L., a 3-year-old with no formal diagnosis, came to therapy due to significant bedtime struggles, long meltdowns, and difficulty tolerating distress. Through a regulation-focused approach that included sensory support, reflex integration, listening programs, and parent coaching, she made meaningful progress with sleep, emotional expression, and family routines. As new challenges emerged during a seasonal transition, her care expanded to include additional behavioral support—highlighting the importance of flexible, collaborative care that meets both the child’s and family’s needs.