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. Began session with sensory activity on "Spooner" which provides vestibular input with rotary movement. He went "fishing" while on "Spooner" for sight words. Once he found a sight word he was asked to read it and put it in a sentence. He required assistance to read the words "little" and "funny" but was able to independently read many level 1 words (ex. I, it, in). Worked on cursive letter lowercase "x". He wrote sometimes "x" too wide. With cues and demo able to write well. Reviewed letters. He did well today.
Richard began the session completing two keyboarding lessons followed by visual closure and visual perceptual skill worksheets. He is demonstrating increased accuracy in these skills. OT noted an improvement in his ability to work through these activities even when it become challenging and errors were made. HE ended the session working on fine motor dexterity and strength. Minimal verbal cues required to correctly grasp the pencil when the pencil grip was not used. Presented Richard with a smaller pencil grip to try, however he continues to prefer The transition pencil grip.
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.
