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. Began session with brushing Libby's hair which she tolerated very well. Continued with having Libby find hidden items in discovery putty. She was able to easily find 12/12 hidden items in the moderately resistive putty. We continue to do hand strengthening exercises like putty to imporove grasp patterns and endurance for writing, coloring, and cutting. Reviewed previously learned letters "r,n,m, and h". She was able to form them all correctly and needed cues for sizing. Libby was instructed on the next letter in the same group which was lowercase letter "b". It is important for her to write this letter correctly since there are two of them in her name. Until this point she has been observed to make "b's" using the motor sequence/form the same way you would make a number "6". She was instructed with visual and auditory cues (fall down, climb up, bubble) and was able to change her form and write it correctly several times today. Every time Libby writes her name it is imperative that she is cued to write this letter correctly, so she can create a new motor memory of how this letter is formed. She used her twist and write pencil today with an open web space and dynamic finger movements achieved.