Client 2 Session no 1

Goal Time taken Rapport building Reinforcement Survey 30 minutes

Procedure

The first session takes was on rapport building for this purpose the client was not taken to the session room because his own class setting was best to make him compliant toward therapist. The most favorable point about the client was that he was expressive and responsive toward therapist. Client was not neatly dressed, his hair were not combed properly. Therapist shook hand when she entered the classroom. First it was assessed that does his response to his name, for this purpose his name was called. Therapist gave him smile when he gave eye contact to the therapist. In first session it was notices that most enjoyable thing for the client was to spent time with in . Due to impaired speech he class teacher was involved in the session. Information regarding clients likes and dislikes was gathered, reinforcement identification was done through her class teacher, she also informed about the problems of the client as irritability, moody nature. Till the end of session the client was much responsive toward the therapist. Therapist waved him good bye when leaving the class.

Session no 2 Goal
Time taken Assessment of child progress level Academic functioning Physiotherapy sessions Speech session 25 minutes

For effective management of the client it was necessary to have information of his academic level so that therapist could design task according to the client ability .For this purpose the class teacher of the client was asked to have his copies. It was seen his functioning level was much improved so the therapist had to continue with the activities that do not require minimal ability. His attention span was up to mark; he was complaint toward tasks as reported by the teacher Therapist also attended his physio session and speech session in physio session his walking was being improved. Therapist asked more about his performance from his physiotherapist, and asked his performance in comparison with other Cp children. As reported by the physio teacher client was much improved in his motor abilities as compare to other CP child.

Session no 3 Goal History taking

25 minutes

Time taken Procedure

Procedure this was first meeting between the therapists and clients mother. The session started in a very f o r m a l w a y . Client mother was quiet cooperative for giving history. T h e r a p i s t s t a r t e d w i t h g e n e r a l o n e questions like hows your mood about clients daily activities, Husband job and occupation. When it was observed that clients mother is comfortable with the therapist. It was time to initiate history Therapist mother was insured that this information will be kept confidential and will be used for the betterment of client. She was much relaxed and her behavior was corporative after she was insured that information regarding client sibling home environment and attachment was collected. Formal assessment was done by administering the checklist of PGEE .PGEE was administered to assess t h e c l i e n t s p r o g r e s s i n developmental areas so that management could be done a c c o r d i n g t o t h e requirements. She delivered the instruction that she has to verbalize yes or no if client perform or does not perform a specific task. Therapist verbalized all the tasks in the PGEE Mother made identified the behaviors the client was able to perform. therapist marked tick sign in front of the items he was able to perform and cross in front of items he was not able to perform .After ending the session therapist showed thankfulness to mother and said she will be asked to come again if needed

Session no 4 Goal
Time taken Procedure
Therapist task was to develop a habit of hand shake because it was observed that in the first session when therapist approached him for hand shake he rejected so therapist asked him to shake hand check make client make him identify his name identify while written on paper. For this purpose the name of the client was written in bold with an other name appearing under his name less bold less attractive With in stimulus promptswere used for this purpose the clients name was made colorful with the help of green glaze paper .client was asked to point out his name at start hew was not5 bale to do that .So therapist had to made it identifiable to the client. Therapist called his name verbally and pointed out his name .she repeated this procedure twice. While repeating she was doing assessment side by side that whether he responds to his name or not. After two trails when therapist asked the client to point out name he pointed out the right name. His interest level during session was high. Therapist main task was to assess that he knows body parts or not for this purpose a picture showing facial parts shown to client he was asked to point out facial .He was able to point out hardly three parts so therapist had to continue with it

Hand shaking Name identification

25 minutes

Reinforcement Reinforcement was provided in the form of biscuits

Session no 4 Goal.
Revision of previous task Gender identification

Time taken

35 minutes

Client was taken to the session room client behavior was compliant before session he was happy when entering the session room. He happily entered the room client was told that he will be given reinforcement after he had successfully repeated the task. First of all revision of previous task was done to rememorize the tasks or things taught. As red color identification, client was given verbal prompt toward red color. Therapists provided the client with a worksheet having a boy or a baby girl playing football, client was asked to point out himself among the two pictures. Client successfully identified that he is boy among the two pictures .Client was asked to identify girl therapist among the two. Client was not able to do that without prompt, therapist used finger pointing toward three right pictures to make it easy fore the client. Second time he was asked to point out boy from the session hall and a girl from the session to make sure client can differentiate gender. He successfully identified boy and girl Client interest level through out session was fine. He was provided reinforcement for this behavior. He was happy after receiving reinforcement.

Reinforcement Reinforcement was provided in the form of chocolate

Session no 5 Goal
Time taken Recognition of Red and green color 40 minutes

Procedure
Client was taken to the session room client behavior was bit non compliant before session he was resistant while going for the session. Therapist set red and green colored glaze paper on the table along with a picture of red apple .First assessment was done that whether he can differentiate between two colors or not . During the session clients attention span was not up to mark he was not much interested in the session but therapist made sure Clients attention by her gestures. Therapist also used red and green color poster paint to make clients identification strong. Client was asked to pick up red color from two paints. After trails the client was asked to point what color should e done in the leaf and tree on worksheets verbal prompts saying here their green leaves were constantly used. When he selected one of the green colors he was asked to paint it so that it becomes clear in his mind that green color is specifically for leaves. Clients mastery level among 10 trails was 6.This mastery level may be due to his short attention span. Therapist asked client to point out red color on charts paper in Clients class

Reinforcement
Reinforcement was provided in the form of football play

Session no 6 Goal
Revision of previous tasks Cutting and pasting

Time taken Procedure

45 minutes

Therapist main task was to work on him help skills sop he was not taken to the session hall first. He was taken out of his class room he was asked to shake hands with all members of session hall. Therapist introduced a task that required his attention and interest the hard chart was placed in front of client .He was asked to tear the chart and then paste it on the paper .Hard card selection for tearing was preferred considering client capability to tear. Hard chart was torn .Therapist initially modeled the

whole behavior and then asked client to repeat the behavior. Client was provided with physical guidance in tearing the card initially but gradually this guidance was faded .tree size was kept small according to clients ability to tear card. It took 10 Minutes to tear the paper and then with the help of guidance client was able to paste it on carrot. When carrot was complete therapist introduced a sense of achievement saying ali made this carrot clap for ali

Reinforcement
Reinforcement was provided in the form of football play

Session 7 Goal
Time Taken
Revision of previous Task Coloring an apple and mango Identifying Up or down

45 minutes

Procedure
Client was taken to the session room .He was cheerful when entered the room. Therapist asked client to hand shake with the members of the group. First previous task were revised by the therapist as client was not reproducing them correctly. On a plane paper an apple and mango were drawn and client was asked to color. One important thing in this coloring activity was this that he was assessed for selection of colors .Whole pack of colors was places in front f him and he was asked to selection the colors he think should be in both pictures .He selected the right color he was then asked to color the pictures .He was provided gap between both pictures as he was CP he might be have fatigue effect if he was not given gap. After that he was asked to point out UP and down. Identification of up and down was done through paper made arrows of above and below along with extra stimulus prompts were used when pointing out toward apple and ground .client interest level was high as compare to other activities in session .Client pointed out up 90 % of times for both identification of Up and Down

Reinforcement
Reinforcement was provided in the form of time spent out side session hall.

Session 8 Goal
Time Taken
Revision of previous Tasks Matching picture with shape

45 minutes

Procedure
Client was taken to the session room .He was bit irritable when entered the room; He was prompted to shake hands with other members. Previous tasks were revised by the therapist so that she can have an idea that which task needs to be revised. Client was taught about shapes in previous sessions .When therapist assessed his previous learning of previous shapes. He successfully recalled all shapes (triangle, circle) Therapist placed pictures of both shapes that were card made triangles and circles. The shapes and the pictures were placed in front of client. NOW he was asked to place the picture on the shape .Client did this successfully for triangle for circle. Again the shapes were jumbled up and client was asked to match them again client did successfully only for triangle. This showed that client was only able to get complete mastery of shapes.

Reinforcement
Reinforcement was provided in the form of biscuits

Session 9
Goal Revision of previous Tasks Matching same color

Time Taken

45 minutes

Procedure
Client was taken to the session room client was bit non compliant before session he was resistant while going for the session. He returned toward class twice and therapist went back to take him for session, so therapist had to introduce an interesting activity to tackle his irritable mood. Therapist todays task was to make him learn same colors or matching concept .For this purpose same color pencils of two different colors were selected. Initially it was demonstrated by the therapist that how to match same color in cluster. Then different color pencils were placed one of color was placed separately, and client was asked to place alike color pencils with it. Client was enjoying this task as he paid full attention to the task without being irritable. Client performed this task successfully except one color was not placed with pencil. He was then asked to place alike color pencils with other color pencil. Client enjoyed this activity too, as his interest was high. According to the instruction reinforcement was provided

Reinforcement
Reinforcement was provided in the form of biscuits

Session 10 Goal
Time Taken
Revision of previous Tasks Solving puzzle Joining the dots

45 minutes

Therapist task was to provide him with a puzzle to solve this, as this was first time that he was tracing a puzzle so .Considering the clients cognitive level puzzle selected was pretty easy. Therapist gave him puzzle and asked him to search way for the cat present in the puzzle. Therapist initially modeled whole behavior of tracing the puzzle on rough paper. Client started the puzzle he was continuously being reinforced by verbal praise that well done and very good. Client had sense of achievement after completing the puzzle The next activity was dot joining to increase clients finger grasping and written commands, the dots was used as a prompts in first row of alphabets were jointed by dots at very small distance but gradually the distance between the dots consciously increased. This increased distance was fading of prompts .Client did joining in first few rows very well but gradually his joining line was bit distracted from expected. Reinforcement Reinforcement for solving the puzzle was provided in the form of biscuits while reinforcement for joining the dots was candy.

Session 11 Goal
Time Taken
Procedure Revision of previous Tasks Draw + in imitation

45 minutes

Client was taken to the session room client behavior was compliant before session he was so therapist had to introduce an interesting activity to tackle his irritable mood. He happily entered the room client was told that he will be given reinforcement after he had successfully repeated the task. Therapist task was to make him imitate sign +.At first client was asked to imitate sign +.Therapist drew + sign and asked him to imitate. Client was not able to do it fully his one of the line was not overlapping his horizontal line so therapist made dotted worksheet for him and he was asked to pencil this whole worksheet .When he had done with it he was again given a plane sheet and therapist drew + sign and asked client to draw + .This time he did that but bit physical guidance was provided in one of the few trails, after that he did that without any prompts. For further assurance he was asked to drew whole page of + sign.

Reinforcement
Reinforcement was provided in the form of biscuits

Session 12 Goal
Time Taken Procedure
Revision of previous Tasks Identification of dress code Identify front or back of shirt

45 minutes

Client was taken to the session room client was bit non compliant before session he was resistant while going for the session. Client stopped many times while he was coming for session, so therapist had to introduce an interesting activity that does not require a lot of attention. Therapist task was to assess his identification of dress code Therapist made a work sheet containing general dresses like shirt pant glasses, socks, hat , frock .therapist asked client to tell by gestures that which dress will be used where. Client pointed out shirt, pant, cap, glasses, shocks but he was not able to identify some of the dress codes .He was given prompts for these dress codes and after the prompts when he was asked to tell he successfully did that.
Secondly he was asked to identify the front side of the shirt . He was given a shirt he identified the right side. He was provided with the reinforcement for right identification

Reinforcement Reinforcement was provided in the form of candy.