Maddie was in a hurry today. She would quickly change gears from one activity to another. This increased her rate of speech and decreased her intelligibility. We decided to go an animal hunt on the playground in order to burn off some energy. We then used auditory bombardment and listening skills to separate the animals in to different sound targets. (Initial /s/,/c/, /f/). Maddie was able to do this with 40% accuracy given visuals. We then shifted gears to a patience and turn taking task. Maddie picked a block from 3 different sound target baskets and we set up a domino run that we built as long as we could before accidentally knocking it over.
The front desk had received notice that Chris would be arriving late to school. However, Chris unexpectedly initiated the session from home this morning in a timely manner. Chris was observably tired, and presented with a melancholy demeanor. He very much wanted to share his "feelings" regarding the move to his new home, and that today was the last day that he was "in his house." Support strategies were provided, new perspectives regarding the move were shared, and Chris responded with a lighter affect and a bit more enthusiasm. Expansion into varied topics and tasks was subsequently successful, however, internal distraction remained evident. Speaker -Speaker overlap was notable today, and familiar cues were provided to best support expanded reciprocity and topic transition.
Chris has continued to exhibit excitement and strong motivation as sessions commence. Conversational expansion was strong this session, and use of more novel topic transition phrases were utilized. Topic maintenance was sustained with notable increases in vocabulary specificity and use of cohesive ties. Response to requests for clarification of intent was strong when details within topic reference were ambiguous, and/or outside of "shared knowledge." Chris expressed greater interest in aspects of presupposition this session. Strong session.
During our second session today, Richard and I concluded our stem experiment. We were able to confirm or deny our hypothesis and then write three concise simple sentences as our conclusion. He still tries hard to avoid writing but did use his best handwriting on this task. We continued by reading a grade level passage on Tornadoes. We were able to read the comprehension questions in advance and he was able to listen for possible answers while the passage was read aloud. He continues to demonstrate more interest in non-fiction text than fiction. He also enjoys researching various points of the passage further after reading. For the comprehension questions, Richard was to dictate his answer to me. The first few answers were longer run on sentences. I let him dictate them completely and then read them back to him so he could edit his answers.
We began the first session creating a STEM experiment. Richard really engages and benefits from hands on activities. He was able to read the modified list of tools and directions. We then used previous knowledge and predictions to make a hypothesis and write it using a complete simple sentence. We continued by practicing /th/ in conversation. Richard did really well with this. He needed a few cues to slow his rate of speech but his intelligibility of articulation was great. He has many ideas and demonstrates some difficulty organizing them into shorter, digestible bits.
Today Christopher was eager to recap the field trip he attended last week. He spoke about a new friendship he started with a peer that he hadn’t previously engaged with much. He was able to tell me ways in which he started conversations with this peer and ways he tolerated things he didn’t quite agree with. This demonstrates growth for Christopher as he was not only to productively creating conversation with a new friend but was also able to reflect upon the positives and negatives of the opportunity. Chris switched topics halfway through the session when he asked if he could talk about something that was bothering him. He wanted to talk about currently moving. He did a great job of objectively discussing what parts of the move were going to be hard for him. He also stated many things he viewed as negative about the move. We then took those negatives and attempted to view them from other family member’s perspectives. He was unable to think of their perspectives on his own but he was able to see them as possibilities when I suggested them. I think Chris is making great progress.
Maddie had a great day in speech today. She is doing better transitioning and beginning the activity as soon as we get to speech. Today we worked on initial /s/ and initial /k/. Maddie tends to replace /t/ for /k/. For example /tow/ for /cow/. This correcting is a bit more difficult since we are attempting to replace a visible front sound /t/ for a back sound /k/. We use tactile cues such as touching her throat to feeling the /k/ production. Overall Maddie was receptive to this but doesn’t quite hear the errors in her own speech yet. We used minimal pairs to help elicit discrimination between correct and incorrect productions. I provided her with multiple initial /k/ objects and requested she listen and slide the item down the slide when I said the word correctly. She was successful 45% of the time during this activity.
Richard was in a great mood today. We began the session with /th/ in conversation. We continued with the practice of pointing to /th/ on paper to elicit self correction instead of SLP stopping his train of thought and interrupting him. He completed the activity with 65% accuracy. He also maintained a slower rate of speech and did well with overall intelligibility. We worked on a listening comprehension and describing key features task. Richard demonstrates strengths with grade level vocabulary. We attempted a read aloud task. Richard's lack of motivation and confidence in his reading skills creates an opportunity for him to engage in multiple avoidance behaviors. Before the task he took a restroom break, requested a few minutes to take a brain break, informed me he needed to go order lunch etc. I gave him the opportunity to do these things and then we proceeded with the task. He did great on this level appropriate task! He read the short sentences with minimal errors and was able to answer questions regarding the text afterwards. I made sure to reinforce his success in attempt to increase his confidence. We finished our sessions with an irregular plural noun task in which Richard completed with 80% accuracy. He is doing great!
Chris was in a great mood today. He was making a lot of jokes. Today we discussed apologizing and accepting apologies from both peers and adults. Chris often deflects with humor when he’s feeling uncomfortable but was able to state a few accurate scenarios for acceptable apologies. During the second half of our session Chris was corrected by an adult for climbing on the playground equipment in a way that was deemed unsafe and previously discussed. Chris demonstrated difficulty accepting information from the adult and continued to just state, “oh why? But why? Why though?” Next week we will discuss this in more detail and brainstorm more appropriate ways to accepting consequences for actions.
S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant for majority of the session. Play-based, child led therapy, along with structured language tasks utilized. O: Noah completed a color identification activity where he labeled items by color. He completed the activity with 90% accuracy. Noah also participated in a sight word identification activity (e.g. I, a, to, is) when provided initial modeling of the words. He completed the activity with 25% accuracy. Noah also read a sight word book with SLP for “I.” He read, when provided with initial modeling, with 55% accuracy. Noah was then asked to follow 1-step directives with the inclusion of spatial concepts (e.g. in, on, under, behind). He completed the activity with 55% accuracy provided minimal to moderate support. Lastly, 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. A: Noah continues to display stability/progress across POC goals. Slight decreases displayed on some activities due to some task refusal. P: Continue with current plan of care and discontinue color identification goal.
