This study replicates and extends prior research on multisensory mathematics instruction (Grünke, Urton, & Karnes, 2018) by integrating a touch points strategy, performance feedback, reward system, and a reinforcing card game into an instructional package. A multiple baseline design across participants was used to evaluate the effects of the touch points package on the subtraction skills of four German female first year students at-risk for learning disabilities. During intervention, the students were administered eight to eleven treatment sessions to learn how to subtract a one-digit subtrahend from a two-digit minuend up to 18 crossing over the tens barrier. Results indicated that all students made substantial increases in their subtraction performance during intervention. Student performance improved from 0 to 2 out of 10 math problems solved correctly during baseline to between 8 and 10 problems correct by the end of the intervention. Effect sizes observed across the four participants indicated the effectiveness of the intervention ranged from high to very high.