Luke was seen in his room for a 45 minute occupational therapy treatment session. Focus of treatment was on improving his bilateral integration/hand usage, fine motor development, graphomotor skills, postural control and sensory processing/organization for improved general performance in various environments. Started session with 50 piece puzzle of Mexico, Central and South America. He was able to complete with moderate to maximum assistance but stayed engaged in task entire time. Reviewed letters in Print Island and where they are placed on the writing line. He required assistance with sizing and needed redirection to stay focused during this task. He required cues to hold paper not his head. Luke seemed tired today (day after Halloween).