to join and extend his interest, this SLP presented additional letters ("g" and "l") "borrowed" from another puzzle nearby and added them to his words his to create, "piggy" and "yellow". Santino promptly protested and removed the rogue letters, off to the side, with each recurring attempt by this SLP. Signs of frustration were acknowledged and validated followed by removal of the errant letters by this SLP...Santino presented the green beverage container. Water and a vanilla drink were presented as choices. Santino requested the water via eye gaze and gesture (tapping). A successful two-way, purposeful interaction with gestures and intentional communication ensued to open the bottles together. Given requests and designated "wait-time", the water was transferred from the bottle to the green container independent of assistance from Santino as he did not seem to show interest in helping with the task. (At dismissal, Ingrid indicated that the green container is for the "milk" beverages, only.) Two new books with predictable story patterns were presented as options to read while he held the green container. Santino requested via eye gaze and gesture (tapping) for "Where's Spot?" As the predictable story pattern was read aloud, Santino lifted flaps spontaneously at the appropriate time throughout the story sequence for 8 out of 8 opportunities and turned the pages successfully for 11 out of 11 opportunities with both verbal and visual prompts...At the end of the story, Santino stood and looked at the array of planned activities displayed at the center table. He was enticed into another interaction with the "Ball Launcher" which progressed successfully in the same manner as indicated in previous sessions for 5 out of 5 opportunities. At one point, Santino seemed to have difficulty locating the ball and walked away from the area. The ball could not be reached no matter how much this SLP "strained" to grasp it. Each "plea" for help brought Santino closer and closer, while engaging in eye contact. He would turn away then come closer, observing, "wheels turning", planning...Given time, Santino "came to the rescue", got down on his knees, stretched his arms and grabbed the ball from deep, deep under the bench, and placed it back in the "launcher"! This time, the roles reversed and he "launched" the ball! For one last time, Santino helped locate the ball when this SLP "could not"!..The session came to a close in the usual manner with side-to-side-rocking in-time with the "Good-Bye" Song and successful photo exchange on his daily visual schedule using both verbal and physical prompts by this SLP...Continue as planned with continued focus on single-word requesting via eye gaze, gestures, and/or picture exchange during highly preferred cause and effect activities.

Santino was seen for session 9 of 9 with this Speech-Language Pathologist (SLP) in the "East" classroom. As usual, Santino appeared pleasant in demeanor and seemed to transition well between sessions as he exchanged photos successfully on his daily, visual schedule with both verbal and physical prompts by
Mr. Marcus...Santino presented with milder cold symptoms and permitted wiping with a tissue as needed...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...In keeping with the routine, the session commenced in the typical sequence. Attempts to introduce the sensory ball in order to assist with regulation and to engage in singing the "Hello" Song were met with rejection. Santino, instead, walked to and from the "letter" stamps located on the shelf. Verbal redirection was unsuccessful at first, but with persistence and increased affect, along with brief "joining" in his chosen activity, the regulation/greeting sequence was completed as planned...Subsequently, Santino walked to the table and chose the "Ball Catapult/Launcher" displayed in a field of two planned activities on the center table. He selected the green ball and ran to the carpet in the "circle-time" area in anticipation of the activity. Santino followed the established action sequence, which initiated only upon eye contact prior to each step of the process. As in the previous session, Santino searched for and located the ball then ran and/or skipped joyfully back to this SLP while engaging in eye contact. Once the ball was returned to the "Launcher", this sequence of purposeful/positive interaction repeated successfully for 15 out of 15 opportunities...Upon completion, Santino selected blocks he had "eyed" but not reached for in previous sessions. He seemed hyper-focused on the block with the letter "P" and repeated "Penguin" (pictured on one side of the block) several times. Attempts to engage in and extend his chosen activity were presented with increased affect and momentarily welcomed by Santino as block "L" and the "lion" depicted, "growled" and "chased" block "P" and the "penguin" back into the box which was promptly returned to the shelf. Santino seemed interested in letters and puzzles for the remainder of the session. He selected 2 letter puzzles and brought each to the carpet one-by-one. Santino immediately removed the letters "R-E-D", returned each to the frame then pushed it away. Efforts to redirect and engage Santino in the remaining planned, preferred activity, Who Lives in This House?" were rejected. Santino returned to the alphabet puzzle. In an effort to engage and extend his chosen activity, the letters were removed by this SLP and a choice of 2 letters was provided. Santino gestured for both then followed a one-step verbal direction to return the letter designated by this SLP into the frame. He was successful in this regard for approximately 5 out of 10 opportunities. Attempts to insert the remainder of the letters in a "My turn/Your turn" sequence were met with some protest, but were tolerated from time to time. Upon completion, Santino returned the puzzles successfully to the shelf with both verbal and physical prompts. The session came to a close in the usual sequence with the "Good-Bye" Song. He removed the photo successfully from his daily, visual schedule with both verbal and fading physical prompts by this SLP. Continue as planned with a focus on single-word requesting via eye gaze, gesture and/or picture exchange during familiar, preferred cause and effect activities. Have a lovely weekend!!!

Santino was seen for session 8 of 8 with this Speech-Language Pathologist (SLP) in the "East" classroom. He appeared pleasant in demeanor and seemed to transition well between sessions as he exchanged photos successfully on his daily, visual schedule with both verbal and physical prompts by Miss Christina... Goals for the session 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...At the start of the session, Santino appeared to be experiencing symptoms associated with a cold. Tissues were required throughout the session and Santino allowed wiping without protest...The session began in the typical fashion as Santino was directed to the sensory ball in order to assist with regulation. The "Hello" Song was introduced and Santino engaged with fleeting eye contact. He participated by completing the patterned lyrics, "I'm so glad to..." with the words, "see you!" for 2 out of 5 opportunities during the the song. Santino seemed regulated and chose to skip and walk on the rug in the "circle-time" area. Attempts to follow Santino's lead and to engage and join him via song and gestures during his chosen pattern of movement proved successful as he initiated eye contact and added the phrase, "my friend" for 2 out of 2 opportunities during the song (i.e. Walking with Santino..., Walking with Santino..., He's "my friend!"...,He's "my friend!")...At that point, Santino walked to the table where two planned cause and effect activities were displayed. He sat in the chair independent of direction and initiated via gesture to engage with a preferred activity, "Who Lives in This House?". He completed the patterned action sequence and requested via eye gaze and gesture for 10 out of 10 opportunities, each. Santino labeled 3 out of 10 items within the sequence. Upon completion of this 20-minute activity, Santino stood for a walking sensory break. Attempts to engage Santino with a new cause and effect activity proved quite successful as he engaged with this SLP for approximately 20- minutes in a playful exchange for 20 out of 20 opportunities. Santino appeared joyful as he located a small, red ball catapulted from a cone-shaped basket via the push of a trigger. Eye contact was required for each count to three followed by the catapult/release of the ball..."Zooooooooom!" He seemed to stand at the ready in order to catch the ball. Santino searched for and located the ball successfully without prompts. He ran with eye contact back to this SLP, placed the ball in the basket, then ran back to the rug, appearing to anticipate the sequence once again. The activity must have made him thirsty as he requested the vanilla shake via gesture. It was poured into his green container and he lay on the rug and had a few sips. At that time, the session came to a close in the usual fashion. Continue as planned for the next session. It was wonderful to share in the activities with Santino!

Santino was seen for session 7 of 7 with this Speech-Language Pathologist (SLP) in the "middle" classroom. Santino appeared pleasant in demeanor and seemed to transition well between sessions as he exchanged photos successfully on his daily, visual schedule with both verbal and physical prompts by this SLP... Goals for the session 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 greeted with the "Hello" Song as he engaged in gentle bouncing on the sensory ball with support at his hips. Eye contact was fleeting...Santino appeared regulated and showed interest in "Who Lives in This House?". He followed a one-step verbal direction successfully to sit in the chair. At the table, he participated for 20-minutes in the action sequence for 10 out of 10 attempts and requested items via gesture and eye gaze for 10 out of 10 attempts. Verbalizations to complete the communication pattern were noted for 3 out of 10 attempts. A walking sensory break followed for approximately 2- minutes, during which he selected and presented the maze activity from a bag of items belonging to Miss Christina. (It has been reported that Santino engages readily with this activity.) Attempts to redirect Santino to a planned cause and effect activity were accepted. The activity required use of a "mallet" to hit 3 balls. Once released, each slid down a series of 3 ramps. This activity did not prove to offer the right amount of challenge as it was quite easy for Santino to push each ball through the hole with his hand vs. hit each with the mallet...The session came to a close after 30-minutes due to the early release procedure planned for the storm. A quick wrap-up ensued as Santino removed the photo successfully on his daily, visual schedule with both verbal and physical prompts from this SLP. A brief version of the "Good-Bye" Song and a hug for Miss Sharon followed...Continue as planned...It was a pleasure to engage with Santino and to speak with Mom!

Santino was seen for session 6 of 6 with this Speech-Language Pathologist (SLP) commencing in the "middle" classroom then transitioning to a smaller, individual room on the "North" side of the campus. Santino appeared pleasant in demeanor and seemed to transition well between sessions as he exchanged photos successfully on his daily, visual schedule with both verbal and physical prompts by Miss Christina...His backpack and "cow" pillow were gathered and brought along to the individual classroom...
Goals for the session 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 entrance to the smaller room, Santino appeared to be in search of something. This was assumed to be a highly favorable activity from his session with Miss Lynne the day prior (which this SLP observed). Santino seemed eager to locate the item, but was redirected to the table where 2 cause and effect activities were presented. Santino seemed interested in "Who Lives in This House?". He participated in the action sequence 10 of 10 attempts and requested items via gesture and eye gaze 10 of 10 attempts. Verbalizations to complete the communication pattern were noted 2 of 10 attempts...Santino appeared interested in the window of the door to the room. Attempts to redirect and engage in an action sequence involving the "Balloon Pumper" were successful 3 of 5 attempts. Still, "hyper-focus" on the window was observed. Attempts to redirect Santino with the "Mickey Mouse Pattern Tile Set" were met with rejection. As the session came to a close, Santino engaged once again when singing and side-to-side rocking in time with the "Goodbye Song" began. He exchanged photos successfully on his daily, visual schedule with both verbal and physical prompts from this SLP...Continue as planned with a focus on determining highly desirable cause and effect activities and on exploring options to determine the optimal space for Santino's sessions.

The session commenced similar to the previous session, with Christopher excitedly sharing the Marvel characters he had with him, as well as new characters from the DC venue. This afforded an excellent opportunity to expand on the concepts of character traits, and expand into broader awareness of similarities and differences. Strong focus once again was placed on the concepts of traits and descriptors, beyond the observable physical characteristics and "things they do." Cues and supports were again provided. Topic shift ensued quickly as the task became more challenging. Support and guided redirection was successful.
Transition into narrative generation was successful as Christopher happily engaged with the story board magnetic props. Prompts were provided, with a focus on character trait development, sequential order of ideas and the notion of " checkin in " with your "listener" by observing their non verbal cues. Strong session once again today.