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 treatment with resistive putty to find hidden objects for proprioceptive input and hand strength. OT realized that Libby is unable to consistently identify several letters of the lower and upper case alphabet at this time. It is in her best interest to first be able to recognize and name the letter before or in conjunction with learning how to form it. We continued with assessing which letters of the upper case alphabet Libby is able to identify. She was able to identify 12/24 letters today. She misidentified or was unable to name the following letters "A, D, E, G , H, J, K, M, N, P, S, U, V, W, AND Z. We will continue to work on letter recognition during OT sessions. Libby was able to tolerate wearing her hair up during OT session and was able to wear a dress during the previous week. Good session.