Chris was joined by another student this morning to say "hello" and share that they were working on a new comic book together. The session focus subsequently highlighted expanded conversation related to story line, character development, and use of story grammar components to support the development of the intended comic book story. Chris was able to provide strong details related to ideas, and character profiles within the context of conversational reciprocity. Acknowledgment of comments, and response to questions embedded within the exchange related to story development was strong. Sustained engagement and motivation were strong this session, as topic maintenance and closure were noted with increased use of cohesive ties.
Additionally, phone conversation with Chris Tisi commenced at 11:00 AM, lasting approximately 40 minutes. Topic focus was the schedule change request, as well as current focus of intervention.
The importance of increased frequency as opposed to increased session length at decreased frequency was highlighted. Brief review of progress to date including aspects of strong progress in the use of natural language in conversation and the subsequent decreased use of "tv" talk or scripted verbalizations. Additional review of current goals was also discussed.

Richard was greeted in the cafeteria finishing up music class. Richard had a smooth transition to his room. He was happy throughout the entire session. We started by recalling events and stories from his therapy session he had with Ms. Andrea yesterday. Andrea and I spoke following his session so I was aware of what activities they completed. Richard did a fantastic job recalling the story for speech yesterday. His attention and eye contact was great. He did require cues to reduce rate of speech for improving overall intelligibility. Richard has been very involved with planning activities to complete at school, usually based on themes or holidays. In order to target many of his speech, language and pragmatic goals - we will be making a "Halloween themed
"milkshake" for him and his friends. It is apparent he is more compliant and attentive to child directed, less structured tasks. We also targeted peer social skills with Matthew (his neighbor in school) and Cabo - that was very effective. Richard's overall confidence with peers is improving. We quickly covered the date/day of week - he continues to demonstrate improvement of this skill. He looks forward to counting down to the weekend/holidays. /s/ in all positions was targeted at conversational level with ~70% accuracy. Mulitsyllablic words were also targeted at sentence level, typically leading to a conversational level. Richard had another productive session. Keep up the good work!

Chris was eager once more to begin the session. He quickly initiated conversation prefacing his comment with "Ms. Lynne, I have good news and bad news." He wanted to share the "good news" first, and prefaced his topic with the familiar sentence starter " Guess what?"
Allowance for reciprocity was stronger this session, as responses to comments were noted with increased cycles of exchange prior to a topic shift occurring. Strategies to support more effective topic transitions were facilitative this session, as use of cohesive ties was noted to increase in response to familiar cues highlighting the need to acknowledge the "perspective," and the use
of gesture and facial cues of 'your' communication partner. Strong session.

Richard was greeted in the cafeteria. He was in a great mood today! After speaking with Andrea (Richard's other SLP), we have implemented a goal oriented system from the program "Big Life Journal". This encourages positive thinking and develops motivation to overcome hurdles (academically, socially, etc.). Richard is motivated by this - there will be a reward at the "top of the mountain" - after many achievements in speech therapy. Today, we targeted articulation skills - specifically /s/ in conversation. Richard has a tendency to make errors when talking at a rapid rate during a topic of interest. He has been responding well to cues recently. Another positive improvement I noticed today was when he was trying to prove a math situation to me and I explained to him how I got my answer - he was very receptive to the explanation rather than defensive. This was great awareness by Richard. We brainstormed fun cooking sequential activities we can do in the future - finding recipes with /s/ in them. We discussed date/orientation of months and days of the week. Richard continues to improve with this. Overall, Richard had another great productive session! Have a wonderful weekend.

Richard was in a great mood during our afternoon session. It tends to be a good time because he has refueled during snack and has had some fun on the playground with his peers during recess. It is a good opportunity to discuss the recess dynamic and where during last year, he required a lot of time processing and working through interactions, he now feels empowered and excited to have fun with his friends. His motor skills such as running and jumping have improved, so he is no longer the first one caught in tag.He is very proud of himself. Today we read a story with the theme of not giving up when things get hard. It included a lot of humor, which kept Richard engaged. Using crayons and blank paper, we made our own story about not giving up. Remembering parts from the story were challenging for Richard, so we turned it into a sequencing activity focused on recall, describing, and checking for accuracy. Once he saw our comic book story compared to the story we read, Richard realized that he was out of order and corrected it. Taking the time to "pause, rewind, and review" is a skill that helps Richard learn from his mistakes.

Christopher was in a great mood, having fun conversation with his peers at lunch about various Tik Tok and YouTube videos. He was demonstrating active, whole body listening and not monopolizing with talking about what he wanted to talk about. He was excited to go outside and play tag with his friends. However, he was having a challenging day on the playground during recess. Although, the rules of tag were already established, he was modifying them to give him the advantage. The kids were upset with him for "not playing fair." Christopher went into "shutdown mode" and did not want to meet in our Monday afternoon "powwow" where we discuss the social strategies that worked and didn't work during lunch and recess. He chose to just sit silently in his chair, spinning around. I acknowledged that that was what he needed to do to cool down and regroup and that we would revisit this problem solving session at a future date.

Session began with parts of the CAAP-2, Clinical Assessment of Articulation and Phonology-Second Edition. It was on the iPad with entertaining pictures. It was helpful for Spencer to see that his speech errors occur with /R/, /R/ blends, and /L/ sounds. Occasionally, there are errors with multisyllabic words but those are inconsistent and often related to Spencer's pace of speech and level of excitability. While playing monopoly, we were able to practice the target sounds. Spencer was more focussed on the game but to earn a turn, he had to say 5 of our target words. With a model and verbal cues, Spencer is able to produce the target sound accurately. He was very pleased with himself when he heard the improvement.

Session began with parts of the CAAP-2, Clinical Assessment of Articulation and Phonology-Second Edition. It was on the iPad with funny pictures. It was helpful for Tristan to see that his speech errors occur with /S/, /S/ blends, and occasional /L/ sounds. He then was very self-aware and self-correcting when we picked up with last week's monopoly game. He said, "look at me, I can say my sounds like the people on TV." With lots of high fives and verbal praise, he was very happy and said, "I guess this speech stuff isn't so bad."

Richard was in a great mood in the afternoon. He used to have a hard time during recess but he has really developed some nice peer relationships. During tag games, he has developed some allies with improved communication skills when it comes to negotiating and advocating for himself during play. However it is hard to transition from unstructured play to structured, more challenging tasks with speech and language. Richard asks for a lot of "breaks." We have been targeting growth mindset skills to remind him that he "can do hard things." Blends and multisyllabic words are targeted during games that keep him motivated. While playing Uno, he knows that we have to say 5 words before each turn.

Spencer wanted to join the monopoly game with his brother but instead we started our own game during our individual session. The ground rules for the game included using our strong, kind, and respectful communication skills. We reviewed how we use our articulators to produce strong /R/ and /L/ sounds and how volume and pace also play an important role in how clear our speech sounds to others. We also reviewed how even when a game is competitive or there is negotiating for properties, it is even more important to communicate effectively. Monopoly provided a great platform to practice speech, reading/phonological awareness practice, new vocabulary, and target some key executive functioning skills. Spencer was sure he knew the rules but after reading the rules together, he realized that there are many different ways to play.