The Common Core State Standards (CCSS) in mathematics were created to help all students become prepared for the demands of future careers and life in an age of technology. Similarly, students with moderate and severe disability will need these skills to meet these changing expectations. Although mathematics instruction could focus on a few of the earliest mathematics skills throughout the students school career, research presented in this article shows students with moderate and severe disability can learn skills that align with the grade level of their chronological age while also practicing early numeracy skills. This article provides teachers with a 6-step approach to providing instruction to students with moderate and severe disability aligned to the new CCSS. (Contains 2 tables and 2 figures.)