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). Worked with Libby in her room for our last session before the holiday break. Libby and OT have been working on a knitting project to make a s'more stuffy. Libby was very excited to work on completion of this project with having the S'more stuffy as her present. She was able assist OT with knitting in the top and bottom graham cracker pieces, place the eyes, and feet. The end product was a success and Libby was very happy with her new stuffy. Lastly, finished up working on Christmas ornaments and other holiday crafts. Libby worked well and her attention and cooperation were outstanding. Continue after the break.

Libby was seen in her room for a 45-minute treatment session after two week winter break. Libby was happy and worked well during today's sessions. 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). Began today's session with warming up hands and increasing hand strength using "rapper snappers" which are tubes you pull to elongate and you can bend them and connect them to make a "o". Libby and the OT both made letters from these toys and we had to say which letter was made. Libby was able to identify and make several letters from both the upper and lower case alphabets. Continued therapy with review of the previously learned letters of the lowercase alphabet. Libby used a pencil to write each letter from the "Fall Down Climb Up" group individually on an index card. Then squeezed glue and sprinkled them with glitter to make glitter letters. She enjoy this multi-sensory activity and reviewed her lowercase letters with fair recall. OT also introduced and made the first three letters from the "Swing Around the Tree" group which were "c, o, a and d". When provided with min verbal and physical cues Libby was able to form the letters well today which included "r, n, m h, b, p, f, c ,o, a and d". Libby had a great first session back from break.

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). Began therapy with ocular motor visual scanning activity in "I Spy" book to work on ocular motor development. Continued with Christmas ornament activity in which she has to paint and decorate the ornament. She did a very good job and was very happy with how it turned out. Lastly worked on handwriting via Print Island. She has been instructed on the letters "r, n, h, p, and b". Today she was shown how to write the lowercase letter "f". Good session.

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). Began session with building hand strength with various exercises. Libby worked on ocular motor function by visual scanning to locate hidden items in an I Spy book. She enjoys this activity but requires moderate assistance to find 50% of the hidden things, minimal assistance for 25%, and can independently find 25%. Lastly reviewed previously learned letters from script island. She needed some assistance for recall of the lowercase letter "n" today. She is making steady gains in therapy.

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). Met with Libby's mom today, Amanda, during Thanksgiving celebration. Spoke in regards to her progress and developments at home. Mom informed OT that they will be moving to a new house after the holidays and that Libby is a little nervous about the move. Her mom seems happy with her steady progress this school year.

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.

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's art teacher, Ms. Anna was happy to report that Libby was asking her and letting her comb her hair in art class. Began today's session with upper case letter identification game. Able to recall and identify 95% of the upper case alphabet today. Libby is observed to continue to use a thumb wrap grasp pattern for coloring and writing unless she is prompted to use her twist and write pencil. This pencil helps her establish and maintain an open web space when writing. Instructed Libby on lowercase "h" today using Print Island handwriting program. She was taught using both auditory and visual cues. It was pointed out how this letter has the same movement as the previously learned lowercase letters in this group "r, n and m" with a fall down and climb up motion. It was further pointed out how this letter is different than the previously learned letter in this group because it is a tall "leaf" letter. Libby was able to form it correctly. Good session.

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 feeling "under the weather" during today's treatment session. Her nose was running and she had a slight cough. Today we started our session with a Halloween " I Spy" activity to work on visual perceptual skills (visual discrimination) and ocular motor skills (specifically tracking left to right). Libby needed assistance to find a few hidden objects and needed moderate-to- maximum verbal cueing to scan using a left to right top to bottom sequence. She would typically look from the right side of the paper to the left and start in bottom or middle. It is beneficial to teach a top to bottom and left to right sequence because these eye movements are needed for reading. Reviewed previously learned letters from "Print Island" today - r,n and m. Had her write each several times to instill a correct formation motor memory. She has a tendency to write her letter from the bottom up versus top down. Worked on writing numbers today as well. Gave her auditory cues for proper letter formations. For example, "across the sky and down from heaven this is how we make a seven", "down and around with a hat like this, number five you can not miss". Even though Libby was not feeling 100% she worked well during her treatment session today.

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.

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 continues to encourage Libby to wear a variety of clothes and hairstyles via a sticker chart. Libby was happy and focused today. We continue to work on letter identification of the uppercase alphabet which has almost been mastered. She got 24/26 letters correct. Today Libby was introduced to "Print Island" which is a handwriting program that teaches children manuscript writing in a fun and creative way. It involves coconuts (starting visual cue for each letter), palm trees (visual cues for sizing of letters, and stories (auditory cues for formation of letters). Libby was introduced to the basic components of the program and seemed to understand the concepts well. These concepts will continue to be reinforced as she goes through the program. She did a practice worksheet of the pencil movement of the first group of letters which has the auditory cue of "fall down climb up". Then she did a worksheet in the program for lowercase letter "r" which she formed and sized well with the visual and auditory cues provided. She is making steady gains and is a pleasure to have in therapy.