Nicholas had brought home a book from his school library about Transformers and we attempted to read it aloud. However, the words proved too complex, difficult, and challenging, so this tutor suggested that Nicholas look it over at home later, to which he agreed. We proceeded to the library where this tutor selected five (5) books ranging in level from K- first grade. Nicholas selected The Cat in the Hat, by Dr. Seuss. When he began reading, Nicholas made up his own story. He did not attempt to sound out the words. Through guided practice and prompts, Nicholas was able to sound out some of the smaller words, such as ‘the’, but he frequently looked at the corresponding page and continued to make words up. After this tutor used a pencil to point to each word and Nicholas was prompted to identify the initial letter and the sound it made, were we able to tackle the expectations of the reading exercise. We were able to complete about 18 - 20 minutes of guided work before moving on to another activity which Nicholas was allowed to select for demonstrating sustained attention to the task at hand. It would be beneficial for Nicholas continue to work on beginning sounds and to attempt to sound out words with different blends before proceeding to consonant digraphs such as ch, sh, th, wh and ph., etc. Using the pencil to guide his reading was facilitative to Nicholas’s ability to remain on track and engaged in purposeful activity. It should be noted that Nicholas needed reminders to read pages in order - first the left page and then progress to the right. He was reminded that reading is an exercise that requires effort and concentration necessitating that he sound out and combine the letters to figure out the words that are written on the page – not those created from his imagination. After his work was logged in for his teacher, Nicholas proceeded to assemble a 46 piece puzzle, demonstrating excellent eye-hand coordination, and visual perceptual performance skills. This was communicated to his mother when she arrived to pick Nicholas up at the end of the day.