Chris was really excited to tell me all about the script he was writing. We discussed different ways he could reach out to friends and creators to include them in his project. We discussed the benefits of collaborations and weighed them against the difficulties of working with people instead of on our own. Chris also wanted to talk about his new living situation. He expressed that he’s having a hard time sleeping because he isn’t comfortable yet. We brainstormed different ways he could change his mindset about the new house. We also read over a few scenarios with temporary and permanent solutions and organized them. We connected the dots by explaining that Chris’s new house may be a temporary solution and how flexible thinking would benefit his perspective on change.
Chris arrived in a timely manner this morning. He was enthusiastic and motivated to engage. He was eager to share "news" regarding his latest video productions. Scaffolding supports provided a framework to organize and share details utilizing stronger cohesive ties and temporal links. Conversational expansion was strong as noted by increased cycles of exchange. Speaker-speaker overlap was notably decreased this session. Topic transition was characterized by use of more novel transition phrases today as well. Strong session.
Maddie was engaged and was able to practice /s/ through play. We used a ball to roll over the target word cards after we attempted them. Maddie demonstrates difficulty focusing during non preferred tasks and required multiple prompts to stay on track. We pivoted to join her class during the second half of the session and worked on initial fronting and backing during “duck duck goose” Maddie enjoyed this and was willing to attempt more accurate productions in between turns.
During our second session, Richard was out of energy from recess. We began by practicing /th/ in conversation. Richard was to accurately produce /th/ while explaining the rules of “sharks and minnows” that was played during recess. He did a great job with this. His /th/ was accurate 80% of the time. His lack of energy also helped slightly as it reduced his rate of speech and increased his accuracy. We continued with a subject predicate activity. Richard was able to identify the subject of the sentence 90% of the time but demonstrated more difficulty with identifying the predicate. He expressed a need for a break so we chose a brain break off the list. We attempted a “crossing the midline” task to increase focus but Richard said he didn’t believe it was helping him. We finished the session with a grade level passage titled “Another point of view” Richard was able to accurately express what he imagined the passage might be about before reading and correct his idea slightly after the passage was read. He benefited from flexible seating during this task and we agree that as long as he was doing his best listening he could sit however he liked.
Richard was really focused during our first session. We began with a phoneme manipulation task, in which Richard completed a word ladder by changing one letter at a time to create a new word based upon clues I read aloud. He did a great job with this and you could tell he was really working hard to figure it out. We continued with a self-rating speech scale to independently observe his growth and opinion of his speech. Richard feels communication partners almost always understand him. He does notice that sometimes he speaks too quickly and also self-reflected that he has the most difficulty with medial /th/ as it is hard for him to get his tongue into the right place in between other sounds of words. I was really impressed with his reflection and I agree with him! We finished with some oral motor exercises.
S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant for the duration of his treatment session. Play-based, child led therapy, along with structured language and speech sound tasks utilized. O: Noah completed a spatial concepts activity where he reviewed spatial concepts (e.g. in, on, under, behind) and was asked to identify spatial concepts reviewed from a field of 2 visual answer choices. He completed the activity with 50% accuracy. Noah also participated in a letter identification activity for the letters A-D. He was asked to identify letters, provided a model, in a field of 3 letters. He completed the activity with 60% accuracy. Noah also completed a quantitative concepts activity (e.g. more/less, big/small) where he identified a variety of quantitative concepts provided given a field of 2 visual answer choices. He completed the activity with 50% accuracy. Noah’s play skills were observed with data collected during a variety of play activities. He displayed the ability to turn-take/share in 73% of trials. Lastly, Noah completed a speech sound activity in which he produced /l/ blend words provided a model as needed. He completed the activity with 65% accuracy. A: Noah continues to display stability/progress across POC goals. Notable increases with letter identification (A-D), as well as /l/ blend word production. P: Continue with current plan of care.
S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant for the duration of his treatment session. Play-based, child led therapy, along with structured language and speech sound tasks utilized. O: Noah completed a spatial concepts activity where he reviewed spatial concepts (e.g. in, on, under, behind) and was asked to identify spatial concepts reviewed from a field of 3 visual answer choices. He completed the activity with 50% accuracy. Noah also participated in a letter identification activity for the letters A-F. He was asked to identify letters, provided a model, in a field of 3 letters. He completed the activity with 30% accuracy. Noah also completed a letter-sound correspondence activity with the letters A-D. He completed the activity with 30% accuracy. Noah’s play skills were observed with data collected during a variety of play activities. He displayed the ability to turn-take/share in 70% of trials. Lastly, Noah completed a speech sound activity in which he produced multisyllabic words provided a model as needed. He completed the activity with 50% accuracy, though limited data is noted. A: Noah continues to display stability/progress across POC goals. Limited data noted for speech sound activity; interpret data with caution. P: Continue with current plan of care.
S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant for the duration of his treatment session. Play-based, child led therapy, along with structured language and speech sound tasks utilized. O: Noah completed a spatial concepts activity where he reviewed spatial concepts (e.g. in, on, under, behind) and followed directions using the concepts. He completed the activity with 40% accuracy. Noah also participated in a basic concepts activity in which he recognized shapes/sizes of objects, as well as followed directions based on shape/size via use of magnet tiles. He completed the activity with 45% accuracy. Lastly, Noah completed a speech sound activity in which he produced /l/ blend words. He completed the activity with 55% accuracy when provided with some verbal/gestural cues for positioning. Noah’s play skills were informally assessed throughout session and appear to display stability with previous data collecting sessions. A: Noah continues to display stability/progress across POC goals. P: Continue with current plan of care.
Chris is making great progress in the area of social cues. Today we readdressed the topic of empathy. I presented Chris with one scenario and asked him to explain how the student might feel and why he might feel that way. Chris then explained that he knew how the student felt but wanted to tell me a story about his previous experiences and why it makes it hard to feel for other people. Chris then explained many situations in his past friendship experiences that now make it hard for him to connect and feel for people. This shows really great progress for Chris. Although he still demonstrates difficulty always putting these ideas into action, he is able to generalize and self-reflect. He wasn’t successful at this at the beginning of the year. I was then able to witness Chris playing with a group of peers on the playground, and on more than one occasion Chris was able to effectively use different social strategies we had discussed.
Richard had extra energy today. I gave him 2 minutes to complete a brain break task from the list in his room. Then we refocused by using a sensory bin of Kinetic sand and /th/ objects hidden to practice /th/ in conversation. Richard did well with this. Initial /th/ was used in conversation with 90% accuracy! Minimal difficulty with medial /th/ in words such as, bathroom (Bafroom), something (someping) etc but it isn’t affecting his overall intelligibility. We continued with a grade level passage. He demonstrated some difficulty listening even as I allowed him to use flexible seating around the classroom. He was able to answer 75% of the questions correctly on the first attempt but required multiple repetitions of the other. Again, this was probably due more to difficulty attending to the task than accuracy of listening comprehension. Towards the end of the session, I noticed Richard had completed a task on white and yellow lined paper with his OT. I complimented him on how nice his handwriting was and how hard he must have worked on it. I am not sure if he thought I was then going to ask him to write on that type of paper because he started to get upset. Which is very unlike him. We reviewed our conversation and attempted to repair the communication breakdown because I wasn’t sure where he started to become upset. We concluded by determining he thought I expected him to always use that paper and that quality handwriting output. I explained that as long as he was always trying the best that he could that was all I expected.
