2/13/2025 12:36PM-1:25PM
S: Alexandra was seen at the Batt School for therapeutic intervention for both a language and speech-sound disorder. She ate a snack prior to beginning the session. Alexandra was eager to work with the SLP throughout the session. Play-based therapy techniques and structured language tasks were utilized throughout the session. O: Alexandra was first probed for stimulability to produce the /sh/ sound in isolation with limited success due to task refusal. She was then asked to produce the /sh/ sound at the word level given a visual production prompt and verbal model. Her percentages at each position in words (i.e. initial, medial, final) are as follows: initial /sh/: 20% ; medial /sh/: 40% ; final /sh/: 0%. Lastly, Alexandra was asked to follow directions given spatial concepts (e.g. put the candles “on” the cake). She completed the activity with 60% accuracy. A: Alexandra is setting baselines for her current POC. Goals will continue to be targeted to develop a baseline and assess progress. Production of /sh/ sound in isolation was met with task refusal, therefore accurate data could not be taken. P: Continue POC and develop baselines. Hold /sh/ sound practice until Alexandra becomes more comfortable is more stimulable in the production of the sound.

2/11/2025 12:36PM-1:25PM
S: Alexandra was seen at the Batt School for therapeutic intervention for both a language and speech-sound disorder. She was initially hesitant to work with the SLP but warmed up as the session progressed. Play-based therapy techniques and structured language tasks were utilized throughout the session. O: Alexandra was first probed with a receptive spatial concepts activity in which she was verbally given a spatial concept and was asked to identify the concept provided in a field of 3 picture answer choices (e.g. which bug is “on” the leaf). She completed the activity with 55% accuracy. She was then asked to identify the spatial concept provided given a picture and a field of visual supports (e.g. a picture of a cow behind a barn with the prompt, “Where is the cow?”, and visual supports for “in front” and “behind”). She completed the activity with 60% accuracy. Next, Alexandra completed an activity where she produced /r/ blend words given a verbal model. She completed the activity with 60% accuracy. Lastly, she completed a probe for the phonological process of stopping using minimal pairs (e.g. sail/tail). She completed the activity with 70% accuracy given an initial model. A: Alexandra is setting baselines for her current POC. Goals will continue to be targeted to develop a baseline and assess progress. P: Continue POC and develop baselines.

The session commenced with Chris sharing that he had "a lot to talk about today." Motivation continues to remain high each session. Chris continues to enthusiastically initiate conversation, and demonstrate increased use of varied vocabulary and novel utterances during topic initiation. Topic transition was supported with provision of familiar cues, which successfully facilitated increased use of transition phrases as needed. Speaker- speaker overlap was variable today however, awareness of instances of overlap was strong. Overlap was most often noted during instances of question or requests for clarification of topic detail. This afforded an excellent opportunity to review aspects of presupposition and perspective taking. Repair and revision of overlap occurrences required the use of familiar prompt and cue strategies today. Attention was strong this session.

2/6/2025 12:36PM-1:25PM
S: Alexandra was seen at the Batt School for a language screening assessment as well as initial therapeutic intervention for a speech sound disorder. She was eager to work with the SLP throughout the session. Play-based therapy techniques and language screening assessment were utilized to assist in developing an appropriate plan of care for Alexandra. Alexandra enjoyed playing with dinosaurs and unicorns throughout the session. O: Through play-based therapy and language screening assessment, Alexandra presented with a variety of language difficulties. These include receptive identification of prepositions (i.e. when provided a field of 4 answer choices (4 pictures) and a prompt to identify a specific preposition), expressive identification of prepositions (i.e. when provided a picture and a prompt to identify the location of a noun shown), expressive categorization (i.e. given a category, listing items within the category provided; e.g. name 3 items on a playground), identifying differences within similar objects (e.g. how are a plane and bird different), expressive use of the present progressive (-ing), and utilizing increased utterance length when discussing a picture scene. Through play-based activities, the /r/ sound continued to be addressed at the word level. Percentages across positions are as follows: initial /r/: 90%, medial /r/: 20%, and final /r/: 20%. /sh/ sound informally targeted. A: Alexandra presents with language difficulties that may impact her both socially and academically. The language concerns mentioned above will be addressed in her updated POC. P: Develop POC.

2/4/2025 12:36PM-1:25PM
S: Alexandra was seen at the Batt School for an additional rapport building session as well as a speech sound screening assessment. She was eager to work with the SLP throughout the session. Play-based therapy techniques and speech sound screening assessment were utilized to assist in developing an appropriate plan of care for Alexandra. Alexandra enjoyed playing with dinosaurs, unicorns, and magnetic tiles throughout the session. O: Through play-based therapy and speech sound screening assessment, a variety of speech sound difficulties were displayed. Errors patterns included incorrect pronunciation of /r/ and /v/ across all positions at the word level, deaffrication (e.g. a “stop” sound (/p/, /b/, /t/, /d/, /k/, /g/) replaces an affricate (/ch/, /j/), and depalatization/palatal fronting (/s/ for /sh/ and /z/ for /zh/). When the assessment was completed, stimulability for the /r/ sound was tracked at the word level via a play-based approach. Alexandra was stimulable in 10% of opportunities. A: Alexandra presents with speech sound difficulties that may impact her both socially and academically. The speech sound concerns mentioned above will be addressed in her updated POC. P: Begin language screening assessment and develop plan of care.

Chris enthusiastically initiated conversation this morning. He was eager to discuss a myriad of topics, as he shared that he had "a lot of stuff to talk about today." Attention was strong, and motivation was high. Chris was observed to utilize familiar topic transition phrases with ease in order to segue into new topics that he was wanting to discuss 6 consecutive times. Periods of speaker -speaker overlap were notable today, and instances of overlap were acknowledged when cue supports were provided. Cycles of exchange were notably more lengthy today, and characterized by use of increased contingent comments and subsequent expansion. Strong session.

1/21/2025 12:36PM-1:26PM
S: Alexandra was seen at the Batt School for an initial rapport building session. She was initially reserved with the SLP, but it is noted that she opened up more as the session progressed. Play-based therapy techniques and informal assessment were utilized to assist in building rapport as well as developing an appropriate plan of care for Alexandra. Formal assessment was initiated toward the end of the session. Alexandra enjoyed playing with dinosaurs, unicorns, and kinetic sand throughout the session. O: Through play-based therapy and informal assessment, a variety of speech sound difficulties, as well as difficulties with utterance length and use of modifiers were noted. Speech sound difficulties such as production of /r/ across positions and substitutions of /d/ for /g/ and /t/ for /k/ (fronting) were seen in informal assessment. During formal assessment, these error patterns were also noted. A: Alexandra presents with both speech sound and language difficulties that may impact her both socially and academically. These difficulties are as follows: utterance length, use of modifiers, and a variety of speech sound errors. P: Continue formal assessment and develop plan of care.

Chris enthusiastically initiated conversation with a strong focus this morning. He was eager to share a "powerpoint" presentation that he has been working on regarding his latest "video" project. This afforded an excellent opportunity to review aspects of narrative generation and story grammar components. Subsequently, Chris was observed to "edit" his presentation which included provision of varied vocabulary and increased detail, as well as increased use of more effective cohesive ties. Additional guidance for review of grammatical markers and detailed sentence structure was only briefly shared, as time did not allow for expansion in this area. Speaker -speaker overlap was variable today. However, awareness of instances of overlap was strong. Chris was observed to identify instances of overlap 12 times within the session and shared, "Aaahhh! Ms. Lynne, I'm so psyched to tell you all about this." Overall conversational reciprocity was strong today. Chris was observed to acknowledge comments and respond to questions with more lengthy, contingent utterances. Strong session today.

Chris enthusiastically initiated conversation this morning. He was eager to discuss a multitude of topics. Guided support was provided as the session commenced, as topic initiation was characterized by multiple starts, shifts and revisions. Speaker -Speaker overlap was notable today, however, response to familiar cue supports was strong, and acknowledgement of overlap was noted on 6/8 instances. Acknowledgement was characterized by use of simple phrases ("Oh, sorry," "Wait, what?" "You go.) He subsequently allowed for repetition following acknowledgement 4/8 times. Topic transition was characterized by use of familiar transition phrases consistently. Chris responded to requests for clarification when details provided within topic were not "shared knowledge." These instances allowed for review and expansion of familiar aspects of presupposition, and perspective taking. He responded favorably, as he shared "Oh yeah Ms. Lynne, I remember that stuff."

Alexandra had her best session yet! She engaged for the entire session and was open to working on her articulation. She was able to produce L with 90% accuracy and SH/CH/ J with 50% accuracyacc