Spencer was in a good mood and requested hot chocolate. Once we tackled our word list with strong /r/ sounds, we moved on to the hot chocolate activity. He works hard and stays focused with a goal in mind.

Santino was greeted as he finished with his previous teacher. He was very happy and verbal today! So much more verbal output in the last few weeks, it has been wonderful to hear Santino's voice and the potential he has for more language. We started our sessions on the playground which he appeared to enjoy. Although he looks back at the door, he did not request to go inside. We targeted mostly verbs and social goals outside. He was jumping off the tire set, sliding, climbing, laughing, running,etc. I was verbally bombarding during play and Santino would frequently repeat me. We also watched some peers play basketball while commenting what they were doing. It was good for him to absorb peer to peer language and interactions. Following that, we played Pop the Pirate by Santino's verbal request - targeting turn taking, requesting with increased utterance length, and joint attention with communication partner. We did verbs (-ing) answering "What are they doing" questions in a structured task- amazing progress he has made. His accuracy has significantly increased with this. We also started to target "where" questions to piggy back this exercise. Overall, another great language session.

Santino was greeted as he got to school. He reportedly ate really well today. Santino was happy upon arrival. He is starting to respond appropriately to "what do you want to do?". Santino responded with "I want sleep". This response was very functional - so that's fantastic. He laid down on the rug for about 3 minutes and when I brought my activities over to the rug for floor time, he perked up and began to participate in floor time tasks. We have been targeting more goals on my iPad on a great app called BOOM cards which targets many of his language goals including basic concepts, spatial concepts (prepositions), verbs, adjectives and comprehension. He enjoys these apps however he benefits from pause time between the direction so he can process the information rather than just pressing the buttons for immediate auditory gratification. Santino has been doing really well in speech therapy in terms of using longer utterance length and sentence structure. After collaborating with Ms. Dorothy, we are on the same page in terms of our goals for this and fading multimodal cues. Yes/No is still being used correctly. Santino is requesting more appropriately. We are continuing to work on answering simple wh questions. We were talking about "what do you see" and "what do you hear" when it was raining and with minimal cues - Santino answered "It's raining cold outside" which was GREAT. Keep up the good work, Santino.

Chris was eager to share that he had "finished " his next video in the new series that he has created. This afforded another wonderful opportunity to expand conversational reciprocity and focus on use of contingent responses in order to sustain topic. Topic transitions continue to be noted with use of familiar " phrases" rather than rapid topic shifts. Self awareness continues to increase as noted by use of a familiar starter followed by a subsequent modification, "Ms. Lynne, I have a question, no actually it's a statement." Aspects of perspective taking continue to be highlighted each session.

The session commenced with detailed comments within a strong reciprocal exchange regarding one of Chris' recent you tube videos. Expanded cycles of exchange were characterized by increased use of contingent responses. Topic transitions were supported with familiar scaffolding strategies and Chris subsequently utilized effective cohesive ties across 4 topic shifts. Expanded vocabulary use with novel sentence generation was strong this session. Aspects of self awareness and presupposition were once again highlighted as Chris continues to demonstrate increased awareness of perspective taking. Strong session.

Richard was greeted as he finished his lesson with Ms. Debbie. He was yawning quite a bit and appeared very tired. He wanted to lay down on his bean bag so he was given a 3 minute transition break. We went over the calendar and discussed what he had planned for the weekend and recapped the week. This was to cover rate of speech which Richard did quite well with during this task. Also, minimal cues were required for /s/ in conversational speech. He made a few errors however quickly corrected them with cues. We played a processing game outside at the picnic table which helped wake him up a bit. It was a game that had categories and he rapidly had to process 2-3 items in a specific category within 5 seconds. He did demonstrate some difficulty with this task but enjoyed it. We did /th/ at the phrase/sentence level and targeted some social/pragmatic skills with peers on the basketball court. Topic initiation and maintenance was improved during play. It was nice to see his confidence in certain situations. He did very well today and I'm proud of him for continuing to make progress in the area of speech, language and pragmatics.

Feeding therapy followed ST. Ms. Dorothy explained that Santino has been successful with the smooth purees for her. We discussed our current short term and long term goals as well as with Ms. Judie after discussing Santinos dietary status and goals with potential new staff coming on. Santino was interested in bringing new foods to his face today. When beginning to work on the Veggie Straws, he was accepting of a few pieces and independently chewed once without the chewy tube. He began to refuse after gagging on the pieces of veggie straws. When offered Apple Jacks near the end, he ate them with good chewing no problem. I put a piece of veggie straw down and without realizing he starting eating it (and chewing), he started to grimace and gagged upon swallow initiation. It is evident he CAN chew however its getting him to chew specific foods. I'd like to work on foods that are similar to his two foods he currently chews which is cereal. This will not be a long term goal however will be a bridge to him eating other table foods.

Santino was greeted in the pre-k room. He was finishing site words with his previous teacher. When given choices of what to start the session with, Santino verbalized wanting to walk. We went for a nice walk outside on the playground and he was happy to be out there for the most part. He kept looking in the direction of the door however he played on the slides/jumping off the tires with a smile on his face. He did not request to go inside immediately. We targeted some language goals outside. Upon speaking to Ms. Dorothy while being out there, we discussed working on spatial concepts to build those skills. We targeted spatial concepts with directives today (i.e. put the water next to the backpack). We also are working on identifying modifiers/adjectives to build sentence structure and increase complexity of expressive language. These are new goals that we started working on today in addition to the goals we have been continuously working on in ST. yes/no continues to be consistently accurate in terms of Santinos desires. When requesting, we are targeting expanding the request by adding verb.

Chris rapidly initiated a multitude of 'topics" that he was eager to share. Supports to assist in increasing cohesion and sequential links were provided as the session commenced to assist with establishing linear topic transitions. Use of increased question stimuli facilitated target topics with subsequent cues to allow for expansion, allowance for comment-comment reciprocity and target transition. Use of more novel "topic shift starters/phrases" was noted as session progressed. Aspects of self awareness and presupposition were highlighted once more.

Santino was greeted in the lobby at 12:15. He was happy upon arrival however appeared very tired in the beginning of the session. He frequently yawned for the first 15 minutes. We went to the cafeteria for a more engaging environment. He was happy to be around peers. Many peers and teachers engaged him socially, Santino required verbal cues to respond however his greetings are certainly improving. We played a turn taking game to target language goals while interacting with peers in the cafeteria . The more peer interaction he Santino is exposed to, the more he will benefit from learning in this situation. We targeted many language goals including pronouns, turn taking, requesting, commenting, answering simple yes/no questions, and expanding utterance length. Santino enjoys the use of the language apps on my iPad. We will continue to target language and social goals as he is demonstrating improvement in these areas. When asked his name, he continues to require moderate verbal prompting. Requesting with increased MLU has been successful recently. Santino will request often using verbs or modifiers with visual or verbal cues. Santino appeared to wake up a bit after our fun session in the cafeteria. Overall, it was a productive session.