1/9/18 and before———
School/home
We are working on as much imaginative play as possible. We had worked on this quite a bit over the years but have been not as engaged with it except for puppet play. Now I’d like to try to throw it in as much as possible. As well as empathy, noticing more of how friends are feeling, etc.
Also, games, and continuing turn taking. Most of the games it will be tricky but we need to do the best we can. His recent favorite is the Minion/Monkey Game. We have the game drawer stocked (far right under TV), as well as the fine motor drawer (center under TV) and the imaginative play drawer (far left under TV)
PIANO
We have been working with the fabulous Peter Emparador on piano for the last year. Peter has transcribed the songs below and we have letters on the keys for him to follow. We try to keep the piano open and work on these whenever we get a chance. This past week we were sitting at the piano and he grabbed the music for “London Bridge” and started playing it independently!!! He did it twice in the last few days 😃 Even while he was sick!
Playing songs:
“What is Love” from Rio
“Ring Around the Rosy”
“Old MacDonald”
“Baa, Baa, Black Sheep”
“London Bridge”
AND The newly transcribed (by fab sissy Lila) “5 Little Ducks"
AAC/Communication
Working on AAC switching it up. Per Dr. Musslewhite when “chatting/social” conversations are happening, we should explain to him “We are using our buttons and our
When quick talk use words verbally or buttons on AAC
Writing for school use the keyboard and take word predict off when doing school work
Writing for fun we can use a tool
One or two words is ok on AAC, rather than trying to tap out the whole sentence, but verbalize the sentence. ALSO verbalize how you arrive at each button, i.e. “Home- You, Feelings- Hurt” when I was trying to connect with him that his tooth coming out was hurting him. I was able to get more in depth after that but started with You Hurt while verbally I was empathizing with him, “your mouth hurts because your tooth is loose. I see it really hurts and it bothering you.”
—— THIS IS THE FIRST TIME IN HIS LIFE THAT HE’S TOLD ME “HURTS” APPROPRIATELY RELATING TO HIMSELF. WHEN HE HAD HIS HAND IN HIS MOUTH HE KEPT SAYING “HURTS” AND I REINFORCED THIS AS MUCH AS I COULD WITH THE AAC DEVICE AND VERBALLY, THANK YOU FOR TELLING MOMMY YOUR MOUTH HURTS… IT REALLY HURTS… I’M SORRY IT HURTS… LET MOMMY TRY TO HELP THE HURT. I eventually got him to let me put my fingers in his mouth to try to pull the tooth out. First time it didn’t come but the second time it did! It’s his first lost tooth that he hasn’t swallowed :)
Talk to team about typing and what keyboard is best to use for school work, if an external larger keyboard is better
When in conversation turn word predict on - make sure to explain to Ian
Communication circle for think pair share time
Meet one time a week
Circle of friends and communication friends
4K and 6k words a day is what you speak to an infant, we should be able to model 400-600 words a day on a device
USE PICTELLO————
Pictello on friends device
Stories he’s writing st school
We saw...
"can you guess what movie we saw?"
"Guess what I thought"
Then he can go into feelings
Social scripts
Social stories are for "I love talking about rio but we are at school and it’s time to talk about x"
use different voices when making pictello slideshows
Home/DI
Current motivational songs are “5 Little Monkeys Jumping on the Bed” and “5 Little Ducks Went Out One Day” When we are trying to make him focus on doing something, use “I can cover my cough.” “I can eat my dinner.” “I can sit in my chair.” etc.
When trying to get him to come down stairs or sit at the table, etc, singing helps. “We’re walking down the stairs, we’re walking down the stairs…” to the tune of “The Farmer In The Dell”
Speech
Working on TH sound - Ask him to make a huge smile then stick his tongue out in front of the mirror
Or just ask him to stick his tongue out and bite down on it with his teeth. We do that reps of 10 sets of 3 or as much as he will do it ;)
Speech-
Toungue doing better, continuing to have him stick his tongue out to get Cheerios to work the tongue muscles and flexibility
putting Cheerios on the side of the mouth and hold head
Functions of objects, pull bed or chair or shovel, or sink
Shovel he said beach and sand, bed he said cozy and blanket,
Have a puppet next to him and puppet says he’s hungry, work on do u want a big or little piece, and have Ian ask him this
Include Ian asking puppet if he wants an apple or banana
PT -
On a gym matt, Sitting down and picking a bingo card, get up from ground using captains pose, switching sides each time. Putting bingo piece in then walking back over to the pieces and doing it again
On the trampoline doing sitting and standing with captains pose again. Switching sides again.
Speech — Put items in the knock knock box and then have cards to match. Pull item out and ask who needs to item, amy or ian. When he gets the pizza and he has pizza card
Speech—
Amy is making cereal, ian is making a sandwich
What do we need, talk about the pieces and out them in box then he would pull out each piece and ask who needs it, "who needs the knife?" He would say me if related to what he needs to make
What do we need to eat the cereal? Spoon
What do we need to spread the jelly? Knife
Nouns are person, place and things.
Mouse, horse,
For more, ask him to stick tongue out 1,2,3 Cheerios
Working on showing pictures of himself and ask who is this should say me
over cheerio above and he will bring tongue up — And to left and right
Trying to show him him
Photo album pics of him and ask who's that work on "me" instead of him saying ian
9/19/17
You and me
Who has the cupcakes, who has the ice cream
Put the tag on the other person and ask who has the ice cream
Cheerio toungue putting in the corner of the mouth and he uses his mouth to get the Cheerios into his mouth
8/26/17
AAC/Communicaiton notes from session
When I got to school Ian was eating an ice cream sandwich and his hands were VERY sticky. We talked about how they were sticky and what we should do about these sticky hands. With prompting he decided he should wash them. I asked "where' we should go, he answered with moderate prompting. When we got to the bathroom he was very focused on turning the water on and off, using wipe board I wrote down 5 steps to washing hands. We talked about the steps and crossed them off as we went. This helped to focus him on the targeted activity. On the yard I asked him what the kids were doing. We discussed how some kids were playing with balls, others where in the castle and some were eating. I wrote down two choices and asked Ian what he wanted to do. This helped him to look around the yard and get his focus on the other children. He was able to make a choice independently when I wrote down two choices. We did this 3 times during the session. Throughout session, I asked "what" questions answered, he answered with 60% accuracy with minimal prompting. He independently said hi to peers on 4 occasions and needed verbal prompting on 2 occasions. He needed less prompting to engage in communication to initiate play and participate in a short conversation as compared to last school year. He independently said "My name is Ian" on 1 occasion and "whats your name?" on 2. He required verbal prompting to ask, "Can I play?" He needed prompting to speak louder. A few times he said the appropriate thing but his peers didn't hear him. He answered "Who" questions with 70% accuracy with minimal prompting when talking about familiar people.
Speech - Try play acting like dogs and sticking tongue in and out to “pant” for tongue stretching and control
8/24/17
Large pics for where questions. Did great with larger pics
Have items and explore where. Baby in the bathtub, cat in the box, duck in the bus
Vocabulary sorting with hospital/doctors office and the market/grocery store
Type "at the” on the iPad so he adds that tho the answer for where questions
Use the tongue depressor to help the toungue move from side to side when getting the cheerio when working on left to right motion
Try to have him bite down on his toungue to get the th sound
8/15/17
Who and where questions with familiar characters in a book
To get s use t before with plural, like cats, bats,
Also bombardment with ssssss is awesome
Showing a picture of kids at the beach and ask where are the kids
Picture of a child in the bathroom
Where questions?
Who, what and wear
Struggling to work a small piece of pretzel with the mouth. So maybe do some more exercises with the mouth like --- Try a thicker piece of string cheese and maybe cut in half or gummy worms
Look for a preferred peer and say look what is Evan doing? Evan is cutting. Let's go join him and cut!
8/3/17 speech
Warm up for ssss's with shhh, then ffffff then sssss plugging his nose the whole time
Make the tissue dance. Hold a tissue front of his mouth and ask him to make tissues dance with his breath
Who=people
Work more on touching tongue with Cheerios
Work on Blow through your nose then blow through your mouth
Use cotton balls and hand held mirrors so he can see he can blow them and he fogs up the mirror
When we plug nose, prompt chin to help keep open for ssss, start with shhhhh then move to sssss by just dropping the chin down from the shhhh sound
Cheerios, hold it out in front of the toungue and have him go out and in 3 times before putting it on the toungue
Ask him to smile then make and S sound. Ask him to smile when asked
Also when we get it to work with the cheerio try for each side
Speech 5/25
Bubbles
Nose headphones ask for ssssss
Try shhhh sssssss model
Have him say ehhhhsssss the word for the letter
Work with sticking the toungue out for cheerios
Try writing shhhhhhhsssssss
Play with a snake and
Regular s syllabuls see, saw, so, sun, simple soap, soup,
Work on Ssssssss snake sound, plug nose when he's saying the s because he pushes it out of his nose
Have him feel the sounds on the hand
The shark eats mushroom. Or give the shark a mushroom.
Oouuuu, Eeeee, oooooh
Oouuuuu, oooohhhh
With a countdown. 9 more, 8 more,
Digging for seashells and mushrooms and starfish. Using the large shovel and the small shovel we will
Lisa - OT
Privacy board for working time like handwriting, etc
Sensory breaks, take a walk, noise cancelling headphones,
Beans with music first
Legos in the dark
Limit visual stimulation one thing at a time
As he completes a task
If he completes a task and Balls in a jar to fill up 5-7 minutes
Speech 4/27
Ouuuu, oooooh
Ouuuu, eeeeeee
Middle sh, sea shells, mushrooms, if it gets mushed together, break it to 2 syllables, mush room
Make pizza play pizza and put mushrooms on it
Hide seashells in beans and use big shovel or small shovel, talking about both activities as you do them
Ouuu eeee's set of 5
Push the yellow fish
Sticking tongue out and push down with depressor
Speech 3/2/16
Yellow fish
Push
Wash
Brush
Ask did the orange fish Did the fish splash or crash? (Pretend a bucket or box is water and floor is crash)
Blowing - we have a wind book and talking about wind we blow each page
1 fish, 2 fish, red fish, blue fish
OT--
What happens if he doesn't do the task, do as much of the task of u can and have him finish it. Has to do the end part of it.
Warm up with initial SH
Then go to do final SH and remind him to use his mouth not his nose. Reward with fast moving fish
Physical prompt to keep the left hand down while working with the right hand on fine motor task such as placing shapes to make other shapes
AAC- verbally Working on asking for a hug or any physical contact. We need to model this and request that he does it as well such as Asking to sniff or giving a hug.
Once engaged then we can work on more reciprocal conversation
1/19
Begin with warm up shh, warm up with 30 then --- Ocean and fish
Give a squeeze of his cheeks when saying sh
Work on the word alone then a sentence
Oooo and ohhh's with a round horn in front of lips
Pepi bath app for working on the sh words wash, brush,
OT
Write in sand in a box with finger
Keeping to tasks getting better :)
3-d shapes
Typing teens- he reversed teens 31 instead of 13
Panther show numbers and counting blocks same time - do it - addition
3-D shapes
Tracy AAC work
Reading a book then asking questions about it and putting the book aside.
Require full sentences. Break from stimming. Interrupt when typing Rio or other regulars when you've asked a question.
1/5/17
Cards with initial sh To warm up
Then to see if we can carry it over to two word, I.e. Blue sheep, red sheep
Then move to two initial sh
Then try for wash as final sh ---
TRY same, warm up with initial sh then move into finals
-------
PT
Maintain the one leg kneel. Right side forward
AAC
Work on something else. Going through a list of choices and ask him, do u want this? No, something else. He says Can I have the phone? And she has him ask, Can I hold it?
And take turns asking Can I hold it? When he asks for Thomas sounds say I don't want Thomas sounds, I want something else.
Make a choice that's not what he wants. He says "no, that's not it." When we get to the right choice, ask is it this one? And he says, "yes, it's that one."
Not it, something else.
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