Richard was given a to do list with 5 items at the start of the session. Richard recalled 4/5 items on his list at 10 minutes, 3/5 at 30 minutes and 5/5 at 45 minutes.
Richard worked on TH sounds in the initial, medial, and final positions today in single words, sentences and in conversation.He had the most difficulty with final TH with a consistent substitution with F.
Initial: 75% in conversation, 90% in sentences
Medial: 70% in conversation, 100% in sentences
Final: 50% in conversation, 80% in sentences

Today Richard worked on retelling the directions to a new game he wanted to play. Richard did a nice job recalling the directions during the game which is something he has been working on with recall. Multi syllabic words including L blends and S words 90% accuracy in single words, 85% in conversational speech. He did a nice job slowing down to articulate his consonants so that his intelligibility was more clear.

Richard focused on short term and long term memory skills and strategies during the session today in addition to L blends. Richard was given a task of going to the grocery store with a list of 8 items. The clinician provided Richard with some strategies on recalling the items (paper and pen, repetition, using categories to recall items such as fruits, veggies). Richard used a pen and paper to draw out the items to help him remember. When asked 10 minutes later what items were to be brought, Richard recalled 8/8 items. When asked at the 45 minute mark, he recalled 7/8 items.

L blends in conversation were at 85-90% accuracy. In structured sentences when provided with an L blend, he was at 100% accuracy.
Richard also worked on overall intelligibility today. He practiced skills such as slowing down so he can hit all of his articulators in addition to taking breaths and swallowing so that his saliva does not pool in his mouth making it harder for him to articulate words clearly.

Richard had an excellent session. Initially he worked on TH sounds in the initial, medial and final position of words. In conversation, Richard continued to substitute /s/ and /f/ for TH in various positions. At the word and sentence level, Richard was able to produce TH correctly 80% of the time without cues. Use of a mirror was presented to Richard and did increase his accuracy so he could see his mouth/tongue positioning. Memory skills were also targeted during this session as Richard was given 3 words at the beginning of the session to recall at 10 minutes, 30 minutes and 45 minutes. At the 10 minute mark, Richard recalled 0/3 words when the clinician gave him the 3 words again. At the 30 minute and 45 minute mark he recalled all 3 words. He repeated the words to himself multiple times as a memory strategy he had previously worked on.

Chris was eager to share the new "plush toys" that he had brought with him this morning. He prefaced "sharing" them by stating "I hope you don't think this is crazy Ms. Lynne" as he chuckled. The toys that he subsequently shared were duplicates of three of the toys that he already has in his collection. This afforded an opportunity to discuss story line ideas, and creative "movie making." His enthusiasm prompted his fast pace as he provided various "ideas" in rapid succession. Supports to allow for pausing, reciprocal expansion and acknowledgement of comment were facilitative. He subsequently shared that he " thinks he is a better thinker now" and that he "thinks about the things we talk about."
Attentional shifting was decreased today, as shared reference was sustained for more lengthy periods, and conversational reciprocity was sustained for increased cycles.
Additionally, Chris was able to identify items within a semantic class and provide rationale with with 60% accuracy. Review of /s/ phoneme production was an additional focus. Chris was observed to self correct targets in short phrases with 65% accuracy. Strong session.

The session commenced with Chris needing to "organize" his belongings as they were clearly in disarray. He shared that he was very tired, and that he had once more stayed up late last night watching a tv show that he had just discovered. He briefly embellished on details regarding the show, and was eager to share highlights of the storyline. Scaffolding supports were provided to assist with linguistic organization, use of cohesive ties, and temporal links. Attentional shifting was strong this session, as rapid topic shifts, and periods of strong internal distraction were noted with increased frequency this session. Topic transition phrase use was supported with familiar cues and prompts. However, following a transition, periodic self interruption was observed, as Chris would pause and suddenly interject " I need to tell you...." and abruptly change topic throughout the session. Conversational reciprocity was characterized by increased speaker -speaker overlap this session. Chris demonstrated awareness of the overlap with moderate consistency and utilized clarification strategies of "Sorry Ms. Lynne, wait, what ?" Allowance for comment/comment exchange was subsequently noted for 3-4 cycles following the repair.

Richard had a great session. He focused on L blends today in conversation and short sentences. He was 75% accurate in conversation, 95% in short sentences and 100% in single words. Richard also worked on memory strategies. He learned 4 rules to learning something new and then executed this new strategy with a board game. He was able to recall 3/4 steps independently. He did a nice job recalling these steps 30 minutes after learning them.

Richard had a great session today. We focused on /s/ and 'th' sounds in conversation and coming up with sentences with age appropriate vocabulary words. He worked on hitting his articulators in order to be more intelligible in conversation. We also discussed swallowing during conversation so that his saliva does not pool in his mouth. We ended the session working on making inferences and understanding the differences between a guess and an inference after hearing a story/ piece of information. He did an excellent job with this.

Today was Richard's first session with his new therapist. He was shy initially but warmed up to the clinician. Richard introduced himself to the clinician and shared information about himself. A game was played to warm up and get to know eachother. After the game, /s/ and /th/ sounds were targeted. Richard was observed to substitute /f/ and /s/ for 'th' in various positions. Weak articulatory contact was heard in conversational speech which impacted his intelligibility. He as approximately 80% intelligible to this unfamiliar listener. In conversation, some difficulties with irregular past tense verbs was noted. Overall, it was a great first session.

The session commenced this morning with Chris sharing his excitement about a new TV show that he had discovered last night. This afforded an opportunity to discuss storyline and characters with increased use of temporal cues and cohesive ties. Supports were provided. Chris was also exited to share that he had "posted" a new video on his SMC "You Tube" site. This new production was unexpected as it was not included on the comprehensive list that he had written in his new "idea book." Additional topic transitions were supported with familiar cues to assist with use of transition phrases this session. Cycles of reciprocity consisted of 1-2 cycles this session, characterized by strong use of verbal acknowledgement ("yeah," "also..um," "I know.") Expansion was facilitated through use of direct question, and carrier phrases.