Santino arrived in a terrific mood. He came in with a huge smile, and was very jovial, interactive, and happy throughout the session. We began by placing our book-bag in its customary location and planning our activities using a visual communication board. Santino and I went outdoors where he assisted me in watering the plants, given hand-over-hand instruction. We also planted a plant in a pot we found, using a spade to dig dirt, patting it down, and watering it. Santino participated in this activity but required prompts and guided instruction to perform successfully. His attention began to wander towards the playground equipment so I allowed him an opportunity to go on the seesaw with me and with another student who asked to join us. He also climbed up the ladders and went down the slides. We found a deflated yoga ball, in which Santino took an active interest, and we used it for various motor activities involving rolling, sitting, throwing and pushing it down the slide. Santino enjoyed these activities very much as they engaged his different modalities and the ball's physical properties piqued his curiosity and desire to experiment. We ended the session washing our hands and Santino initiated the correct motions to dry his hands using the towlette he was handed. Santino has been making slow but steady gains in and across several areas of his performance. For example, he engaged more actively with a peer in the playground today, was more responsive to requests to participate, and he clearly articulated "wash up,” as we went inside to wash our hands, following my prompt. I am suggesting that he wear a light pair of pants to school in order to minimize him getting bit by mosquitoes. Today, we used the bug spray on the exposed areas of his body, but he still got some additional bites. Mom has kindly offered to bring in more bug spray for Santino.