Chris was extremely tired this morning. He shared that he "didn't really sleep much." Once the session was underway, he was attentive and participatory as usual. He initiated conversation with a strong focus. He was eager to share his completed powerpoint presentation that he began working on in January. Once again, this afforded an excellent opportunity to review aspects of narrative generation, and story grammar components. He had clearly revised his initial presentation, and utilized the guidance provided in a previous session.
Expanded use of cohesive ties, increased use of detail, stronger setting clarification, and expanded character development and perspective were all incorporated into his revision. Review of both grammatical markers and sentence structure components was highlighted today. Strategies to enhance target use of punctuation as a framework to clarify storyline intent were shared. Expanded details regarding verbal narrative generation as well as written narrative generation were also highlighted. Speaker -speaker overlap was notable today, however, awareness of instances of overlap was strong. Familiar supports were provided to assist with successful conversational repair.
Chris enthusiastically initiated conversation this morning. He presented with a happy demeanor and was eager to discuss a myriad of topics today. He was eager to share new "video segments," and a new power point project that he had created. However, the technology presented with challenges this morning. He maintained balance, although he was observably frustrated, and simply asked "Ms. Lynne, let's plan to do this next week ok?" He subsequently utilized a familiar transition phrase to segue into a new topic of choice. Additional topic transitions were characterized by use of strong transition phrases 3 times. Remaining transitions were supported with cues and supports. Speaker -speaker overlap was notable this session, as attentional shifting was moderate. Awareness of instances of overlap was variable, and supports were provided to successfully repair overall occurrences. Topic choices this session allowed for strong expansion into the familiar aspects of presupposition, perspective taking, and "filtering."
2/10/2025 3:30PM-4:30PM
S: Noah was seen at the Batt School for a rapport building session, as well as for assessment to develop an updated plan of care. He was eager to talk to and work with the SLP throughout the session, telling the SLP about school, friends, family, etc. Play-based therapy techniques, speech sound screening assessment and structured language tasks were utilized to assist in developing an appropriate plan of care for Noah. O: Through speech sound screening assessment and play-based therapy, some speech sound difficulties were displayed. Errors patterns included deaffrication (e.g. a “stop” sound (/p/, /b/, /t/, /d/, /k/, /g/) replaces an affricate (/ch/, /j/) and incorrect production of /th/. Language probes were also provided. First, Noah was asked to spell his first name and completed the task with 100% accuracy. He then was asked to spell his last name given verbal cues (i.e. isolated letter sounds). He was able to spell his last name with 43% accuracy. Lastly, Noah completed a letter-sound correspondence activity where he was asked to identify the letter when provided with its sound and a field of 3 letter choices. He completed the activity with 54% accuracy A: Noah presents with both speech sound and language difficulties. Speech sound difficulties include production of affricates and production of /th/ across positions of words. Language difficulties include phonological processing skills such as letter-sound correspondence. P: Continue assessment and develop a plan of care.
2/18/2025 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 completing her lunch when the session began. Alexandra was initially hesitant to work with the SLP but quickly warmed up as the session progressed/activities were presented. Play-based therapy techniques and structured language tasks were utilized throughout the session. O: Alexandra first completed 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 57% accuracy. She was then asked to identify the spatial concept provided given a picture (e.g. a picture of a cow behind a barn with the prompt, “Where is the cow?”). She completed the activity with 55% accuracy. Next, Alexandra completed a quantitative concepts activity where she was asked to identify the concepts “more” and “less” in a field of 2 picture answer choices. She completed the activity with 90% accuracy identifying more and 10% accuracy identifying less. Lastly, Alexandra produced the /r/ sound in isolation and at the word level given a verbal model. Her percentages are as follows: isolation: 60% ; initial /r/: 100% ; medial /r/: 60% ; final /r/: 60% A: Alexandra has developed baselines for expressive and receptive spatial concepts. It is noted that Alexandra has difficulties with receptive and expressive identification of “next to,” “above,” “below,” “under,” “in front,” and “behind.” Quantitative concepts and /r/ production baselines are still being established. P: Continue POC and develop baselines.
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.
