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. Began treatment with ball hanging on string tracking/cognitive multi-task activity. Luke was able to alternate hands to push the ball back and forth with the OT while reciting the alphabet in sequence with good timing and accuracy and minimal mistakes with both the alphabet and alternating of hands. Continued with graphomotor work to refined handwriting. Luke needs to continue to practice and learn the size and line placement of the lower case alphabet. Steady progress seen.