1/21/2025 12:36PM-1:26PM
S: Alexandra was seen at the Batt School for an initial rapport building session. She was initially reserved with the SLP, but it is noted that she opened up more as the session progressed. Play-based therapy techniques and informal assessment were utilized to assist in building rapport as well as developing an appropriate plan of care for Alexandra. Formal assessment was initiated toward the end of the session. Alexandra enjoyed playing with dinosaurs, unicorns, and kinetic sand throughout the session. O: Through play-based therapy and informal assessment, a variety of speech sound difficulties, as well as difficulties with utterance length and use of modifiers were noted. Speech sound difficulties such as production of /r/ across positions and substitutions of /d/ for /g/ and /t/ for /k/ (fronting) were seen in informal assessment. During formal assessment, these error patterns were also noted. A: Alexandra presents with both speech sound and language difficulties that may impact her both socially and academically. These difficulties are as follows: utterance length, use of modifiers, and a variety of speech sound errors. P: Continue formal assessment and develop plan of care.
Chris enthusiastically initiated conversation with a strong focus this morning. He was eager to share a "powerpoint" presentation that he has been working on regarding his latest "video" project. This afforded an excellent opportunity to review aspects of narrative generation and story grammar components. Subsequently, Chris was observed to "edit" his presentation which included provision of varied vocabulary and increased detail, as well as increased use of more effective cohesive ties. Additional guidance for review of grammatical markers and detailed sentence structure was only briefly shared, as time did not allow for expansion in this area. Speaker -speaker overlap was variable today. However, awareness of instances of overlap was strong. Chris was observed to identify instances of overlap 12 times within the session and shared, "Aaahhh! Ms. Lynne, I'm so psyched to tell you all about this." Overall conversational reciprocity was strong today. Chris was observed to acknowledge comments and respond to questions with more lengthy, contingent utterances. Strong session today.
Chris enthusiastically initiated conversation this morning. He was eager to discuss a multitude of topics. Guided support was provided as the session commenced, as topic initiation was characterized by multiple starts, shifts and revisions. Speaker -Speaker overlap was notable today, however, response to familiar cue supports was strong, and acknowledgement of overlap was noted on 6/8 instances. Acknowledgement was characterized by use of simple phrases ("Oh, sorry," "Wait, what?" "You go.) He subsequently allowed for repetition following acknowledgement 4/8 times. Topic transition was characterized by use of familiar transition phrases consistently. Chris responded to requests for clarification when details provided within topic were not "shared knowledge." These instances allowed for review and expansion of familiar aspects of presupposition, and perspective taking. He responded favorably, as he shared "Oh yeah Ms. Lynne, I remember that stuff."
Alexandra had her best session yet! She engaged for the entire session and was open to working on her articulation. She was able to produce L with 90% accuracy and SH/CH/ J with 50% accuracyacc
Chris enthusiastically initiated conversation this morning. He presented with a "happy" affect, and was eager discuss a myriad of topics. Attention was strong for the duration of the session this morning. Allowance for reciprocity was notable, however, periods of overlap were frequent. Awareness of overlap was strong, and Chris was observed to recognize instances of overlap and subsequently respond with phrases such as "Oh, I'm sorry," and "Oh wait...What?" He appropriately allowed for repetition and or clarification as needed. Use of familiar transition phrases to allow for successful topic changes was noted 6/8 opportunities this morning, allowing for a significant increase in natural flow and fluidity of conversation. Increased integration of true intention and novel language use was also noted. Chris was observed to provide inferences when provided with hypothetical scenarios with 65% accuracy. Strong session today.
Alexandra had one of her best sessions yet! She transitioned very well into the session today. She was ready to work. Her L sound production in the initial position was very accurate- 85% accuracy with minimal to no cues. Sent home L initial worksheet for home practice.
Introduced CH sound and positioning. She was able to produce it 5x with moderate cues. Words practiced: chicken, chair, cherry, cheeseburger, chop
Alexandra had a difficult time transitioning into her classroom today but warmed up after a few minutes. She was initially resistant but got excited to chat about her unicorns which opened her up to working on her sounds. Focused on SH/CH/ and J. 50% accuracy with minimal cues.
Today's session was the first session following the holiday break, and it commenced with an unanticipated change. Chris initiated the session from home this morning. He shared that he wanted to "be sure to meet this morning, since we hadn't seen each other." He went on to share that he was home sick, and had just returned home from the doctor a few minutes prior to the start of the session. He was clearly not feeling well. He was commended for showing such initiative, and for taking responsibility to honor his commitment, especially since he was home sick.
He initiated conversation rapidly, sharing that he had been working on his new video project over the break. He provided a strong monologue, as he shared storyline details, and well as changes that he had made since our last discussion. Attention was strong today, as he was eager to discuss highly preferred topics. Additional topic presentations were characterized by responses consisting of minimal verbal expansion. Allowance for conversational reciprocity was variable, as speaker -speaker overlap was significant today. Awareness of instances of overlap was notable, as attempts to repair the breakdown were observed on 8/12 opportunities. Chris was observed to fatigue as the session neared closure, however his motivation remained strong throughout the session.
Alexandra was excited to begin the session but then remained cautious in trying to practice her sounds. We talked about her holidays and she colored some of her target words. Will work on SH, CH, J and L Thursday in the initial position of words.
Alexandra had a great session today. She loved working on her L sound with a variety of dinosaur names. In addition, she loved working on her SH sound today. She enjoyed doing the ‘quiet’ sound nice and loudly.
