We began the session by reviewing counting by ones and tens to 100. Efforts to relate counting to addition were attempting using an abacus and counting ten more from a specified even number. For example, what is ten more added to 40. Nicholas has difficulty arriving at the next ten spot after 39. His answers are often random and he grows frustrated if asked to focus his attention on the strategies pointed out to him. He was reminded to visually look at the first number in the 2-digit number to figure out what the next ten would be. While this technique appeared to facilitate his performance, he required prompts to sustain his gaze where indicated and relied on other cues, such as auditory emphasis, to arrive at the correct answer. Nicholas forgot his math homework from school again. When asked if he had received it, he replied that he couldn't remember and that he changed classes. He has said this before when he forgot his homework. I wrote a note asking that Nicholas appears to require reminders to get his homework and put it in his folder and book bag before leaving school. I made a copy of the assigned page from the math workbook we have for him at our school and we completed the work together. Nicholas was tasked with using tens and ones to read and write numbers from 110 to 120 and to problem solve. Nicholas frequently repeated "I don't get it" when asked to resume work. He understood the expectation of bringing his work home.