Competence in early numeracy skills highly correlate with success in mathematics in later years; however, many students, including students with moderate and severe disabilities, lack a sound foundation in early numeracy skills. For this population, the gaps in skills widen as students progress through academic years, making it more difficult for students to access the general curriculum, and consequently, students exit school without the skills needed for the 21st century. This article provides a conceptual model for teaching early numeracy skills to elementary students with moderate and severe developmental disabilities, as well as pilot research in both special and general education settings. Limitations and suggestions for future research are included. (Contains 2 tables and 4 figures.)