Libby was seen in an office for a 45-minute treatment session with focus of session on improving her fine motor skills especially in the area of grasp patterns, ocular motor skills (saccades), self care skills, handwriting, as well as improving her flexibility for wearing different clothing and wearing her hair different ways. Began OT session with showing Libby her OT chart and little rewards (baby squishmallows) for her to choose from. OT had her put her hair up at start of session so she could earn a star and receive her first baby squishmallow. She choose a baby duck. She wore her hair up throughout session only asking to take it down once. She even walked around the school and hesitantly showed it to her brother, Teddy who was in Art. Several teachers and Miss Judie commented on how beautiful she looked with her hair up. OT also had her take her blue sweater off at the beginning of the session because it was very warm outside and she was just coming in from recess. She demonstrated no aversions to taking off her sweater and never asked to put it back on. We reviewed lowercase letters r and n and Libby was instructed on lowercase m today. While working OT realized that Libby does not know all her lowercase letters and when shown is unable to say which lowercase letter is which. She seems to know her uppercase. OT will work on lowercase letter recognition before continuing lowercase letter writing. Libby needs to be able to recognize the lowercase letter before learning how to write them. We will continue to work towards her established goals.