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. Libby was eating her lunch (soup) during the beginning of her session because her lunch arrived late. Today she learned a new letter through the "Print Island" program that was in the "fall down, climb up group" which was letter "m". Libby reviewed the previously learned letters "r and n". Libby used a "twist and write" pencil to help her establish a tripod grasp pattern otherwise she resorts to using a thumb wrap grasp pattern in an attempt to gain stability and control for pencil control. Libby told the OT today that she feels embarrassed when people notice that she wears her hair a different way and says things like "wow your hair looks so pretty today", etc. She does not like the attention wearing her hair different ways brings. She also told the OT she doesn't like having her star/sticker chart up in her room so we took it down and put it away so it is not on display. Good session with good communication today.