Santino happily arrived and without hesitation rapidly walked directly into the office. Mom shared that Santino had fallen asleep early last night and was awake by 4am, noting that perhaps this may impact the session. Santino happily engaged with the materials provided within a choice framework. Noun label use to request desired items was supported with increased frequency today as carrier phrases. models and binary choices were often needed in succession. Spontaneous noun label use to indicate request was noted with decreased frequency today. Support to request assistance with use of the sentence form "help me +action" was successful given visual cues and carrier phrase for an initial 4/8 opportunities. Spontaneous request for assistance was noted on the remaining 4 opportunities via use of "help me." Santino utilizes a head shake "no' in response to question forms related to the immediate context with increased frequency. 432 Hz music continues to be utilized throughout the session. Santino was clearly tired this session, as Kim had noted as a possibility today, and although feeling fatigued, he was participatory and happy.