We began by sorting stackable cardboard boxes by size, from biggest to smallest. Santino enjoyed throwing them up in the air and watching them land haphazardly, but needed refocusing to order them by size. I took out some food options from which he could select which included yogurt snacks, Fruit Loops cereal, and 2 different drinks. He chose the yogurt snack and handed it to me for me to feed him. He was more tentative eating this snack today which may have been due to it being blueberry instead of the usual strawberry flavor he brings in; however after one or two small bites, he did eat more readily and was receptive to watching as I modeled how to grip the spoon. He also cooperated during hand-over-hand feeding. I attempted to work on a color-sorting activity with him next, using an assortment of four different colors, red, blue, orange and purple. I asked Santino to hand me the green block giving him a choice between blue and green. Santino required excessive prompts to focus on the blocks and repeatedly handed me both blocks. I identified the blue block and the green block after engaging his attention and asked him to hand over just one block - the green one, modeling as I went along. Santino continued to hand over both blocks. He repeatedly yawned and attempted to lie down on some pillows on the floor, but I continued to provide him with activities that might stimulate his interest. We sat at the table and used markers, crayons, and paints to connect dots and draw lines from numbers to words. Santino passively participated in this activity; he seemed tired and unfocused. He pushed away the remainder of his yogurt snack as he did with some pretzels that were offered to him. I introduced an activity using plastic animals to identify, but this, too was met with marginal success today. Santino hummed quietly to himself and remained largely unresponsive to prompting techniques and methods to engage his attention. I will reconvene with Santino in an hour, following his hour of OT with Christine. Santino was more alert during his second hour. It appears that he was responsive to the sensory stimulation afforded him, which we continued in an adjacent classroom, using a large ball with which to execute gross motor skills and activities, such as rolling. He was interested in manipulating some beads of various colors, gravitating towards the red ones and using them to play with, threading them through his fingers, feet, and toes. I asked him if he wanted to play with 'more ‘of them, showing him the different colored bead necklaces. Santino responded by clapping, which closely approximated the sign for 'more.' He remained engaged with the beads, complied with my request to follow me back into our original classroom, and requested a drink by bringing me his bottle. I gave him his PediaSure vanilla shake which he drank while lying on the floor. He enjoyed the sensory stimulation of feeling some light brush strokes on his arm while finishing his shake and I helped him put on his socks and sneakers as we prepared for dismissal.