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. Luke lost a tooth right before OT session today. He put it in a tooth necklace. He was excited about losing the tooth. Began session with sentence writing activity. Worked on spacing, sizing and formations. Luke required assistance for the appropriate size of the letters "f and d". He needs assistance with forming the letters "a and d". At the start Luke needed friendly reminders about making the "trunk" letters in the trunk and the "leaf" letters tall. By the end of writing task he needed less cues and was sizing the letters well. We played a game together at end of session called "Grouch Couch". Luke did well taking turns but wants to win at all costs.