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. Upon arrival to Luke's room today he talked about some emotions he was feeling and wanted to address them with another student. OT and Luke went to other student's room and Luke proceeded to calmly tell the other student how he made him feel. The other student apologized and Luke was able to go back to his room and felt better. This is a step forward for Luke with dealing with is feelings and regulation in a more mature and calmer approach. Continued treatment in his room with an emotions activity in which he checked in on his emotions on a daily basis. OT showed Luke break cards based on which Zone he is in but he did not respond well to them. Lastly, we worked with small interlocking flat plastic blocks on refined hand skills. Luke was able to make letters and build out these blocks. Great work today.

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 treatment with resistive putty to find hidden objects for proprioceptive input and hand strength. OT realized that Libby is unable to consistently identify several letters of the lower and upper case alphabet at this time. It is in her best interest to first be able to recognize and name the letter before or in conjunction with learning how to form it. We continued with assessing which letters of the upper case alphabet Libby is able to identify. She was able to identify 12/24 letters today. She misidentified or was unable to name the following letters "A, D, E, G , H, J, K, M, N, P, S, U, V, W, AND Z. We will continue to work on letter recognition during OT sessions. Libby was able to tolerate wearing her hair up during OT session and was able to wear a dress during the previous week. Good 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. Richard was absent on Tuesday this week because he was experiencing some stomach issues (per Richard). He reported he felt better today but was not 100%. Today we began treatment working on manuscript handwriting with bright line paper. OT had Richard participate in an activity that is called "correct the sentence". He needed to look at a short sentence with a grammatical error (i.e. no punctuation, proper noun not capitalized, etc.) and rewrite with corrections. OT observed Richard using a thumb wrap grasp pattern with no web space. He reported he no longer wanted to use his grip. OT explained to Richard that when writing becomes longer in the future that his hand with be quick to fatigue with this grasp pattern. We will continue to try to figure out which grip will meet Richard's needs. Richard is unable to fix the grammatical errors of the sentence which were a capital to start the sentence and capitalizing a proper noun. Reviewed cursve letters "n" and "m" today. He was able to write the following words in script : am and man. 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. Upon arrival Luke was on a laptop in his room. OT played one game of Chess with Luke and had him transition off laptop by having him go outside for a heavy work activity to organize and regulate. He transitioned without complaint. During activity OT and Luke talked about emotions. We went over different situations and scenarios about people (familiar adults and children) and discussed different times certain people were in certain zones, why they were in this zone, and how he could tell they were in this zone. 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 ball hanging on string tracking/cognitive multi-task activity. Luke was able to alternate hands to push the ball back and forth with the OT while reciting the alphabet in sequence with good timing and accuracy and minimal mistakes with both the alphabet and alternating of hands. Continued with graphomotor work to refined handwriting. Luke needs to continue to practice and learn the size and line placement of the lower case alphabet. Steady progress seen.

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 our treatment session outside with basketball. We took turns and talked about different zones of regulation and what is expected and unexpected behavior. For example, pushing peers while playing basketball would be unexpected behavior. Continued to Luke's room to work on graphomotor development. Luke was able to write/copy from near point a sentence with accurate letter formations, size and line placement with some verbal prompts needed. He made a Pokemon book which he took home. Good session.

Richard presented with an increased arousal level today and more difficulty remaining on task. He began with room/material organization by setting the timer for 2 minutes for Richard to clean up trash and place items where they belong. Moderate verbal cues needed to stay on task and guidance of where to place certain items. Noticed improved fine motor dexterity during a shading task, however he continues to struggle with right to left shading, without moving his entire wrist or arm and thumb mobility, as he uses a thumb wrap over his writing utensil when a pencil grip is not used. He continued to work on keyboarding skills and visual perceptual skills while completing 2 mazes with good accuracy, only drawing outside the line 2 times each maze.

Richard participated in a whole school solar eclipse event with peers and teachers. Followed by playing a game with 3 other peers that worked on fine motor strength, eye hand coordination and visual perceptual skills with good participation and skills. Noticed an increase in Richard's overall confidence, peer social interaction, strength and gross motor coordination.

To work on executive functioning/organizational skills, we began the session with the timer set for 1 minute to place trash into the trash can and another minute to put all his belongings that were on the floor, where they belong. He was successful in this task with moderate verbal cues and stopping the timer twice when he became distracted. Before keyboarding Richard participated in finger exercises with good ability to copy OT. He worked on keyboarding skills with good attention to hand positioning with minimal verbal cues and good finger placement on keys. He continues to get scores of 70-90% accuracy with increased time.

Worked with Richard on executive functioning skills to help with management of school materials including organization of the items in his room at school. He was initially resistant but after explaining what other children do at different schools to keep their books, assignments, backpacks and writting utiencils organized, he was more willing to participate. The use of a timer and breaking down tasks to do one task at a time was helpful for Richard. At the end of the session OT spoke with two of Richard's other teachers about how we all can collaborate on helping him with this skill.