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. OT has also focused on sensory processing and having Libby be more comfortable with wearing a variety of clothes (weather appropriate) and different hairstyles (only wants to wear her hair one way which is down). Libby continues to be encouraged with a sticker chart to wear different clothes and her hair different ways. She is excited to report what she wore and how she styled her hair over the past week to earn stars on her chart. We continued therapy with recall for upper case letters. Libby is now able to identify all of the letters of the upper case alphabet with 100% accuracy. We continued our work on Print Island. Libby was taught the "fall down, climb up letter" lowercase "r" two weeks ago. Today she was instructed on the lowercase letter "n". She was able to form and size it well when provided with a coconut and a trunk as a visual boundary. By the end of the practice page she was able to form it independently well. We continue to work on hand strength, dexterity and manipulation to work the intrinsic muscles of her hands. Great session, Libby is making good gains this year.