You are Tia's communication specialist. Tia is a 3 1/2 year old girl with a trach which was placed when she was 6 months and old and which her doctor has said will be permanent. She has Spina Bifida as well as the health issues due to the trach. She is verbal and scores right at her age for cognitive skills. Communication, however, remains her area of greatest need. She has numerous articulation errors and often is not understood by other children or strangers. She needs to greatly increase her breath control and stamina so that she can wear a different type of valve on her trach. The new valve would improve her speech intelligibility and decrease the functionality and health problems of her having to remove her vent and place her finger over her trach opening in order to speak.

You usually work with Tia at the end of snack time and beginning of free-choice play twice a week. You would like to begin doing some type of group activity to provide Tia with support as well as to enhance the other children's interactions with her. If you did a group activity you would have to decrease your other time with Tia, because your schedule is completely full.

You try to attend as many of the numerous meetings regarding Tia that you can, but find it difficult with your large caseload. It would really help if you could do more "role release" with the early childhood teacher and have her embed the training activities during other opportunities on days when you aren't on site. The team is gathering today to address your concerns with Tia's communication plan and to plan for her progress toward being physically capable of wearing a valve on her trach opening.

What questions to you hope to get answered at this meeting? What plans do you want to share with the team? What do you hope will be the outcome of this meeting?