Luke was seen in his room for a 45-minute occupational therapy treatment session. Focus of treatment was on improving his bilateral integration/hand usage, fine motor development, graphomotor skills, postural control and sensory processing/organization for improved general performance in various environments. Luke lost a tooth right before OT session today. He put it in a tooth necklace. He was excited about losing the tooth. Began session with sentence writing activity. Worked on spacing, sizing and formations. Luke required assistance for the appropriate size of the letters "f and d". He needs assistance with forming the letters "a and d". At the start Luke needed friendly reminders about making the "trunk" letters in the trunk and the "leaf" letters tall. By the end of writing task he needed less cues and was sizing the letters well. We played a game together at end of session called "Grouch Couch". Luke did well taking turns but wants to win at all costs.

Luke was seen in his room for a 45-minute occupational therapy treatment session. Focus of treatment was on improving his bilateral integration/hand usage, fine motor development, graphomotor skills, postural control and sensory processing/organization for improved general performance in various environments. Began treatment with a cutting activity in which Luke had to cut a 5-inch by 5 inch character. He has better control and no longer exhibits associated mouth movements or drooling when he cuts. He colored his character with rainbow colors and was able to use dynamic finger, hand and wrist movements for refined coloring. Worked on role playing with the Zones of Regulation, gave Luke a scenario and he would have to say which zone he was in, problem size, and reaction size and one way to help regulating himself if needed. Example one was Dad is going to a NBA game but he can't take you - Luke said this would be a big problem and he would be sad and disappointed. We went over ways to feel better and discussed how this is not a big problem. We went over four more scenarios and he did well saying which zone he would be in but less well with determining size of problem, reaction and regulation. We will continue to work on Zones and regulating oneself in therapy.

Richard demonstrated good participation throughout the session with one movement break. Richard reviewed keyboarding home row keys and upper row followed by fine motor dexterity activity of shading in various directions with colored pencils. Minimal verbal and tactile cues required to encourage hand stabilization, while only moving his fingers during right to left and diagonal shading. A cross over pencil grip was used during this activity.

Began session working on motor coordination and upper extremity strength with peer. Richard demonstrated good ability to copy familiar and novel gross motor movements involving crossing midline and coordinating upper and lower extremities together, including cross crawls, skipping and alternate side arm/leg strides with good coordination and timing. Ended the session working on visual perceptual skills while completing 2 Cat/mouse puzzles with minimal verbal cues.

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. Today was Libby's first OT session. She easily separated to join OT. Began session with clothespin activity to increase grip and finger strength for improved grasp patterns and distal control. Continued with Bunchem's stick ball game for tactile input and showed Libby her rainbow sparkle chart. Explained that she would get a star every time she wore shorts, short sleeve shirts, or a dress and her hair up (any way she chooses). Libby asked if she could wear different clothes starting at home not at school. OT said that is okay but Mom has to send a picture. Continued OT with introducing Libby to Print Island. She was instructed on the lower case letter "r" today and was given the auditory cue of "fall down, climb up, hook". After practicing big on glitter paper to practicing small on index cards Libby was able to form the letter "r" correctly. She will need continued practice to change the established motor memory for this letter and all the letters she has learned to form incorrectly. Great first session.

Richard was seen in his room for a 45-minute treatment session. His session focuses on improving his postural control, integration of retained reflexes, visual motor skills and integration, fine motor skills, dexterity, manipulation, ocular motor development and graphomotor development/keyboarding as an alternative means to written communication. Worked with Richard Wednesday with peer to paint his ceramic bowl and today he glazed his bowl to finish his project. Richard continues to use a thumb wrap grasp even on paint brushes but does not complain of fatigue. This type of grasp makes refined and dynamic finger movements hard to achieve. Continued with game with peer.

Richard was seen in his room for a 45-minute treatment session. His session focuses on improving his postural control, integration of retained reflexes, visual motor skills and integration, fine motor skills, dexterity, manipulation, ocular motor development and graphomotor development/keyboarding as an alternative means to written communication. Began session outside with mat exercises to work on integration of the ATNR reflex by doing cross crawling exercises and various MRNI techniques. Continued to work on ocular motor skills with head turn, tracking, fixation, saccades and pursuits exercises. Reviewed previously learned cursive letters by writing them with chalk on sidewalk. Richard's recall for previously learned cursive letters is fair and he continues to require verbal cues and demo's for approximately 3/10 letters. Lastly worked in room on ceramic craft in which Richard drew a design he would be painting and glazing by the end of the week to take home for Easter. Good session.

Luke was seen in his room for a 45 minute occupational therapy treatment session. Focus of treatment was on improving his bilateral integration/hand usage, fine motor development, graphomotor skills, postural control and sensory processing/organization for improved general performance in various environments. Luke was in good spirits today and stayed well regulated throughout session. No mention of not being able to take home vase yesterday and worked well to glaze and finish it today. He was happy he was able to take it today. Continued session with a Easter egg hunt outside which involved finding eggs that had child do various gross motor activities like jumping jacks or list says things like "sing the alphabet", "sing a song" or answer questions like "what can you do if you are in the blue zone, what can you do if you are in the red zone". This was fun activity and Luke enjoyed searching for the eggs. Good session.

Luke was seen in his room for a 45 minute occupational therapy treatment session. Focus of treatment was on improving his bilateral integration/hand usage, fine motor development, graphomotor skills, postural control and sensory processing/organization for improved general performance in various environments. Luke has a bit of a stuffy nose but seems in good spirits at beginning of session. Began treatment with hand strengthening closthespin work to increase grip strength. Asked peer to work with Luke in his room on painting their ceramic projects together. Second day of three day ceramic vase project involved painting his designs he drew yesterday. Both painted cooperatively side by side throughout session with no issues. Shared paints and brushes and stayed well regulated throughout with appropriate peer conversation. When it was time to clean up and for Luke to go home he wanted to take the wet, unfinished vase and went to stick it in his backpack. When he was told he could not take it home he got very upset. At this point across the hall peer was instructed to go back to his room. Luke insisted on taking home vase and had difficulty regulating himself and accepting he couldn't. In the end he left without the vase, sad but calm. He needs to figure out how to use his strategies for situations like these in which he has to delay gratification and not get what he wants when he wants it. We will continue to work on self-regulation strategies in OT. When he was upset he could not "hear" the strategies so OT tried to just demo them by taking very deep obvious breaths, etc. to try to get Luke to do the same.

Luke was seen in his room for a 45 minute occupational therapy treatment session. Focus of treatment was on improving his bilateral integration/hand usage, fine motor development, graphomotor skills, postural control and sensory processing/organization for improved general performance in various environments. Began treatment in Luke's room. He appeared tired today. Worked on a visual motor activity drawing sequence to make a design. He created a palm tree, bird, flowers and bunny all from step to step instructional book. He made these designs on a vase which was explained as a three day craft. One day to draw designs, second day to paint, and third day to glaze. He was able to stay on task and participate in the activity well. He wanted to take the vase home today but was able to transition well without it. Good session