I was so happy to see Richard had his glasses today. He was ready to participate in preferred activities and wanted to save the reading and comprehension task for the end of the session. We practiced /th/ in words 90% in all positions, 75% in sentences and 50% in conversation do to lack of direct attention to target and coarticulation of other sounds increasing the difficulty. We read a grade level appropriate non fiction passage together. He was able to correctly identify and define words when given the context clues to determine. We completed a deductive reasoning task to increase sustained attention and problem solving skills. He demonstrates difficulty focusing for extended periods of time but does better when he can move freely around the room.

S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant throughout the session. Throughout session, play-based, child led therapy was utilized along with structured language/speech sound tasks. It was noted that Noah had difficulty transitioning out of treatment session. Use of timers will be utilized in future sessions to assist with this. O: Throughout play-based activities, Noah was noted to use increased MLU during preferred play activities. Present progressive was also worked on within the session. Noah independently produced the present progressive form of a variety of verbs with 80% accuracy. He also worked on /l/ and /r/ sounds across positions of words within connected speech. He was noted to produce speech sounds within sentences with 60% accuracy. A: Noah displays continued increases in MLU. He is maintaining his use of the present progressive and generalizing it into conversation/play. Speech intelligibility at the sentence level is noted to display some deficits, with some stimulability concerns when compliance is decreased. P: Continue with current POC. Introduce use of timers to assist with transitions between activities as well as transitions from treatment to home.

Christopher had a great session today. He was excited to tell me about how his week was going and how he is looking forward to spring break. We spent today’s session discussing safety online. He was able to brainstorm certain things that may be considered unsafe in online friendships such as disclosing his first and last name or agreeing to meet up with friends he has made online without asking his parents first. He had a difficult time determining the line of appropriate content and inappropriate content.
We also discussed how his friendships were going at school. He said as of right now he has been able to implement some of the strategies we discussed. I was able to witness him on the playground today and I saw him going out of his way to make pleasant conversation, engage in conversation with less familiar peers and adhere to the rules of the game.

Maddie did a great job today. We had speech outside and we were able to minimize distraction. In isolation, with a mirror she was able to produce /f/ very well! She stated she had been practicing with Dad at home. When we attempted /f/ in the initial position she was only 40% accurate. We reverted back to /f/ followed by a vowel in order to increase coarticulation. I will collect baseline data for medial and final /f/ next week.

The session commenced a few minutes ahead of schedule as Chris arrived at school in a timely manner. He eagerly initiated conversation as he began to describe in detail all of the new projects that he has planned in collaboration with other "Plush Tubers." Allowance for increased cycles of speaker listener reciprocity was noted as speaker- speaker overlap was markedly diminished. Periods of self correction were noted as well, as Chris was noted to observe nonverbal cues with greater frequency and subsequently clarify what he perceived as miscommunication. Familiar supports to facilitate increased linguistic organization and topic shifting were successful. Strong session today.

S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant throughout the session. Throughout session, play-based, child led therapy was utilized along with structured language/speech sound tasks. O: Throughout play-based activities, Noah was noted to use 3-4+ word utterances with minimal to no cueing for utterance expansion. Present progressive was also worked on within the session. Noah independently produced the present progressive form of a variety of verbs with 90% accuracy. He also worked on a variety of speech sounds across positions of words within connected speech. He was noted to produce speech sounds within sentences with 60% accuracy. A: Noah displays increases in MLU. He also displays increases with use of the present progressive. Speech intelligibility at the sentence level is noted to display some deficits. P: Continue with current POC.

S: Noah was seen at the Batt School for treatment. He was eager to work with the SLP and compliant throughout the session. Continued rapport building noted throughout session. Throughout session, play-based, child led therapy was utilized along with structured language/speech sound tasks. O: Noah was asked a variety of “wh” questions (i.e. who, what, where) in a field of two visual answer choices. He answered the questions with 60% accuracy. He also worked on the /l/ sound in the initial position of words. He completed the activity with 60% accuracy. Throughout play-based activities, Noah was noted to use 3-4 word utterances with minimal to no cueing for utterance expansion. Present progressive was also worked on within the session. Noah independently produced the present progressive form of a variety of verbs with 80% accuracy. A: Noah was noted to show minimal interest in “wh” question activity. Presentation will be flexed for future sessions. Some stimulability for /l/ sound observed. Interdental /l/ was utilized to assist with positioning. P: Continue with current POC.

S: Noah was seen at the Batt School for an initial treatment session with a new SLP. He was timid when transitioning into the treatment room, but he began to open up with SLP as session progressed. Session is noted to be a rapport building session with probes of previous speech/language goals. O: Goals were informally assessed via play activities/rapport building. A: Goals were informally assessed and deemed to be appropriate to continue in POC. Noah displays some communication breakdowns within conversation d/t rate of speech and speech intelligibility. Length of utterance appears WFL. Use of the /l/ sound within words is noted to be difficult for Noah. Verbal/visual models assist with intelligibility displaying stimulability for speech sound goals. P: Continue with current POC.

Richard read “Sam and Tam”, a book at his reading level, and answered corresponding comprehension question with 100% accuracy. When presented with a short passage at a slightly higher level, he did everything he could think of to avoid the task. I read the passage with him and then read him the comprehension questions and he was able to answer them with 85% accuracy. I provided auditory bombardment of /th/ in the medial position of common words while he made a valentines bracelet. He was able to then identify and separate common medial /th/ words from /sh/ words. We also worked on a task where he corrected irregular plurals (leafs/leaves) with 70% accuracy. Richard is a hard worker and I hope we can find reading passages that interest him and boost his confidence.

Today Chris and I were able to review what I observed on the playground during a recess earlier in the day. The recess was successful and so we took the time to look at what made it that way. From my perspective, he was able to engage in many positive social interactions. He was able to gracefully accept when he had lost, take redirection positively, and include many of his peers in the game equally. From Chris’s perspective, the game involved more kids than usual. In particular, older students decided to participate today. We concluded that was helpful in changing the dynamics. We decided that when more kids were participating, there were more opportunities to engage in conversation/ turn-taking that he preferred. We ended the session by Chris telling me something he was proud of for himself. This really helps change his mindset and attitude in the moment.