Chris rapidly initiated conversation by sharing his new weighted vest. The topic of his new weighed vest and also use of weighted blankets was a topic of conversation during Monday's session as well. Today, however, topic expansion was significant as reciprocal exchange was strong and his motivation to acquire my "insight" was quite clear. This afforded a more in depth discussion of aspects of "self awareness," with expanded discussion of strengths, talents, interests, and skills that are unique to him. Additional topic focus included aspects of the school day including social dynamics with peers, and navigating adult input related to such dynamics.
Spoke with mom following the session to share noted increases in goal achievement, the recent visit to New York, Chris's perspective on self, as well as strategies to support self confidence, and the aspects of carryover among service providers. Strong session and such a positive conversation with mom.
Christopher initiated the session with strong intent to share that he was not happy that we did not see each other on Wednesday of last week. He went on to share a great deal of detail regarding his trip to New York, and recent discussions that have taken place surrounding the visit. These details also included the reason for the visit and his feelings regarding the visit, as well as his perspective regarding his own self reflection around much of the information that was shared with him. Strong support was provided for Chris, supporting aspects of self esteem, self acceptance, as well as familiar aspects of personality traits. Chris was eager to expand, and conversational reciprocity was supported as attentive listening was strong this session.
Santino was greeted in the pre-k room as he finished with his previous teacher. He was happy throughout the entirety of both sessions with me. He had a nice transition from each activity. Santino appears to enjoy moving during the session. We worked at the table, then the floor, then the table again. We started the session at the table doing a book activity working on attention, turning pages, answering simple questions, etc. Following that, we did a pull-up change which provides many opportunities for requesting help and following directives. Santino will grab my hand or point however not verbally request for things unless prompted to do so. For example, when we were putting his shoes on, he slipped his foot in but the back was not on - he grabbed my hand to help him. Using multimodal cues, Santino requested help 4x. We worked on sequencing washing hands following directions. We targeted play with Mr. Potato Head and play doh combining word combinations. Santino answered "what doing" with verb cards with 40% accuracy. There were many opportunities to comment and describe given a model. Santino's scripting of tv shows was increased today. When asked what his name was, he independently provided his whole name which is great! We also targeted answering yes/no questions based on his wants. "do you want?" - cues are still required.
Santino was greeted in the pre-k classroom as he was doing an education.com book on the computer. He operated the mouse/book independently. Santino did appear tired in today's session. He was frequently yawning. We started the session with a Halloween themed book. Santino demonstrated fleeting attention however with some cues, his attention returned to the book. He assisted with turning the pages, inconsistently following one-step directions and answering simple questions about the book. Santino requested Play Doh. This is a great activity for requesting for more, help, all done. The play doh fell on the floor and Santino pointed and grabbed my arm 2x - this was an opportunity for verbal requests versus pointing/gestures. We targeted verbs such as "roll, push, put on, take off, put in". We did a structured "wh" question with object function task. Santino was given visual support in a field of 2. He receptively identified 7/10 correctly. We went to the play- ground to continue to target social/peer interaction, requests, commenting, and verbs. Santino was very gassy during the session however did not appear uncomfortable.
Richard was greeted in his class on time. He was happy upon arrival and throughout the session. He was quite communicative today. He covered a lot of informal language skills as well as /s/ and /s/ blends at the conversational level. He continues to required min-mod multimodal cueing to reduce the amount of errors with his lingual lisp and weak articulatory contact however he is very receptive to cues and will immediately correct the production. Overall, his speech is improving. We quickly completed the date/time calendar activity. Richard enjoys discussing countdowns to holidays and long weekends. He expressed that him and his family is going to Alaska for winter break. He was so excited to talk about the things he will do in the snow. We read a Halloween themed book with advanced vocabulary and Richard was asked to explain what the words meant given context clues, Richard did well with this - he would use the illustrations for assistance however overall, he did well with this task. Lastly, we targeted past tense (both regular and irregular) as well as possessives. He continues to omit the -s with this. Another great and compliant session from Richard.
Anticipated Chris' arrival this morning. Upon inquiring with Elise, she shared that he was traveling to New York for a followup comprehensive evaluation.
Chris was once again excited to share items that he had brought with him to school. He was observably very tired, and subsequently shared that he had been "up" since very early in the morning. He initiated conversation via use of familiar "starters." Expanded exchanges were supported through the use of familiar cues. Topic shifting was significant this session, affording the opportunity to review the familiar concepts of self reflection, perspective taking and presupposition as a foundation to enhance communicative success. The familiar concept of vocabulary specificity was revisited as well this session to assist with increased integration of intention and clarity of message.
Richard was greeted in the lobby as he finished his class. He was in a great mood and transitioned nicely to his classroom. Richard was interested in completing an art project I supplied. We started with completing the date/day of week task which was great. He is starting to understand the concept of time (i.e. "my costume will be here in 3 days" after looking at the calendar). Following that, we discussed his new schedule with reducing therapies and increasing reading. Richard tends to transition easier when he knows what is the next class/therapy. A new typed schedule was requested. We did a paint/fall art craft to target mostly speech sounds (/s/ and /s/ blends), rate of speech, peer social interactions, language concepts including possessives, plurals, and answering "wh" questions. Richard did well with this task and responded well to constructive cues. Attention was good today. Overall, Richard continues to make great progress in speech and language therapy.
Santino was greeted following an art class. Santino was happy upon my arrival and transitioned well to the table. His pull up was changed in the bathroom. A seasonal/holiday book activity was introduced for language auditory bombardment and using carrier phrases for Santino to fill in the appropriate response. He appeared to enjoy this activity. In addition, since safety has been a primary concern - we practiced answering to his name as well as answering to what his name is. Pause time helped with this and he did answer 1/3 trials given pause time. We targeted following one step directives fading visual support. Simple wh questions were targeted with object function given a field of 2 with visual support. We went to the playground to target requesting, social interaction and tolerance with peers, increasing utterance length independently, commenting, and using verbs in action. Santino enjoyed being outiside however he did become agitated and requested to go inside when other kids joined on the playground. Santino appeared over stimulated and independently requested "inside". Santino's scripting and echolalia were present today however not more than usual. Using pause time to answer questions rather than verbal modeling is helpful to reduce the amount of echolalia occurrences. Great work, Santino!
Chris was eager to share a great deal of "news" regarding "Super Mario" and character line up for new game releases. Allowance for speaker listener reciprocity was supported with familiar prompts and cues. Expanded conversation with increased use of cohesive ties and temporal links continues to be a strong focus. Aspects of perspective taking continue to be supported as well. Character traits and personality traits were also re-visited this session as aspects of "relationship" were applied to concepts of "liking" characters within story lines, movies, game characters, and the more complex dynamics of "relationship" highlighted in reference to social dynamics with peers and adults. Strong session.
