Santino was in good spirits and well-rested upon arrival to program. He was happy to accompany me to the classroom and we placed his book-bag in its usual spot over his cubby. Santino worked on hand-over-hand puzzles to facilitate his ability to attend to a task and follow directives. He works best when afforded hand-over-hand guided instruction, and we worked on the activity as he leaned back up against me, between my outstretched arms. Shapes were verbalized and Santino repeated 2 shapes after they were identified by this teacher. We then moved on to replicating patterns. Santino followed my movements, placing one leg before the other, as we walked alternating legs following a straight line. The words, 'left' and 'right' were uttered repeatedly as he coordinated his feet correctly replicating the pattern and demonstrating good balance and coordination skills. Santino enjoys movement exercises which are often accompanied by music or singing. When we went outside, Santino squealed with delight and went straight to his favorite playground equipment, the big slide, where he experimented going up and down in different angles and positions. He has become adept at climbing up the rung ladder and we count to 7 as he climbs up. Spatial concepts are also repeated and reviewed so that he becomes more familiar with words and concepts such as up, down, over and under. When we went back indoors, Santino immediately proceeded to the sink on his own and prepared to wash his hands. He is getting better at lathering, and we continue to work together pushing the lever to dispense soap from the wall mounted dispenser and to dry our hands after getting a paper towel. Before moving onto his next class and teacher, Santino was prompted to repeat the 'mom' or 'mommy,' which we have been working on, and he did so. Santino was afforded verbal praise and high fives by myself and another older student who was passing by and heard him. Today was a rewarding, fun, and productive day.