Santino arrived to the program refreshed, having slept through the night and eaten a good breakfast and snack prior to arrival. We placed his book bag on the table and took out his food options in the event he got hungry during the session. When he does get hungry, Santino will select his choice from the array of options available and hand the food item or beverage to me to open it or pour into a bottle, respectively. Next, Santino worked on an animal puzzle, and he independently assembled the 5 pieces without difficulty, demonstrating the visual perceptual skills and eye-hand coordination necessary to complete the task satisfactorily. Our next activity was related to animals as well. Santino listened to the Old McDonald Song and was prompted to show me the animal puzzle pieces mentioned. Although physical prompts remained necessary, Santino did say "oink" when the pig was mentioned in the song. When Santino's OT, Kirsten, arrived, she was shown into a smaller classroom in order to help Santino sustain attention and better focus on acquiring the skill sets necessary to eat and to feed himself with a minimum of distractions.