Within four weeks, the patient will use a speech-generating device to communicate basic medical, safety, and personal care needs (e.g., pain, toileting, hunger, assistance requests) to familiar, trained partners in 80% of opportunities and no more than one verbal cue across three consecutive therapy sessions.

To improve speech intelligibility and increase communication with peers and family, Alexis will independently produce “r” in the initial position of target words within individual therapy and small groups with 80% accuracy across three sessions. 

Within 12 weeks, Seth will expand his expressive vocabulary to verbally request familiar items during 15 minutes of structured play within the home environment with no more than two semantic cues.

Within four weeks, the patient will independently use rotary chewing, effective bolus manipulation skills, and alternating solids and liquids to consume IDDSI level 5–7 textures with no more than trace oral residuals between bites across three consecutive therapy sessions.

Given visual and verbal cues, Maria will increase independence for following instructions during grooming routines (bathroom, bath, getting dressed) by receptively identifying common items within her environment with 75% accuracy across three sessions by January 2028.

Given visual supports and up to one adult prompt, student will use context clues to define curriculum-based vocabulary words in four out of five opportunities across three sessions by May 2026 in order to participate in classroom discussions.

Within eight weeks, David will independently use a strategy of choice to reduce physical tension and fear of stuttering during a personally relevant communication activity (e.g., phone call, work meeting, social conversation) in four out of five opportunities.