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 today's treatment session with lamb/lion self regulation craft activity. Luke had to make both a lion and a lamb out of a paper towel cardboard roll (cut in 1/2). Luke did a great job with cutting during this task with no associated mouth movements observed. Lion/lamb activity was aimed at teaching self-regulation, self awareness and self regulation. This activity identifies the lion emotion as loud, fast, roaring, etc. and the lamb as representing quiet and soft emotions. Luke was able to name some emotions represented by each animal. We discussed times when it appropriate to feel like a lion and times when it appropriate to feel like a lamb. We will continue to work on identifying emotions and providing Luke with words to describe how he is feeling. Next we worked on graphomotor task and Luke with instructed on the lowercase letter "y" today in Print Island. He was able to write it well after being provided with visual demo and verbal cues. 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. Started session with 50 piece puzzle of Mexico, Central and South America. He was able to complete with moderate to maximum assistance but stayed engaged in task entire time. Reviewed letters in Print Island and where they are placed on the writing line. He required assistance with sizing and needed redirection to stay focused during this task. He required cues to hold paper not his head. Luke seemed tired today (day after Halloween).

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. During today's session Luke and OT went over concept of problem size and reaction size and ZOnes of Regulation. For the concept of problem size matching reaction size Luke was shown visual of what constitutes a small problem, medium problem and big problem. It was explained to him that a small problem should have a small reaction, a medium problem should have a medium reaction and large problem should have a large reaction. OT gave Luke various situations and asked if he thought this particular situation was a small problem, medium problem, or large problem. Luke did think some small problems were bigger than they should be and that his reaction to small problems was too big at times. He needs continued work on identifying problem size and reaction size. 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. Began treatment with a letter placement activity to where a letter is placed on the writing line. Luke has to write a previously learned letter and place it either in the leaves of a palm tree (if tall letter) in the trunk if the tree (if middle of the line letter) or in the roots (if the letter went under the writing line). Reviewed concepts from the Zones of Regulation and behaviors in each zone. Reviewed letter i and t and was instructed on lower case letter "j" which is a root letter. Luke wrote this letter well in the Print Island workbook. He is motivated to focus and work hard when rewarded with small lego stickers for letters written correctly. Lastly Luke participated in a cutting task. He continues to make progress with bilateral hand tasks and less associated mouth movements have been observed. Min. cues needed to manage saliva. Great 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. Began treatment with yellow putty pegs to work intrinsic muscles of the hands. Reviewed Zones of Regulation and feelings in each zone. Luke seems to grasp concepts of how you feel in each zone. Went over "figure eight" breathing and did a few times together. He seemed to understand breathing technique but may not be able to idenify when to use it effectively. Worked on Halloween following directions activity. Luke required directions repeated 3/4 times today when given a two-step direction. Lastly worked on forming letters and line placement of letters in print. Luke was able to write previously learned letters well and was instructed on the lowercase letter "i,t" in the "Fall Down, Jump Up" group today. Good session.

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. Began treatment with eye exercises - continue to work on saccades, pursuits, convergence and divergence exercises. Work on cursive handwriting and reviewed previously learned letters "i,u,w,t,p,j,s, and i". Was able to connect letters to write the word "pit" to work on letter connections. He was able to connect letters well but needed demo before he was able to write on his own. Good session.

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 coughing today and just got back from his visual processing evaluation. Worked outside with visual tracking and motor coordination tasks. Richard was able to keep a ball going back and forth for ping pong 17 times in a row. He was able to jump rope 7-8 times and threw and caught with two hands and was able to catch 3/5 times. Went to room and practiced letter "p " in cursive in "Script Island" book. We reviewed all of the previously learned letters in cursive. 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. During today's session Luke and the OT made a ZOR board - with four different sections with four different colors representing each zone. This board will be used as a visual to reenforce the concepts of ZOR. Continued session with two-handed beading activity. Luke continues to work at tasks that require refined hand skills, manipulation, dexterity and proximal stability in order to decrease associated movements and increase proximal control for distal success. Today we reviewed the "Swing Around the Tree" letters. Luke required verbal cues to make an "o" with a "c" first - which means making it in a counter clockwise direction. He has a previous motor memory pattern to make these letters in a clockwise direction (because you don't have to cross midline when writing them this way). Lastly he was instructed on the letters "l and t" from the new group "Fall Down, Jump Up". He wrote both these letters well. Productive session today.

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 tong activity in which Luke was required to use tongs to pick up small objects and cross midline to release objects into a container. Luke required assistance to hold the tongs with a three finger grasp pattern and to separate his ulnar from the radial side of his hand. Luke is showing improvements with managing associated movements and secretions when concentrating. Next we focused on one ZOR today. Luke wanted to learn more about the red zone. heightened state of alertness and intense emotions; not an optimal level for learning; out of control; feels mad/angry, terrified, yelling/hitting, elated, out of control. We talked about how everyone experiences all of the Zones at one time or another. Lastly we played a game with different pictures of characters from children's movies showing obvious emotions. Luke was asked to place each character in either the blue, green, yellow or red zone. He was able to do so with 100% accuracy. Good session today.

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 session with putty and peg activity to work on intrinsic strength in hands and provide deep proprioceptive input to hands. Continued with introducing Luke to the "Zones of Regulation" program (abbreviated ZOR) and its concepts. This is a program geared at helping children in the area of self-regulation. Self-regulation can also be called self-control, self management and impulse control. Self regulation is the "ideal" or best state of alertness of both the body and the emotions for the specific situation. The idea is to teach children the ability to identify which zone they are in and learn how to use strategies to change or stay in the Zone they are in. It will give Luke an increased vocabulary or emotional terms, help him read other people expressions, perspective about how others see and react to their behavior and insight into things that can trigger their behavior. It can also teach Luke how to use calming and alerting strategies and problem solving skills. We began today going over the four different ZOR which are the blue zone (tired, sad, bored), green zone (calm, organized and ready to learn), yellow zone (frustrated, silly, worried) and red zone (mad, angry, out of control). Luke participated in a cutting activity to do a cut and paste activity to go over the Zones. He needed cues to separate the radial side of his hand from the ulnar side of his hand. He did well and seemed to understand the initial concept of the ZOR.