The session commenced with Chris unexpectedly initiating the session a few minutes ahead of schedule from home this morning. He rapidly revisited the "news" of his upcoming move. He shared specific details about the move, as compared to the last visit when he "briefly mentioned" that he would be moving to a new house. He was able to generate a short timeline, and share the responsibilities that were on his mind. Use of familiar cues to support expansion of details and increased use of cohesive ties and temporal links were successful. Periods of increased internal distraction were noted today, and subsequent repetition of question stimuli followed by a reply was also noted. This familiar support strategy, which he has utilized more frequently as self monitoring has improved, has been successful for him during periods of increased distraction. This tool has enabled him to sustain interactions more successfully, as well as increase responses to question stimuli during periods of increased distraction.
Today we worked on social inferencing. Chris demonstrated difficulty listening today. He seemed to be thinking of something else most of the session. He required multiple repetitions of the scenarios before he was able to comprehend the questions that followed. During our session Christopher starting talking poorly about himself. He was referring to an entrance exam he had recently taken at another school that he was informed he didn’t do well on. He and I attempted to list a few things he liked about himself. He continued providing me with negative “self talk” and it was evident that his lack of focus on our original task may have been because this other situation was bothering him. We finished by discussing the importance of self confidence and how we can return to the list of positive attributes we brainstormed when he is feeling less confident in himself.
During our second session today, Richard and I worked on a comprehension task. We read a nonfiction text comparing two animals and their strengths and weaknesses. We continued by completing a grammar task in which Richard had to unscramble simple sentences to correctly arrange the subject and the predicate. Richard demonstrated difficulty with this even when I was reading all the parts of the sentence. He demonstrated difficulty recalling the words I had listed and attempted to add many additional words, changing the meaning of the sentence. We played a Synonym /th/ game where we discussed the the meaning of “synonyms” as well as accurately producing /th/ targets while answering questions.
Richard was still not feeling well. He explained he recovered from Pink eye but now feels like he has a cold. Richard had a lot of extra saliva present today. He required multiple prompts to swallow the extra saliva instead of letting it run down his chin. It is possible that he has a stuffy nose and the additional mouth breathing was causing extra salivation. He was overgeneralizing many of his /th/ words today. His speech was a little less clear but he still produced initial /th/ with the most accuracy and medial /th/ with the most difficulty. Richard’s thought pattern was very erratic today. He was demonstrating difficulty completing one idea before moving on to another. We completed a thought pattern chart in order to list a few ideas he wanted to talk about to help him prioritize his thoughts and accurately convey ideas fully.
The session commenced with Chris eagerly wanting to share thoughts across a multitude of topics. His enthusiastic demeanor this morning was quite evident. Chris initiated topics with use of familiar "starters." Reciprocity was sustained across 6 topics consisting of 3-4 exchanges. Rapid topic shifting was noted, and familiar strategies to support more successful transitions were successful for the duration of the session. Scaffolding supports to enhance linguistic organization and use of novel vocabulary within more lengthy utterances were facilitative as well.
Engagement and motivation were strong this session.
Today Christopher was in the mood to tell jokes. He told me multiple situations and then when I asked him how he felt about it he responded with a joke. He said he couldn’t be serious and preferred to use jokes instead. We discussed different friendships and peers he was having difficulty connecting with on the playground. Chris feels as though he has no options when it comes to befriending peers at school that he has nothing in common with. He demonstrates difficulty empathizing and expressed he feels that people are teaming up against him. We attempted a perspective taking task and Christopher had difficulty putting himself in another’s shoes.
Richard wasn’t quite himself today. He was complaining about his left eye irritating him. We began with a grade level passage that I read to him. During this text we made predictions about how the passage would continue. Richard used knowledge from previous experience to make inferences about the text. We continued the session by completing an executive functioning task that involved planning his own restaurant. He was excited about this task and engaged while creating a menu with multiple imaginary dishes and prices.
He created his own Earth day character with superpowers to save the Earth. He used descriptive vocabulary and imagination to create a story about his character. He said his story aloud and we separated the parts into a beginning/middle/end. We determined the problem and solution of the story. We finished our session working on /th/ in the medial position of words at the sentence level. Richard mostly created run on sentences for each target word, so we worked on using a subject and predicate to create a simple sentence to increase articulation and appropriate grammar.
Maddie did a great job in speech today. We worked on /f/ and /s/ targets in isolation and then in the initial and final position of words by feeding a large dinosaur different snacks that began and ended with our target sounds. Maddie demonstrates difficulty with pretend play. She understands the concept but doesn’t sustain attention very long. We continued on the playground working on action verbs.
Chris arrived a few minutes early today, and quickly initiated conversation. Speaker listener reciprocity was strong this session, as Chris was able to provide contingent comments across 4-6 cycles of exchange 8 times within the session. Topic shift was characterized by use of familiar starters, and provision of scaffolding strategies supported use of more novel vocabulary and expansion of topic initiation. Chris was observed to provide inferences within varied contexts, and
predict outcomes given cue supports with increased accuracy. Attention and engagement were strong this session.
In our second session, Richard and I began with an auditory comprehension task. He demonstrated difficulty sitting still and changed his seating multiple times during the short story. When I paused the story to ask him about it, he was able to say he just needed to move around a little but was still listening. After the recording, we reviewed grade level vocabulary. Richard was able to define most of the vocabulary in his own words and was quick to ask for assistance in words he didn’t know. I then scaffolded by providing him the word in a sentence and we used the context clues to help create a definition. We continued by looking up the definition using the talk-to-text feature on the iPad. We also played a game of /th/ connect four using the words in sentences before placing them in the game grid.
