Richard presented with an increased arousal level today. We began the session with a movement break. He demonstrated improved coordinating during alternate arm/leg strides, jumping jacks and cross crawls 20 each. Richard also was able to sustain a plank for 4 minutes, showing an improvement full body strength. OT continued to help Richard with organizational skills by setting the timer for 2 minutes to help him clean and organize his belongings in his room before getting started with our activities today.
Worked on fine motor coordination and strengthening followed by pencil pushups to encourage thumb mobilization while writing. Moderate difficulty noted with this skill. Richard continues to utilize a thumb wrap grasp when he does not use a pencil grip.

Richard began the session working on organizational skills. With the timer set for 1 minute Richard raced the clock to clean up all trash and then an additional minute to organize his belongings. Verbal cues were needed to help him put items where they belong rather than push them under furniture. He worked on visual perceptual skills while completing 4 mazes with good accuracy, only drawing outside the line 2-3 times each maze, demonstrating improved fine motor dexterity and visual motor integration skills.

Today Richard finished the Beery visual motor integration assessment (visual perception and motor coordination subtests). OT will score the assessment and include results in Richard's end of the year progress note.

Today Richard completed the first part of the Beery visual motor integration assessment. Plan: complete two subtests next session. Scores will compared to his VMI scores from the end of last year and will be included in a progress note. He ended the session working on keyboarding skills, completing two lessons with good accuracy with increased time due to not wanting to make mistakes.

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. Upon arrival to pick Libby up she was independently brushing her hair in the art room. We began treatment in room with going over her last week's hair and clothes options. She didn't seem to have had practiced as much this week wearing different things or different styles of hair. Reviewed the first five letters of the uppercase alphabet that we we're learning and reinforcing from last week. We reviewed the letters A,B,C,D and E in a multi-sensory format. First we traced over our glitter letter index cards which had now dried from last week. OT had her say the letter, the letter sound and draw a little picture on the index card of a thing that started with the letter sound. Next, we made the letters out of sticks from Handwriting Without Tears Program. Libby was able to identify A,B,C, and E well but struggled with the uppercase letter D - wanting to call it B. We wrote each letter, using a coconut as a starting point and auditory cues for formations. She wrote them adequately with this type of assistance. Lastly, we worked on ocular motor skills with tracking and saccades activities. Libby did well trying to separate her head from eye movements. By the end of the session she was able to recognize D. Good work today and she is a pleasure to work with.

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. Began today's session going over her hair and dress from last week. She told OT that she wore a dress to church. She let the OT put her hair up during session for a star on her star chart. She is continuing to work on getting a prize. For today sessions, OT worked on only five letters of the uppercase alphabet to improve recognition and recall. Libby's session involved a multisensory approach to learn the letters "A,B,C,D and E". At the beginning of the session Libby accurately was able to identify B,C and E. She didn't know A and was confusing D with B. We made each letter on an index card, traced them with glue and sprinkled then with glitter. She enjoyed learning this way. Once dry she will be able to reinforce the movement pattern and identification of the letters by saying the letter name, sound while forming them with her finger. Lastly, worked on Libby's tracking by having her participate in game where she had to follow little object with her eyes without moving her head. Great participation and concentration during today's 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. To begin today's session OT quizzed Richard on identification of the cursive lowercase letters since he has almost learned them all except three. He was able to identify "i,u,w,s,p, e,l,h,b,c,o,a,d,q,g, n,m,and v". He needed cues or couldn't identify the cursive letters "y, f, j and k". Lastly, participated in a game of cross pattern UE movements to work on bilateral hemisphere communication in order to improve processing speed. Great 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. Started session with working on hand intrinsic muscle strength with putting together small interlock puzzle pieces. Continue with cursive review of the letters "n and m" from the "The Monkeys Go Mountain Climbing" in Script Island. Richard was able to recall and rewrite these two letters adequately. Continued with instruction on lowercase letter "v" in cursive today. This letter is a "high connector" just like lowercase "w". Richard seems to understand how to connect these type of letters but we will continue to go over this once he learns all the lower case letters. Richard demonstrated how he is doing with reading today. Also OT found Richard's pencil grip in his room and told him he has to go back to using it for writing. He complied and was using it during our session. 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 began session by tracing over the glitter letters he made yesterday in therapy. He was able to use the correct formation when tracing demonstrating that he has correct kinesthetic awareness for most of the lower case alphabet. Had Luke work on writing a short sentence with help. Continue to check in with our emotion worksheet to figure out how the day was going. He seemed to be well regulated. Lastly, went outside for movement break and participated in basketball before lunch. OT taught Luke how to do a lay-up. 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. Worked in his room on fine motor and graphomotor development today. Told Luke I needed his help to make index cards for a slightly younger student to help them with learning the line placement of the letters. Went through each letter of the lowercase alphabet and had Luke write each one concentrating on where the line is situated on line writing line. He was able to for about 70% with the appropriate line placement. Once he wrote all the letters in a grout (according to Print Island) then traced them with glue and sprinkled them with glitter. He enjoys this multi-sensory approach to learning. Well regulated today.