Terry is an 18-year-old woman with a diagnosis of moderate-to-severe intellectual impairment of unknown etiology. Her hearing is within normal limits and her vision is mildly impaired (myopic) but corrected with glasses. Terry exhibits subtle motor planning problems evidenced during classroom tasks and activities of daily living. Her communication abilities include the use of natural gestures (e.g., leading, pointing, showing), facial expressions, body orientation, and behavioral responses such as physically withdrawing from people who make unwanted demands. Terry speaks in phrases of one to three words that are intelligible to familiar listeners. She uses five words in sign language. Terry comprehends context-based one- and two-step directions related to familiar routines. She is regarded as an intentional communicator who expresses requests for favorite items, events, and people. Terry protests and reports when peers have broken a class rule. A picture schedule is currently used to help Terry understand the steps associated with daily class routines.