Three-year-old Kasey has cerebral palsy (CP) with seizures. He often pushes books away, putting his head down instead. Kasey is learning preliteracy skills and enjoys manipulating objects but has great difficulty with fine motor abilities. Kasey’s twin, Kolby, also has CP. He enjoys having books read to him. He will often seek out books during check-out time, but he cannot interact with them on his own because of fine motor difficulties. His strengths include enjoying the computer with an adaptive switch, and he has the ability to understand key concepts in a story. Chandler is an active four-year-old with language delay, who often engages in imaginary play where he fights with ninjas during storytime. He seldom initiates looking at books, and when he does, he folds the pages, bends the corners of the book, or even tears the pages. During sensory activities such as playing in sand, finger painting, and playing with play dough, he is very attentive and will not leave that area. His strengths include his sustained attention to the sensory area and manipulatives table, his imagination, and his understanding of simple plots.