Chris initiated conversation this session by sharing that he was experiencing ear pain and that he was going to the doctor later in the morning. He was strongly vested in the session as he so often is, however, it was evident that he truly was not feeling well. He was clearly tired and his voice quality was slightly raspy. He was participatory and engaged, however, ability to sustain attention within expanded language tasks was inconsistent. Familiar scaffolding strategies were provided to best support Chris as he navigated aspects of recall, vocabulary, and topic expansion.