Santino was seen for session 39 of 40 with this SLP in the individual classroom and appeared pleasant and calm upon transition between sessions. The daily, visual schedule was referenced and reviewed. Santino verbalized "Sharon"...Goals for the session remained consistent and included the following...1. to engage in forming a relationship with Santino that includes regulation, and shared attention and interest 2. to enter into two-way, purposeful interactions with gestures and intentional communication 3. to determine highly motivating/favorable, cause and effect activities, so that Santino may develop a feeling of control and predict/anticipate what will happen next 4. to imitate predictable action sequences and communication patterns through cause and effect activities 5. to develop single-word requesting via eye-gaze, picture exchange and/or verbalization...Santino was presented with 2 novel and 2 familiar activities. All were met with rejection as Santino appeared to search for another option. Redirection to presented options was rejected once again. Another option was presented ("The Little Old Lady...") and immediately requested via photo exchange paired with reference. Once more, Santino appeared to take immediate interest in the text and illustrations. During a 30-minute period, Santino requested the book twice via photo exchange and engaged in two-way, purposeful interaction with gestures, shared interest, and intentional communication. He pointed to text as if decoding whole words (paired with reference to illustrations) and verbalized the following, expanding his utterances throughout, as an adapted version of the story was presented by this SLP: "Once Upon a Time, Old, Little Old Lady, Cottage, Walk, Moon, Stopped, She Stopped, Shoes Went CLOMP! CLOMP!, Two Big Shoes, Pants, Pants WIGGLE! WIGGLE!, Bumped, Shirt, Shirt SHAKE! SHAKE!, Two White Gloves, White Gloves Go CLAP! CLAP!, Hat, Tall Black Hat, Faster, Scary Pumpkin Head, Boo! Boo!, Ran Fast, Door, Locked Door, Rocked, Knock-Knock-Knock, Open, Open Door, Bravely, Bed, Good Night...Santino was encouraged to use the action sequences of the Shoes, Pants, etc. and did so with moderate to minimal verbal and/or physical assistance and model by this SLP...During the next 10-minute segment, Santino completed 3 Comprehension activities related to the story. He sat at the table and appeared to reference the 4 photo choices presented as possible answer choices. Maximum hand-over-hand assistance was provided to complete all paper/pencil tasks..."All Done" was referenced by this SLP then selected and verbalized by Santino who appeared tired and teary-eyed. He stood independent of direction and lay on the pillows. Attempts to entice and redirect were met with rejection. Santino fell asleep within minutes and slept for the remaining 20-minutes of the session...Continue as planned with focus on intentional communication to request and initiate via social referencing paired with photo exchange and verbalization.