Alexandra had a good session. She had a hard time transitioning into the session but once in she warmed up. She worked on SH in the initial position of words. She was ~50% accurate in single words.
Chris enthusiastically initiated conversation this morning. He was eager to discuss a myriad of topics this morning, as he presented with a rather happy demeanor. Attention was strong, and topic shifting was characterized by use of familiar transition strategies. Periods of speaker-speaker overlap were noted, however, awareness of instances of overlap was strong, and requests to clarify message was noted 80% of the time. Cycles of exchange were notably more lengthy than in recent sessions, as attention, intentionality and mindfulness were observably strong today. Review of key aspects of presupposition were highlighted this morning, as conversational exchange was notably strong.
Alexandra had a good session today. She was shy to warm up but enjoyed engaging with uni and baby uni. She did a good job teaching her uni's how to make the SH sound. We did it in the initial position of words.
Alexandra had her best session yet! When she has baby uni and uni she tends to be much more vocal and motivated to do her words. She did an excellent job with medial L. She is more consistent with L in the middle of words than at the beginning. Will continue to target both.
SH / CH in single words
The session commenced with Chris sharing that he was once again "super tired." In addition, he shared that he had a "tough morning." He briefly shared minimal details about what had transpired, and then fairly rapidly shifted into the preferred topics that typically are highlighted during our sessions. Speaker -speaker overlap was strong today, and multiple cue supports were provided to enhance increased reciprocity. Topic expansion was minimal this session, as internal distraction was significant. Chris was noted to inquire about the tools that have been utilized to support attention and attention shifting in previous sessions, as he thought he
"might need them today." Chris asked if we could close a few minutes early today, as he was needing some time to "feel calmer, like we talked about." His request was honored, and we closed the session.
Chris presented with a melancholy demeanor once again this morning. He immediately shared that he was "so tired," and that he wanted to share some "positive news" first, followed by "not so good news." Strategies to expand topic variation as well as conversational reciprocity were facilitative, however, internal distraction was evident throughout the duration of the session. Topic preference did however afford an excellent opportunity to highlight the familiar aspects of presupposition, timeline clarification and detail related to recall of events. Additional focus was placed on aspects of "attention" and self advocacy within episodes of distraction, and attentional shifting. Chris remained somewhat passive once again, as responses to both questions and comments were characterized by brief contingent verbalizations. Chris' overall affect was noted to shift as the session progressed, allowing for brief periods of expansion.
Alexandra had a difficult transition into the session today but slowly warmed up. She was resistant initially but enjoyed coloring and working on initial and medial L sounds.
Sent home following words:
Lion
Love
Light
Look
Lemon
Balloon
Dolphin
Melon
Alexandra had a great session. She worked on a variety of dinosaur names in order to practice her sounds today. She was highly motivated by working on dinosaur sounds. She did great.
Parent meeting with Alexandra’s family via zoom to discuss report and goals. Referral to ENT.
Chris presented with a melancholy demeanor once again today. He initiated conversation rapidly however, and shared that he was "super tired." He also shared that he was getting involved in "modding" once again. Additional topics were subsequently introduced as a springboard for expanded conversational reciprocity. It is significant to note that pausing, and clearly latent responses were observed today across topics. Allowance for pause time was provided, and Chris utilized familiar repair strategies of question or comment stimulus repetition to support attentional shifting that was strongly evident. This afforded an opportunity to revisit aspects of self- awareness, attention and repair of conversational breakdown. Chris shared that he remembered "all of that attention stuff we talk about." He also shared that his "brain is loud inside, and is jumping away like it used to today." Familiar support strategies such as breath work, and movement sequences adapted from the Brain Gym literature, and the Reflex Integration literature were reviewed. Additional familiar supports, compensation techniques, and self regulation strategies were provided as well. Self- awareness and self advocacy were reviewed as well to best support interactions across his school day.
