Richard worked on fine motor dexterity and visual motor integration skills. He was able to complete a moderately difficult maze, only drawing outside the lines 3 times. He was not wearing his glasses today however, he demonstrated an improvement in this skill since the last session. Richard continued to work on finger dexterity to assist with pencil control during writing. Began with Finger Aerobics-finger flexion and extension, 10 times each, while maintaining a tripod grasp with moderate difficulty. Richard required moderate verbal and visual cues to shade 3 inch, forms diagonally and side to side.

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 with various activities to integrate his retained ATNR reflexes with outdoor mat work. Continued in room with various visual processing and ocular motor work to improve visual system. We continued with practicing writing in cursive and in print today. Richard continues to be slightly resistive to writing but is demonstrating slow yet steady gains. Good session

Luke was seen in his room for a 45 minute treatment session. Focus of treatment continues to be improving his postural control, fine motor coordination, visual motor skills, handwriting, sensory processing abilities and self-regulation for increased self awareness and self management. Began treatment outside with having Luke participate in an obstacle course that involved following multiple step directions - it involved drawing infinity eights (working on crossing midline) with chalk on pavement, hopscotch and lastly jumping jacks. Luke did well crossing midline to draw eights but needed verbal cues to continue to work and follow a path in a coutner clockwise direction. He needed verbal cues of "star" - "solider" to perform jumping jacks. He does not have higher level gross motor coordination to do a smooth and quick jumping jack at this time. In general a child is most likely be able to perform a smooth and coordinated jumping jack at the age of 5-6 so this is a skill Luke can develop.

Luke was seen in his room for a 45 minute treatment session today. Focus of treatment was on improving fine motor skills (hand strength, grip strength, dexterity and manipulation), visual motor integration, ocular motor skills, and graphomotor skills/keyboarding as an alternate means to written communication. Began session with I Spy book activity to work on visual perceptual skills particularly visual figure ground and visual discrimination. He needed assistance to find 4/12 of the hidden pictures and was able to find 8/12 independently. Next, Luke was asked to write four words in print. He reluctantly wrote very well with proper letter size and formations. He wrote best when provided with a box and a dot (for start point cues) and visual boundaries (for size cues). Lastly, practiced previously learning upper case and lower case letters on the Magic Pad. He continued with good participation today.

Luke was seen in his room for a 45-minute treatment session today. Focus of treatment was on improving fine motor skills (hand strength, grip strength, dexterity and manipulation), visual motor integration, ocular motor skills, and graphomotor skills/keyboarding as an alternate means to written communication. Began session with visual motor activity in which Luke had to draw by following step-by-.step directions to create animals of his choice which were a fox and a wolf. To create these creatures he had to make rectangles, triangles, curved and diagonal lines. He did very well. Next, we worked on expected versus unexpected behaviors. Luke is very aware and gets all the answers correct when asked about certain behaviors being expected or unexpected. Lastly, play Zingo to make CVC words. Worked on letter indentification and sound. He required assistance to make and sound out words like put, rag, cat, and
rat. Good session and better participation and on-task behavior today.

Luke was seen in his room for a 45 minute treatment session today. Focus of treatment was on improving fine motor skills (hand strength, grip strength, dexterity and manipulation), visual motor integration, ocular motor skills, and graphomotor skills/keyboarding as an alternate means to written communication. Began treatment with putty activity to work on strengthening the intrinsics of the hands. Continued with Whole Body listening lesson. Explained how each body part has its job when listening. For example: eyes on the the speaker, heart - cares about what is being said, etc. Worked on Print Island today and wrote letters uppercase U and W. He wrote them well. Need to continue to work on listening skills.

Richard was seen in his room for a 45 minute treatment session today. Focus of treatment was on improving fine motor skills (hand strength, grip strength, dexterity and manipulation), visual motor integration, ocular motor skills, and graphomotor skills/keyboarding as an alternate means to written communication. Richard was seen in his office and had strep throat earlier in the week. He did not seem to feel 100% today and was somewhat fatigued. Began treatment with ocular motor exercises with tracking, depth perception, localization and timing activity involving a ball on a string in which Richard was required to poke the ball alternating between his right and left index fingers. To add another component to this activity OT had him say the alphabet while poking the ball. This was difficult for Richard with poor timing, losing track and not knowing order or forgetting order. We will continue to do this type of work to improve many visual and executive functioning skills. OT then read Richard a short story and had him come up with two sentences to write about the story. He wrote in print adequately. Continued with Ann Arbor tracking program in which Richard was timed scanning left to right, top to bottom to find words hidden in scrambled paragraph. Richard performed two trials and was able to find 12/12 words within 1 min. 2 seconds and 6/9 words in 55 seconds. Good session.

Richard was wearing his glasses today and presented with good self regulation and attention to task throughout the session. Today's session focused on fine motor dexterity and visual motor integration skills (VMI). Richard was provided a maze with instructions to remain in path the best he could. When finished he crossed the path 9 times. Richard demonstrated increased difficulty shading in 3 inch shapes in a diagonal and side to side pattern. He had increased accuracy with circular and up and down motions. These challenges were shared with Richard's other OT. We will continue to work on both VMI and FM dexterity skills.

Richard was seen for 45 Minutes and demonstrated good participation and attention to task. Following a fine motor strengthening and coordination warm up, Richard worked on keyboarding skills with focus of top row reach keys and home row with 79% accuracy with increased time. Accuracy improved when the typing program volume was turned off and he said each letter he typed.

Luke was seen in his room for a 45 minute treatment session today. Focus of treatment was on improving fine motor skills (hand strength, grip strength, dexterity and manipulation), visual motor integration, ocular motor skills, and graphomotor skills/keyboarding as an alternate means to written communication. Upon arrival to session Luke was all excited about playing pickleball during recess which had just ended. He was able to settle in and work at table. Began with putty activity to strengthen intrinsics of the hands. Continue therapy with working on manipulation and dexterity skills through a rolling dice game. Luke enjoyed that game and stayed engaged throughout this activity. Luke needed a break during session and hugged his avocado plush toy. OT pointed out it is okay to take a break like this and when he needs a break during his school day he should ask for it to help him stay in the green zone. Continue to work in his Print Island workbook. Luke was focused and engaged in writing today and practiced the uppercase letters F, E, L, K, and H. Great session.