Spencer was in a great mood and hot from being outside at recess. Instead, he wanted to practice our speech while doing a fun experiment in the kitchen. He found the ingredients he was looking for and made one of his ice pops. He requested some ingredients for the following week to make some variation of his popsicles. It was great to see his planning and polite, respectful communication.

Tristan likes the routine of doing speech therapy outside. To get in some extra practice, we tried to target some words before going outside. He completed the practice list once on the basketball court.

Santino was seen for speech/language therapy. He reportedly has been up since the middle of the night and had difficulty falling back asleep. He had intermittent spurts of being tired and laying on the rug while he was "taking breaks" but overall he did pretty well. We targeted language/auditory comprehension with a book activity by request. Verbs were targeted in Both structured and unstructured settings. Santino has done well with specific verb cards we have been working on however I'm working on generalizing the skill into real time events. For example, on a card with a child playing soccer - he will say "kicking ball", however when we're outside and is asked "what are they doing?", there is often time no response or will respond with the noun "ball". This of course is a more abstract concept that will take time to carry over and generalize. Santino has been requesting with " ____ yes". Moderate cues are used to request using I want + verb + object/desired activity. We interacted with peers and targeted language goals on the play ground for approximately 10 minutes. Santino has been enjoying the play ground again, being quite brave climbing on new equipment and up slides. Auditory bombardment during this play is beneficial. Santino required cues to answer safety questions today (name, live). Following directions to complete functional things like changing diaper and washing hands required cues as well.

Richard was seen for speech and language therapy from 11am-12:00pm. He was happy throughout the session. He stated his stomach hurt with a stinging feeling. It may have been a cramp. He got some water and had some of his peach & within a few minutes, he was okay and went and played outside after our session. Richard was excited to tell me about playing with his new neighborhood friends this weekend. His event recall and sequencing has seemed to improved. Minimal cues were needed for /s/ (tongue thrust) at conversation level and reducing his rate of speech. There was only one instance in this session that I couldn't understand something he said due to rapid rate of speech. We discussed his upcoming vacation that he is excited about. During conversation, we cover many of his goals in an unstructured way (i.e. verbs and possessives). Auxiliary verbs were targeted in a structured worksheet, required moderate cues. Irregular past tense was targeted in a structured setting - achieving 80% accuracy independently. /th/ was not targeted today upon noticing some thrusting of his tongue with /s/ in conversation. Overall, Richard did well.

As the session commenced, Chris shared that he was feeling a little better and that he has an ear infection. He also shared that he has "drops" for his ear and that he did not take his regular "medicine" today. Chris was eager to share topics of interest as he quickly shifted to topics he preferred. Scaffolding and familiar cue supports were provided as topic shifting was frequent this session. Speaker -speaker overlap was noted with increased frequency this session. Use of familiar repair strategies were modeled and facilitated within familiar prompt hierarchies. Conversational expansion was noted to be facilitated with increased question stimuli, as comment - comment exchange was less frequent this session. Chris was participatory and motivated today, however, it was evident that he was still not feeling quite himself as of yet.

Chris initiated conversation this session by sharing that he was experiencing ear pain and that he was going to the doctor later in the morning. He was strongly vested in the session as he so often is, however, it was evident that he truly was not feeling well. He was clearly tired and his voice quality was slightly raspy. He was participatory and engaged, however, ability to sustain attention within expanded language tasks was inconsistent. Familiar scaffolding strategies were provided to best support Chris as he navigated aspects of recall, vocabulary, and topic expansion.

Richard was greeted in the lobby. He happily transitioned from the cafeteria discussing the outcome from the art contest that took place that week. Richard does demonstrate some difficulty in the area of event sequencing and making his point clear, however with multimodal prompting - it improves. We briefly covered the calendar (date/day of week) and did some auditory and reading comprehension tasks. We targeted /th/ in the medial position at the sentence level. This was more difficult for Richard because it is not in the first part of the word. We reduced the complexity to the word level to increase accuracy for him. This appeared to help. Also, we went outside and completed some processing work involving the game "5 Second Rule". We have done this before and today, Richard demonstrated great improvement in his processing skills. Following that - we did 10 minutes of social/peer pragmatic goals playing basketball with another student and teacher. It has been nice to see Richard's confidence and conversational skills improve. Lastly, we finished with targeted language goals including past tense and auxiliary verbs. Richard is given a choice of correct options, and most of the time - he chooses the correct answer.

Santino was greeted in the preK classroom as he finished with his previous teacher. We discussed some of his current academic activities that are being done with her and ways to incorporate additional language goals. As discussed yesterday in the meeting, we are going to start to incorporate more language into sessions throughout the day so he is getting additional support in the area of language. Santino chose a Paw Patrol book that had buttons on the side to push that matched with the words in the book (interactive) out of my bag of materials. Santino was assisted with verbal prompting to increase utterance length for requesting. Also, we targeted use of verbs and -ing. We identified some prepositions during multi step directions. Following that, Santino responded yes to wanting to go outside. He was back to his old self enjoying the playground without a sense of fear which has been so enjoyable. We were on the playground with other children and he came up to me and grabbed my arm to come play on the slide with him which was GREAT social interaction and initiation. Auditory bombardment of our actions during play was beneficial (climb, jump, run, high, low, slide, down, etc). Santino changed his diaper at the end of the session, as there was a urine smell. Assistance was required however he is becoming faster at doing this task independently. Answering what/where questions is still difficult due to the abstract concept, we will continue to target these. Music goals were discussed with his music teacher on how to target specific things (i.e. the piano) and how I believe Santino would learn best given a specific hierarchy and strategy. Overall, it was a good session. Santino was happy throughout.

Student absent. Session scheduled 12-1pm

Richard was greeted in the lobby - he was happy throughout the session and did very well with transitions. We targeted pragmatic and social goals initially. We have been working on topic maintenance and asking appropriate questions. He required moderate cues for this today. It should be noted Richard's rate of speech has improved and slowed down resulting in increase speech intelligibility. In addition, we heavily targeted language/grammar including auxiliary verbs, past tense, irregular plurals. Richard tends to omit /s/ with many words at the conversational level however, with prompting - Richard discriminates between the correct and incorrect production. Please continue to target/gently correct him at home during structured play/games. We covered the calendar - Richard was excited to cover the new month and what he is looking forward to including his spring break and St. Patty's Day. He is becoming more comfortable answering questions about days of week/date. This skill is more natural for him. Also, we targeted both voiced and voiceless /th/ at the initial position at the sentence level. Richard achieved 80% accuracy with this task independently. Overall, it was a good session. Some speech was altered due to a very loose top front tooth however that is to be expected. Well done, Richard!