It was anticipated that Chris was going to be a few minutes late this morning, however, he arrived promptly, and a bit out of breath as he had clearly run to his room. He exuded familiar excitement as he began sharing new ideas about his upcoming "You Tube" projects. He itemized the 6 -7 ideas with use of fairly strong cohesive links, and expanded novel vocabulary. Topic shifts were subsequently supported with cues, as familiar transition phrases were utilized for the duration of the session. Expanded cycles of reciprocity were noted as well today. Review of target phoneme production facilitated stronger generalization of accurate /s/ production across all positions of words within short phrases. Strong session today.

Noah transitioned easily into the session today. He was ready to work! We started off with multi syllabic words to help increase overall intelligibility. Noah did a great job with 2-3 syllable words. Some 3-4 syllable words were difficult such as elephant. We focused on slowing down and tapping out syllables to help cue him. He is ~75% accurate. Noah engaged in a good amount of pretend and imaginative play today. He enjoyed playing doctor and role playing. He worked on using present progressive form while naming action picture cards. He did a nice job naming the action but had difficulties putting it in sentences. Sent home action picture cards to continue working on putting actions in full sentences. 'What is she/he doing?' and then Noah replying 'He is____' or 'She is ___'
Overall excellent session -

This morning's session commenced with a unique and unexpected change. Just prior to the meeting time, Chris' father phoned, sharing that following a weekend event, he and Chris were still in Hollywood at their hotel, and that Chris was "adamant" about making sure that he attended our session this morning. Virtual connection was established effortlessly and Chris happily participated from his hotel. Conversational reciprocity was strong, as he excitedly "gave a tour" of the suite, and shared details regarding the concert that they had attended. Linguistic organization was strong this morning and provision of contingent comments was consistent as cycles of exchange were 4-6 cycles in length. Topic transitions were notably fluid as topics were semantically linked and use of cohesive ties was noted with increased frequency. Novel topic transitions were supported with cues, and subsequent use of familiar transition phrases was noted.
Strong session today, and as the session closed, Chris shared that he was "really happy that we could meet today."

Noah transitioned very well into the session today. He greeted the clinician and said 'I go play toys!' We started working on WHERE question cards and Noah had fleeting attention. During this activity, Noah said 'tummy tummy' and I asked if his tummy hurt. Noah said 'Tummy tummy hurts' and a minute later needed to use the restroom. He is doing a nice job of verbalizing these requests clearly. He continues to add in jargon/non sense in between real words/phrases.
Noah was about 50-60% accurate with where questions. He benefitted most from a choice of two.

Noah worked a lot on pretend play today and expanding utterances. He did excellent play with the people from the toy house. He put them to sleep, made them food etc. He used the following phrases:
" I sweeping'
'I pee pee in the toliet at noah school'
'I can't open it'
'I cooking now'

During most of this play today, I worked on sentence closures with him. He would say 'I cooking' and I would say 'I am cooking _____' and wait for him to fill in. He did not always fill in but it is a good tool to get him to use more words per utterance.
Lastly we worked on multi syllabic words- 80% accuracy with minimal cues.

Richard was a pleasure to work with today. He focused on articulation during the session today, specifically TH and L. TH continues to be difficult for Richard to use in conversational speech when he is excited to talk about something. He requires moderate to maximum cues. L sound sounded excellent today, 95% accuracy with no cues.

Richard had a great session. Today we focused on multiple meaning words. These are words that have the same spelling but have different meanings. Richard was initially very confused by these but after watching a quick video to learn about them he really got the hang of them. He was able to define both meanings in 6/11 multiple meaning words. Next we worked on synonyms and antonyms. Richard said these were new for him. We discussed what they are.

Christopher started the session with great initiation 'how are you today?'He did a nice job of listening to the clinician and then answering how he was. Christopher quickly shifted topics, without a transition, to discuss the new plushies that are going to arrive to his house today. He enjoyed telling me about these new plushies. Frequent topic shifting was noted today. We worked on a few role playing situations 'what would you do' and 'what would you say.' He was fairly sarcastic in his replies and later would give an appropriate answer/response. He was a pleasure to work with today.

The session commenced with Chris very much wanting to share additional "plush" toys that had arrived in the mail. This afforded an opportunity for expanded conversation as the characters were unfamiliar, and not typical of the Mario repertoire that he often shares. Chris was able to provide elaborate detail of the characters as well as details regarding the role that these characters would potentially play in his upcoming videos. Topic shifting was strong once again, however the provision of familiar cue supports was successful as Chris was noted to utilize transition phrases for the duration of the session. It is significant to note that periods of comment or question repetition was needed as increased internal distraction was also noted this session. Self awareness was strong once more as Chris was keenly aware of the need for stimulus repetition and requested clarification 8 times this session and subeqently provided a contingent response.

Richard had a great session focusing on his articulation today. We specifically worked on TH today in single words, phrases, and at the conversation level. Richard is doing excellently in words and phrases with minimal cueing. He is able to do TH about 80-85% of the time. In conversation, he requires moderate to maximum cueing in order to correctly produce TH, especially if he is excited about something. Will continue to work on TH Thursday.

Chris rapidly initiated conversation this morning as he excitedly asked, "Do you like my SMC costume?" Chris was glad to elaborate on each detail of his costume following specific question stimuli. Periodic redirection was needed to support the use of cohesive ties as he expanded.
Rapid topic shift was noted today, and familiar cues provided the foundation for use of transition phrases for the duration of the session. Internal distraction was noted this session at a higher intensity. However, his awareness regarding his attentional fluctuation was strongly evidenced as responses to question or comment were characterized by use of affirmation, subsequent apology, and request for clarification. For example, "Yeah, uh- huh, wait, sorry Ms. Lynne, what ?" was utilized 4 times within session. Self awareness continues to improve, supporting increased success within communication exchanges across expanded topics.