For our first session today we focused on sentence structure and grammar. We spotted the difference between a complete, incomplete and run on sentence. We looked at irregular plural nouns. Richard was irritated by the fact that many plurals “don’t make sense” or follow the regular rules. He completed the activity with 50% accuracy. He correctly used the irregular plural of child, teeth, tomato, man, family but missed foot, goose, mouse, fish and deer. We will continue to practice these words in their singular and plural form.

The session commenced with Chris unexpectedly initiating the session a few minutes ahead of time from home once again. He shared that he was "ready" for the session even though he had not arrived at school yet. Chris was attentive and highly motivated as he answered questions using more lengthy detailed responses, and engaged in more lengthy conversational exchanges consisting of increased comment /comment cycles. Occurrence of speaker -speaker overlap was significantly diminished this session. Chris demonstrated stronger linguistic organization within conversation as well as increased use of topic transition phrases. Chris was excited to share ideas related to his newest "YouTube" productions as well as plans for spring break. Review of /s/ phoneme production was also a focus today. Self awareness and self correction was supported with familiar cues. Strong session.

Chris was in a great mood today. He was excited about new technology he was using. Today we discussed the topic of Accepting Criticism. When I first introduced the topic Chris has an immediate reaction. He explained he was shocked that I decided to discuss that because he recently received criticism and did not like it. On a self rating scale of 1-5, Chris rated himself on the lower end with a 2 as far as his ability to handle criticism. We discussed the differences of receiving criticism online and in real life and from adults/teachers and peers. Chris did agree the best option may be to ignore criticism online but was also able to admit this is very difficult for him to do. We thought of the ways we can handle criticism and the difference between negative and constructive criticism. Overall, Chris was receptive to the discussion and was able to self determine it is a weaker skill of his and something he needs to work on.

Maddie was eager to attend speech today. We began with auditory bombardment of initial /f/ words. We continued by reviewing why we come to speech. We used the mirror to elicit /f/ in isolation. Maddie does well with this. She continues to be able to produce /f/ in the initial position of /f/ + a vowel with 60% accuracy using the mirror. I sent home the activity that we completed and Maddie should continue at this level. Her accuracy decreasing significantly when we attempt /f/ in the initial position or words. The coarticulation of the various sound still continues to create difficulty for Maddie therefore she should continue accurate productions at home of just /f/ + a vowel.
We also worked on pronouns and she currently uses “he” in place of she when talking about or describing manipulatives. We finished with a flashlight task where Maddie enjoyed turning off the lights and searching around the room for our f manipulatives.

Richard and I completed multiple activities today. First, we worked on comparing and contrasting age appropriate vocabulary. He read a short /o/ book and answered comprehension questions in a written format. He has a tendency to guess the word ending without looking at the corresponding letters. Multiple prompts were given to use his finger and his eyes to follow along. He said he couldn’t because he didn’t have his glasses. He answered questions with medial /th/ words in sentences with 80% accuracy. It should be noted that he over compensated on few occasions and over generalized, adding the /th/ sound to the middle of words that did not have /th/.
Finally we completed sentences with irregular past tense verbs. He filled in the blanks with 60% accuracy and often second guessed the ones he did get correct. We reverted back to regular past tense fill in the blank and I determined he often changes the sentences to accommodate using the verb in its present tense form or another past tense verb. For example, He will pick the flowers, he is picking the flowers, He gave her the flowers (Instead of he picked the flowers). We will continue to work on this.

Chris continues to be engulfed in "you tube" video production, and has expanded his scope to include collaborations with other "PlushTubers" as mentioned in previous session notes. Chris was eager to meet this morning, and arrived a bit early for the session. He rapidly initiated conversation as he was clearly distressed about a fellow "you tuber" who had posted a video that was critical and hurtful of Chris' content. He shared that "Some person made a hate video on me." Support and guidance were provided as discussion regarding social media, as well as the aspects of varied emotions such as jealousy and envy were expanded upon. Review of the aspects of social dynamics, and relationships highlighting concepts from the familiar Social Thinking literature were successful in supporting Chris. Additionally, gentle guidance away from the use of inappropriate, mean spirited name calling, and the acknowledgment and need to maintain respectful boundaries for both adults and peers was reviewed. Allowance for reciprocal conversational exchange increased as the session progressed, as the repetition of "attention grabbing phrases" diminished. The session closed on a positive note, as Chris shared that he was "feeling better."

S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant throughout the session. Play-based, child led therapy, along with structured language tasks utilized. Speech sounds assessed informally. Use of timers for transition out of treatment utilized and continue to be successful. O: Noah continues to increase his MLU with SLP. It is noted that his intelligibility during activities tends to decrease when excited, but he will repeat models of sounds/words when provided. Object function was probed again in session in a field of 3. Noah completed the activity with 80% accuracy. Noah was probed with color identification activity. He completed the activity with 40% accuracy. He was also probed with following 1-step directions with 2 key words (e.g. give the pencil to the bear (when provided with 2 objects and 2 animals)). He completed the activity with 55% accuracy. Speech intelligibility informally targeted. Noah’s average intelligibility throughout session ranged from 60-70% depending on context. A: Noah’s MLU displays great progress. Object function displays increases from initial probe. Color identification tasks are noted to be difficult for Noah, as well as directions with multiple key words. Noah’s intelligibility and stimulability are noted to be at a stable level. P: Discontinue MLU goal. Continue to informally assess and target informally as needed. Monitor object function goal and add to POC as deemed necessary. Continue to probe color identification and following 1-step directions with 2 key words. Continue speech sound goals as written in POC.

Chris arrived a few minutes late once again, however, he eagerly initiated conversation as he had quite a few thoughts that he wanted to share this morning. He requested input regarding upcoming storylines for his latest video ideas. Provision of scaffolding strategies afforded the opportunity for stronger organization and an increased awareness of the need for temporal links and cohesive ties.
Topic transitions within conversation were supported with familiar cue strategies to enhance the use of transition phrases, as topic shifting was strong. Review of novel language use, and the use of "previously learned utterances" within conversation was also a focus this session.

S: Noah was seen at the Batt School for treatment. He had difficulty with transitioning to treatment and was noted to cry and scream upon entry. Calming strategies were utilized (e.g. take a deep breath, choose a preferred activity) and successful. After initial difficulty with transition to speech, Noah worked well with SLP. Play-based, child led therapy, along with structured language/speech sound tasks utilized. Use of timers for transition out of treatment utilized and successful. O: Throughout play-based activities, Noah was noted to use increased MLU during play activities, often engaging with SLP and asking/answering questions. Object function was probed in a field of two answer choices with 60% accuracy. Noah also produced /l/ across positions of words. When provided a model, he produced the /l/ sound with 70% accuracy across positions. Noah’s overall speech intelligibility throughout the session ranged from 50-60% accuracy depending on context. A: Noah displays continued increases in MLU and is engaging more with SLP. /l/ sound continues to be practiced as an interdental /l/ to promote correct production. Speech intelligibility ranges throughout session depending on activity and excitement level. P: Continue with current POC with a continued probe for object function prior to adding to POC.

Motivation and participation were strong this session. He happily provided inferences following varied stimuli given cue supports, and was able to predict outcomes given verbal scenarios related to his Marvel characters and potential story lines. He was also eager to ask questions related to the many familiar topics that he often prefers to discuss. Topic transition was supported with use of familiar phrases 6/8 opoortuites today. Strong session.