I arrived a bit early and observed Santino working with the O.T. for a few minutes. He was working on identifying words, when prompted, but he was more interested in the pointer and required several refocusing efforts to attend to the task. The therapist asked if I could change him into clean, dry undergarments, so this was the first order of business when we switched hands. I changed Santino into a clean Pull-Up in the classroom. Although initially a bit resistant, he soon allowed me to change him, and complied when asked to pull up his shorts. We then began working on the concept of big and little, by putting plastic tools in order by size, playing with sorting and stacking toys, comparing shoe sizes, since Santino's shoes were already off, and sorting plastic toy animals. Efforts to elicit speech were attempted and modelled, with intermittent gains noted. We also ordered straws by size, compared big and small letters and traced them, and we finished off the activity using 5 stackable boxes to order from smallest to largest. Santino initially seemed interested working with the boxes but required assistance and physical prompting methods to complete the task in accordance to expectations. When done putting away the materials used for the day, we proceeded to the kitchen to wash our hands. Santino began the steps necessary, requiring minimal prompts to assist him to dispense the soap. Obtaining the towel from the dispenser was broken down via task analysis and Santino grasped the concept of pulling down on the towel to remove it from the dispenser. He required a bit more assistance to perform the steps necessary to dry his hands thoroughly. I offered him a drink of cold water from a paper cup and Santino drank sips of it as I held it for him. I tried bringing it to his lips but not tipping it enough for him to obtain any liquid, which successfully prompted him to independently tip the cup higher himself to procure the water, and he then drank it on his own with minimal assistance. Santino continues to make slow but steady gains in the area of self-help.