Libby was seen in her room for a 45-minute treatment session with the focus of therapy on fine motor skills specifically grasp patterns, ocular motor skills (saccades), self care skills, and handwriting. Libby participated well and was focused throughout her treatment session. Work on refinement of fine motor precision and manipulation skills with activity involving using tweezers, spray bottles and small beads. She completed this activity and followed directions well with her brother Teddy. We continued with alphabet recognition for both the upper and lower case alphabet today. She was almost able to identify all the letters of the uppercase alphabet today she got 23/26 correct. She is able to identify about 1/2 to 3/4's of the lowercase alphabet independently. She is improving with wearing her hair in different ways and not limiting the clothes she will wear. She is making steady gains.