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This paper briefly overviews my research in supporting children to learn number concepts by relating number words, research-based visual supports, and math symbols. I first outline my approach to helping children build relationships between the use of concrete materials and the building of abstract concepts. I then focus on two crucial early aspects of building meanings for numbers: (1) understanding break-apart partners such as 5=3+2 that support addition and subtraction with small numbers and children’s moving on to Level 2 counting on and algebraic problem representations, and (2) the use of visual five-groups in understanding numbers 1–1000 and in drawings to support multi-digit computations. The research-based learning path of visual-spatio supports is shown and discussed for each topic, including examples of children’s math drawings for representing word problems algebraically and for multi-digit computations. I have found math drawings to be a key visual support that helps children transition to working meaningfully with symbols and words alone. I close with a brief discussion of the difficulties children have with the number line. This overview can provide a framework within which future research on number learning by individuals with trisomy 21/Down syndrome can proceed.