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Students with learning disabilities (LD) show persistent difficulties in understanding fraction concepts. We report on the effects of a nine-session intervention grounded in learning trajectories with an emphasis on using student thinking for 13 students with mathematics difficulties (MD) and learning disabilities. Results show a statistically significant increase in performance on a measure of fraction concepts. Students also showed discernable improvement of the cognitive operations consistent with conceptual growth. The results of this pilot study show the potential to improve students’ performance in school settings and warrant further exploration.