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 session with Ann Arbor tracking program. Richard had to find words of a sentence hidden within a scrambled paragraph of words. He scanned left to right and top to bottom (same visual skills used while reading). He was able to find 6 words in 41 seconds today and 5 words in 21 seconds. Using Script Island, Richard was instructed on the lowercase letter "s" in cursive today. This is the second session in which Richard was instructed on the lower letter "s". He seems to understand how this letter is formed now. Lastly played "Battle Dots" to work on quick visual localization and saccades. Great work.

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 visual exercises and had Richard work on switching from near point to far point vision to work on accommodation and recovery while patching right and left eye. Richard reported that it was easier to do with his left eye versus right (he is left eye dominant). During this activity there was a lot of stopping and starting again and some errors. Continued with Brock String to work on divergence and convergence - OT moved the red bead slowly while RIchard had to follow with his eyes and lastly we did bug on string activity -eye movements (convergence and divergence) were adequate with some jumping in place noted with "bug on string" task. Working on keyboarding via typing.com. He was able to use isolated finger movements to type 4 wpm- 6wpm with 96% accuracy in the beginner review section of this program. Lastly, Richard was instructed on the lowercase letter "s" in cursive via "Script Island". This letter was more difficult for him to learn but with visual cues and verbal cues he was able to form the "s". He will need more practice in this area of writing. He reviewed all previous letters learning in script and wrote them well today. Good session.

Richard began the session working on reflex integration activities with moderate right elbow bend during ATNR activities. He finished the home row keys on Typing.com program and started with pointer finger top row keys. He demonstrated good hand positioning and works hard at using the correct finger 80% of the time while typing. Richard ended the session working on handwriting in the cursive book. He continues to enjoy both of these activities, is hard working and is good at working through mistakes rather than giving up.

When OT arrived to Richard's session, he was quiet and appeared tired. He reported that he went home early Friday. He worked on visual perceptual skills while playing the Bugs card game. Richard only required 2 verbal cues for assistance throughout the entire game, demonstrating a significant improvement in visual perceptual, visual scanning and figure ground skills.

Richard demonstrated excellent participation throughout the session with movement breaks. He started with activities to work on integration of the ATRN reflex. Moderate right elbow bend was noted 75% of the time. With verbal cues Richard was able to maintain correct positioning 90% of the time. Richard also worked on eye/hand coordination, while drawing with bilateral hand drawings (fair accuracy) and lazy 8's with good accuracy. His tactile awareness of letter formation (back writing and guessing and drawing the letter) has significantly improved to 90% accuracy. He still needs to work on letters b and d.

Richard began his OT session with a fine motor strengthening activity, removing 20 items from green medium resistive theraputty followed by working on cursive handwriting book, lower case letter t, with excellent letter formation and good- line awareness. Consulted with Richard's other OT on visual motor and handwriting goals and progress.

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 requested to make a solar system with star beads, construction and glue OT brought into session. We drew all the planets and wrote the first letter for each planets on his creation. Luke required cueing today to use the correct amount of glue. He has a tendency to want to use too much glue both when using a glue stick or with liquid Elmer's glue. Continued with Print Island and Luke was instructed on lowercase letter "g" today. Lowercase letter "g" is a root letter and goes under the writing line. He was able to form and size this letter well when provided with visual boundaries and auditory cues. We reviewed all previously learned letters on the Magic Pad. Lastly, played sight word "Poof " card game which seated on the floor in his room. He is able to maintain an erect posture when seated criss cross with his legs on the floor without slouching or leaning for approximately five minutes. He is able to read about 50-60% of the sight words correctly without assistance.

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 resistive putty to warm up and strengthen hands. Participated in cutting activity in which he had to cut out several two inch by two inch squares for an uppercase and lowercase letter match activity. The matching aspect of the activity was too easy for Luke. Lastly reviewed all his previously learned letters on the Magic Pad with good letter formations observed.

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 reviewing previously learned letters from "Print Island" on the Magic Pad (light up pad you can write and draw on). Luke was able to write the letters "r,n,m,h,b,f and p" well. He also learned the "Swing Around the Tree" letters c and o and wrote them as well. Next, Luke participated in a Halloween cutting and coloring activity in which he had to cut out parts of Frankenstein, color and glue on the paper. He did a great job cutting with decreased associated mouth movements seen. Lastly instructed on lowercase letter "a" in Print Island book. Luke was able to write this well when provided with visual cue of coconut, visual boundary of trunk and auditory cues. He has been forming lower case "A" incorrectly so this will be a letter in which he will have to change his motor memory (with practice and repetition this will be able to be achieved). 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 putty and hidden object activity. Luke was able to find all the hidden objects well to warm up his hands for fine motor work. We worked on bilateral hand tasks today to sew felt Frankenstein craft. Sewing is a great fine motor bilateral hand task. Luke required minimum to moderate assistance with the sewing. He was able to glue on the eyes, nose, etc. adequately. Continued with Print Island work and Luke was instructed on the last letter in the first group of letters taught which was "f". This is a tall "leaf" letter. Luke was able to write and size this letter well and his recall for the previously learned letters is good when provided with minimum verbal prompting. Good session.