S was seen at his home with his Mom, brother, PSP, and Graduate Intern present.

Outcomes:

1. S will name pictures and toys during play (15 min).

2. S will repeat sounds and words during play (15 min).
3. S will use words to let us know what he wants in play (15 min).

1: S used approximations to label toys and picture cards throughout play. While he required
minimal prompting to attempt a label, he often required maximal visual and verbal prompts in
order to produce the target sound or the accurate number of syllables. For example, S produced
“dur” for turtle, “shuh” for shovel, “he” for here, and “dull” for pull. S typically substitutes /d/
for bilabial sounds, however was able to produce “baa baa,” “boo,” and “papa” with prompting.
2: S was able to attend to PSP and Intern throughout play when prompted with verbal and
gestural cues. He was able to attend to adult model’s lips and imitate motions used to facilitate
the production of bilabial target sounds. S made multiple focused attempts to repeat sounds,
demonstrating success with production of /m/ when using the associated gesture.
3: S used an increased amount of intentional communication such as approximations and
gestures to attempt to get his needs met and share his ideas during play. PSP and Intern had
difficulty understanding what S was trying to communicate. As the interaction went on S
resorted to using an increased amount of jargon paired with gestures to get his message across.

PSP demonstrated how to use cues and models in order for S to utilize gestural prompts that
were practiced during the session, as well as continued use of the picture cards provided the
previous session to elicit target sounds. Mom demonstrated understanding of all strategies
discussed. PSP also discussed the idea of trialing a communication device with S. Mom was
receptive to the idea as S’s older brother also uses a communication device. PSP discussed the
options for funding and the process of trying out a loaned iPad to see if it is the best fit for S.

Next visit is planned for June 5th at 9:00 at their home. PSP will provide additional information
about the process of trialing a communication device and follow up with Mom about options for
additional funding for summer services. PSP and Intern will also plan to evaluate S’s carryover
of prompts, continuing to focus on bilabial sounds. Prompting will be evaluated and adapted if
needed depending on the success that S is experiencing.