Santino was greeted at the door while being dropped off by his mother. His mom reported waking up early and being upset/tired upon transition. Santino went to the pre-k classroom and immediately laid down on the floor with a blanket while crying. Sensory input was provided to his arms and chest with a tapping motion. Santino did calm down and appeared regulated until an attempt to transition to his classroom area. He cried again, therefore we did three sing along songs which did help as well. After transition, Santino was putting his fingers in his ear, saying "ear", and opening/shifting his jaw as if he was trying to relieve pressure. Play-doh was presented and played with targeting many goals including requesting, following directions, answering simple yes/no questions, increasing utterance length (2-3 word utterances), commenting, using descriptive words, requesting help following a sabotage activity (opening the play doh when given to him with the top on), all while providing proprioceptive input. Santino was calm during this activity and very receptive to the fading multimodal cues given to him. A vocabulary task was completed following the language task. Santino named + carrier phrase of "it's a __" 15/20 objects. A book activity was implemented to target use of verbs and attributes. He requested a book given a choice of three. This is the point of the session when Santino became very tired and heavy eyed. We went to the playground to "wake up our bodies". Santino independently requested to go inside after a few minutes. Santino did respond well to therapy although he appeared very tired and may not be feeling well.