Christopher had a difficult time sitting at lunch, complaining that the kids were bothering him. We discussed some of the comments that bothered him and we tried to look at it from a different perspective. He realized that maybe he was being too sensitive and rejoined the lunchroom, knowing that recess would be more fun if he was getting along with the peers. He was a little quiet on the playground but didn't have any unpleasant interactions. During the pow-wow after recess, he said "everyone is just annoying. I wish I didn't have to talk to them." We discussed the alternative of not having any friends and he agreed to "deal with it."

Richard was in a great mood after recess and ready to tackle his work. The mountain reinforcement chart has served as a good reminder to get our work done and then move on to short breaks with some fresh air outside, chatting with a neighbor, or looking up Pokemon cards. We read a book about Fall and a pumpkin patch adventure. Answering WH questions were challenging for him but it was later revealed that he did not understand some of the "fall" vocabulary. We then reviewed the vocabulary and he achieved 80% on the WH questions about the book, with pre-teaching vocabulary, visual and verbal cues.

Spencer wanted to play monopoly but with a different spin. SO using questions from a game of fun lists, Spencer would name things such as desserts, favorite games, things that are funny, things that are gross, etc. It was a good opportunity to get a lot of /r/ words in for speech practice. Some of the lists left Spencer confused, so it led to good conversations with new vocabulary. Spencer doesn't really feel he needs to practice the speech but with repetition of sounds, he hears how he can change the way his speech sounds.

Continuing the world's longest game of Monopoly(carrying it over session to session with pictures of our money and properties), Tristan is determined to win and show off his strategies. Using good speech strategies, focussed on "strong /s/," Tristan gives his monopoly strategies as if he was presenting to people on TV. He is motivated by Monopoly money and we have negotiated some of our own rules with extra speech practice.

Santino was greeted in the pre-k classroom. He had just gotten to school and was in a great mood. He was happy for the entirety of the session. We started the session with a Halloween themed sensory painting art/craft to target many goals including verbally requesting, combining 2 word utterances, following 1 step directions, and simple sequencing. Santino enjoyed this activity as he painted a "squishy" pumpkin with brown paint. We did many functional tasks of daily living following simple one step commands (i.e. turn on the water, get the soap, wash hands, dry hands, get the brown chair, throw away the garbage, etc.). Santino does well when given moderate visual support following directives. Santino was less vocal today however joint attention was improved and he was focused during session. We did a book activity of Santino's choice. We targeted simple "wh" questions given a carrier phrase as a cue. Lastly, we went to the playground to target commenting and verbs.Santino has been saying "Amazing!" appropriately so we started to expand on commenting appropriately. Also, we targeted using verbs such as jumping, climbing, sliding, running, driving, walking, etc. Santino had a great session with many speech and language opportunities. Feeding therapy followed this session.

Richard was greeted in his classroom following Ms. Debbie's lesson. Richard had garbage/classroom items on the floor and was asked to tidy his work space (which he did with minimal hesitation). We discussed the importance of keeping our work area clean so our brain can stay organized and it will be easier to remain focused during sessions - he was in agreement and compliant. Richard was happy and focused throughout the session. We covered the date/day of the week quickly as Richard continues to require less assistance with this. We targeted peer social/pragmatic goals with friends in the cafeteria discussing peer interests covering topic initiation, maintenance and conclusion. In addition, Richard has been showing interest in Halloween as it approaches - this was a great way to target /s/ at the conversational level. Richard's connected speech tends to appear "slurred" and almost wet sounding due to excess saliva; when given cues to swallow and slow his rate of speech - intelligibility of overall speech significantly improves. Following the unstructured tasks - I provided an art/craft Halloween activity to target specifically speech goals and multisyllabic words since it was a pumpkin "squishy". Richard loved this!! As for language goals - past tense, possessives, and plurals were targeted informally as well. Richard is able to discriminate between correct and incorrect productions of these concepts.

Chris happily responded to the compliments shared about his new hat as the session commenced. His response to the inquiry about his weekend celebration and the concert that he attended provided a strong springboard for conversational expansion. Topic transitions were observed to be supported by increased use of cohesive ties and use of more effective temporal links. Response to comments was facilitated via use of familiar cue strategies, and subsequently characterized by expanded cycles of conversational exchange. Engagement and motivation were strong, although Chris was observably tired. He shared that he had returned home very late following his birthday celebration weekend.

Richard was greeted in his classroom as he was finishing with Ms. Debbie. Richard was in a good mood and happily complied with therapy tasks. He requested to make a gift for his classmates birthday. This was a great task for sequencing, problem solving, executive function, social initiation, maintenance, and turn taking with peers, and speech tasks as well as rate of speech. We have been focused on being resourceful and asking for help when feeling frustrated to reduce the frequency of frustration. Richard did a great job making a craft out of a tissue box, drawing, markers, and cutting out paper symbols. He did give his friend the box targeting appropriate social interactions - requiring minimal verbal cues. Richard enjoyed this. I supplied a seasonal art/craft activity to target /s/ blends at conversational level. This was a pumpkin "squishy" that he can paint and put faces on. Richard loved this task and it targeted many speech goals. Richard continues to require verbal cues to increase /s/ and /s/ blend accuracy at the conversational level. Language tasks were targeted by answering "wh" questions with minimal assistance. Richard's confidence and overall happiness was shining bright today. Overall, Richard had a good session with increased attention to task and increased joint attention with SLP and peers.

Santino was greeted in the pre-k classroom as he finished with Ms. Janis. Santino was happy throughout the session. We began the session with the book/interactive activity with "There was an old lady who swallowed a fly". Santino interacts quite a bit with this book, he completes the sentences given carrier phrases. This also targeted simple "what" questions. Santino required moderate cues for that goal. In addition, answering "what doing" questions with verb cards. Santino answered 3/10. A model was provided for 70%. Echolalia and scripting was increased today. We went to the playground to elicit many goals including requesting, commenting, increasing MLU's, requesting help, social initiation and maintenance and answering simple wh questions. Commenting was strong today given verbal modeling. He went down the slide a few times and with cues, Santino reported "That's fun", "I like it", "That is great". Santino had a good session today.

Santino was greeted in the lobby when his mother dropped off. Mom, Santino, and I discussed current feeding status as well as goals for feeding. Judie joined the informal meeting to collaborate as well. It was noted Santinos goal is to eat table food (nutritious) for a variety of people. He eats minced food at home for particular people. The primary concern at this time is Santino's safety, of course. We transitioned to the back cubby area where we have been working with ease. Santino was happy upon arrival as well as the entirety of the session. We started with a book/hands-on activity with "There Was an Old Lady Who Swallowed a Fly". Santino LOVED this activity. His joint attention and eye contact improved. He was following one-step directives with improved accuracy as well as repeating many of the desired utterances appropriately. He was benefiting from carrier phrases with simple "wh" questions. He required moderate/max cues answering questions without a verbal model. Santino answered simple yes/no questions with 80% with a verbal/visual cue. He continues to improve. He does shake his head for "no" in protest which is a nice form of communication as well. Santino identified verbs (-ing) in a field of 4 with 90% accuracy!! He named verbs (-ing) following the question "what doing?" with 20% accuracy. Santino continues to demonstrate the understanding of verbs receptively with a field of 4. Santino was given a choice of a play activity to target increased MLU, Santino verbally requested Play Doh. Word combinations such as object+verb, descriptor + object, adjective +noun, etc. was modeled throughout this activity as well as sabotage opportunities to express desires such as "help", "open", etc. We completed the session using an app on the iPad called "my play home". It is an interactive app that elicits speech and language.