Session no 1

Goal Rapport building Reinforcement Identification Time taken 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 was he responsive towards 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 noticed that most enjoyable thing for the client was to spent time with in the class. Due to impaired speech his 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. Information regarding how he shows his irritability, handling of his irritable mood was gathered from the class teachers. Presenting complains by the class teacher were also asked from the class teacher. Till the end of session the client was much responsive toward the therapist. Therapist waved him good bye when leaving the class. Reinforcement
Reinforcement was provided in the form of chocolate.

Session no 2
Goal
Time taken Procedure 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 clients ability .For this purpose the class teacher of the client was asked to have clients copies. It was seen that his functioning level was much better so the therapist had to continue with the activities that do not require minimal ability. His attention span seemed to be up to mark. As reported by the teacher he was complaint toward tasks. Therapist also attended his physio session and speech session in speech therapy his progress was bit slow as he was at initial phases of learning sound production. 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 compared to other CP children. Assessment of child progress level Academic functioning Physiotherapy sessions Speech session 25 minutes

Session no 3

Goal
Time taken History taking PGEE Administration 25 minutes

Procedure Procedure this was first meeting between the therapists ancients mother. The session started in a very formal way. Client mother was quiet cooperative in giving history. So therapist felt comfortable in taking history. Therapist started with general one questions like hows your mood. Husband job and occupation. Clients daily routine at home, mothers hobbies .When the general information was in flow it was time to initiate formal history of background of problem, family history, educational history. Therapist mother was ensured 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 .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 the clients progress in developmental areas so that management could be done according to the requirements. Mother made identified the behaviors the client was able to perform .Clients mother was 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

Pre Assessment
Subscale Socialization Language Self-help Cognition Motor skills 1st Missed item Corresponding Age Range Years Years Years Years Years Last Passed item Corresponding Age Years Years Years Years Years

Pre rating
Behaviors Stubbornness Throwing Object Shrieking Non compliance Leaving the class Irritability Ratings

Session no 4 Goal

Hand shaking Name identification Identification of Body parts

25 minutes

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 was bit shy while shaking hand, he did not follow the command off the therapist initially regarding hand shake. So therapist modeled the behavior when entered the room with members in the session hall. He followed the commands and was provided instant reinforcement in the form of verbal praise. Therapist next task was to assess 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 not able 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. 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 was 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 .Therapist used verbal prompts and pointed out her own facial parts to make them identified by the client. During the session client was equally prompted to take part in identification of parts when he was able to point out 5 parts at 70 % mastery level session was terminated. Reinforcement Reinforcement was provided in the form of biscuits

Session no 5 Goal.
Revision of previous task Gender identification Identification of red color

Time taken Procedure

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. Pointing out to his name, revision of facial parts. For red color identification, client was given with red color pencil, red color apple, and red glaze paper then verbal prompttoward red color was given then he was asked to point out red color. When client had successfully done with that it was time to move on to next task. For gender identification 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 the 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 6
Goal Revision of previous task Matching of Red and green color Time taken 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 took the client to the park and there she spent time with the client. First of all revision of previous task was done to rememorize the tasks or things taught. Pointing out to his name, Red color. Identification of boy nag girl was done. 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.Therapist asked client to point out red color on charts paper in Clients class.For further learning he was asked the match puzzle of colors .He was matched them using pencil. He had successfully had done that it was time to move further. Clients mastery level among 10 trails was 6.This mastery level may be due to his short attention span. Reinforcement Reinforcement was provided in the form of candy 40 minutes

Session no 7 Goal
Revision of previous tasks Cutting and pasting

Time taken Procedure

45 minutes

Client was taken to the session room client behavior was compliant before session he was happy when entering the session room. Therapist main task was to work on him help skills he was taken to the session hall first and was asked to shake hands with all members of session hall. Therapist introduced a task that required his attention and client had great interest in tearing activity so hard hart was placed in front of client .He was asked to cut the chart with blade and then paste it on the paper .Hard card selection for tearing was preferred considering client capability to tear. Hard chart was first cut by the client. 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 for pasting the chart 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 ahsan made this carrot clap for ahsan

Reinforcement
Reinforcement was provided in the form of football play

Session 8
Goal
Revision of previous Task Coloring an apple and mango Identifying Up or down Time Taken 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 responding to name, pointing to ear in facial parts because 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 placed in front of him and he was asked to select the colors he think should be in both pictures .He selected the right color he was then asked to color the pictures. He was given reinforcement for this in the form of claping. .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 Up and Down. Apple was placed higher on the self of session hall and he was asked to point out up by indicating toward that apple. Clients interest level was high as compare to other activities in session .Client pointed out up 90 % times correctly for both identification of Up and Down . Reinforcement Reinforcement was provided in the form of time spent out side session hall.

Session 9
Goal
Time Taken 45 minutes Revision of previous Task Identification of shapes Currency concept

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. Therapist first task was to make him identify shapes ( circle ,triangle, square).For this purpose a worksheet was used on which three shapes were drawn with colorful glaze paper. First client was asked to point out circle which client did successfully, next he was asked to point out triangle, and he was not able to do that and pointed wrong shape. Identification of the triangle was continued by the therapist because it was the ongoing task of his classroom, for this purpose the triangle was drawn in the center of page catching clients attention. Therapist pointed out toward finger with verbal prompt triangle .It was repeated number of times. After it was being noted by the client had gained mastery over it .Therapist ask client to point out triangle among three shapes, and client pointed out right thing .Clint attention during the task was fine. Therapist next task was to give currency concept to the client. For this purpose the coins of one, two, and five rupees were used along with a note of five rupee was used. Client was first assessed tat did he had money concept he was not able to identify from coin but he successfully identified from note. Therapist continued to identify him from coin for this he was taught to read the number from the coin. It was bit difficult for the client as he had visual impairment so it took time to make him identify. it took 20 minutes to complete but still he had 60 % mastery over it Reinforcement Reinforcement was provided in the form of chocolate and candy.

Session 10
Goal Revision of previous Tasks Matching picture with shape Hand washing

Time Taken Procedure

45 minutes
Client was taken to the session room .He was bit irritable when entered the room;

Therapist took the client to the ground and there she spent time with the client 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. as recalling Up and down. 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. Client was asked to wash hands it was asked that: ahsan has to wash hands: saying this instantly he was taken to the wash basin. He was asked to wash hands,for this purpose he was then asked to open the tap as he was CP child he was not able to do this alone therapist used hand over hand guidance for this purpose .then clients hands were placed under the water and modeling prompts were used to show hoe to wash hands .Clients interest in this activity was very high he enjoyed this a lot . Reinforcement Reinforcement was provided in the form of biscuits

Session 11
Goal Revision of previous Tasks Matching same color Identification of dog

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. Previous tasks were revised by the therapist so that she can have an idea that which task needs to be revised. as recalling currency concept. 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 by using Modeling. 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 for color matching 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. Along with color pencils the matching color worksheet also revised. Next task was to identify dog. For this purpose the a dog was made on a page .and client was asked to point out dog initially he was not able to do that but when prompts were given in form of finger pointing .He soon got mastery and on request pointed out right picture.

Reinforcement
Reinforcement was provided in the form of biscuits

Session 12

Goal Revision of previous Tasks Solving puzzle Joining the dots 45 minutes

Time Taken

Client was taken to the session room client behavior was compliant before session he was happy when entering the session room. Previous tasks were revised by the therapist so that she can have an idea that which task needs to be revised, as recalling currency concept. Therapist task was to provide him with a puzzle to solve this, as this was first time that he was tracing a puzzle. 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 Hand over guidance was provided for this purpose. 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 13 Goal
Revision of previous Tasks Identification of dress code Draw + in imitation

Time Taken
Procedure

45 minutes

Client was taken to the session room client behavior was non compliant before session, 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 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, socks 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. 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 14

Goal
Revision of previous Tasks Identify front or back of shirt Post Assessment

Time Taken Procedure

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 introduced an interesting activity that does not require a lot of attention. Client was asked to identify the front side of the shirt. He was not able to do that but when therapist pointed out button side of the shirt he easily identified that side. Next time when he was asked to point out, he identified the right side. He was provided with the reinforcement for right identification Reinforcement Reinforcement was provided in the form of lays chips Post assessment was also done as it was the last meeting between therapist and client Post assessment Subscale Socialization Language Self-help Cognition Motor skills 1st Missed item Corresponding Age Range Years Years Years Years Years Last Passed item Corresponding Age Years Years Years Years Years