OCCUPATIONAL THERAPY

Treatment Session Plan

Client’s Name: Client Supervising Therapist: Heather Arias

Student OT Practitioner(s): Kellen Lewis
Date: Time in/out:12:30- Units: Safety Issues/Precautions:
10/4/2017 13:30 3
Clients Goals to Address in Session: (DDDM, Step 1, 6, & 8 -Identification of Participation
Challenges, Goals & Measures)
1 Within 6 months, Client will demonstrate Proximal Measures GAS Scale
increased attention and fine motor control to Grip (Distal)
independently write 22/26 capital letters utilizing Letter formation
a tripod grasp. Level of VP
2 Client will attend to/participate in a self-selected Date: Date:
activity for ten minutes, over five consecutive Time
data collection days, Sensory strategies
within six months. Level of VP
3 Within six months, Client will cut curved lines up Date: Date:
to 6-8” long, demonstrating improved improve Handling of scissors
bilateral hand-eye Handling of paper
coordination by correctly picking up scissors and Level of VP
cutting out the object within 1/4” of the line with
80% accuracy in 4 of 5
trials.
4 Within 4 months, Client will independently Date: Date:
complete novel 1-2 -part gross motor activities
geared toward bilateral
coordination and/or motor planning with 80%
accuracy in 4/5 consecutive trials to demonstrate
improved motor
planning, coordination and attention.
5 Within 6 months, Client will independently button Date: Date:
and unbutton 4 large buttons on clothing in 4/5 Manipulation
opportunities to Grip
improve self-dressing skills. Level of VP
Clients Occupations to be treated include: ( Check all that apply; DDDM, Step 7-Design
Intervention)
X ADL’s/Self Care: (bathing, showering, toileting & hygiene, swallowing/eating, feeding, Personal device
care & managing personal belongings, personal organization ,functional mobility, personal hygiene and
grooming)
X Instrumental ADLS & Graphic Communication: (Care of others, Care of pets, child rearing,
Communication management, driving & community mobility, financial management, health
management & maintenance, home establishment & management, meal prep & cleanup,
religious/spiritual activities & expression, safety & emergency maintenance/awareness, & shopping &
Handwriting, Keyboarding, Drawing, Coloring, Art, etc).
Rest & Sleep: (Rest, sleep preparation, sleep participation)
Work: (Employment interests & pursuits, Employment seeking & acquisition, job performance,
retirement preparation and adjustment, volunteer exploration & participation).
x Play & Social Participation: (Social Awareness, Building/Maintaining Relationships, Turn-taking,
imaginative play, sharing materials, exploring new play ideas/opportunities, play exploration, social
participation in community, family and with peers)
Leisure: (Leisure exploration & participation)
Client Factors & Performance Skills/Patterns addressed: (Write goal number(s) that
this skill will be addressed in; DDDM Step 7-Design Intervention)
Motor/Muscle/Movement Sensory Skills Social Skills
Skills
Core x Manipulatio Temperatur Pressure Engages/Approaches Others
 OCCUPATIONAL THERAPY
Treatment Session Plan

Stability n e
Endurance x Coordination Hearing Taste Concludes/Transitions/Takes turns
x Position/Alig Motor Vestibular Smell Communicates (verbal/non-verbal)
ns Planning
Joint Mobility Reaching/gr Tactile Pain Looks/Turns (Makes eye-contact)
asp
Joint Stability Reflexes x Propriocepti Visual Emotional Expression
ve
Tone & x Controlled Discriminati Modulati Physical behavior (regulates
Strength Movement on on movement, position, touch)

Other Other Other

Processing/Cognitive/Mental functions: Visual Perceptual/Visual Motor Skills
x Attends Experience of self & Oculomotor Skills Object Perception
time
Memory Emotional Visual Attention x Eye-hand
regulation Coordination
Sequences Tasks Energy & drive Visual Discrimination Copying Shapes
Executive Functions x Notices/responds to Visual Motor Speed Spatial Relations
cues
Chooses/Uses Pacing of activities
Visual Memory Form Constancy
materials
Locates/Gathers Organizes Materials Depth Perception Visual Acuity
materials
x Adjusts/Accommodate Navigates Visual Closure Sequential Memory
s Environment
Initiates/Continues/Ter Orientation to self, Figure Ground Visual Closure
minates other, time & place
Tasks/Activities
Intervention: (Briefly describe planned intervention; DDDM, Step 7,9-Design and Conduct
x Other: heeding Other
Intervention)
Brief Description of Intervention (DDDM, 7-Design Intervention) : We will have Client do activities
where he has to draw continuous lines on a chalk board, write letters, cutting and performing
gross motor activities in the context of imaginative play (Astronaut). Gross motor warm-up,
cool-down and breaks will be used. Cutting out a spaceship and writing letters found in the
moon sand.

Identify Desired Outcomes (DDDM, 8-Identify Outcomes):

-Proximal Outcomes: (e.g., range of motion, strength, balance, pencil grasp, attend to small task,
taste new food, write a new letter)
-Distal Outcomes: (e.g., dress UE independently, wears two new types of clothing, transfers from w/c
to bed with mod. I, writes all letter
of alphabet from memory; prepares a meal with min A; participates in circle time at school with min
A)

Identify How you will Measure Outcomes and Collect data on Intervention Outcomes: We will
measure the amount of time Client is able to stay on task, level of verbal prompts, level or assist, accuracy
paper cutting and letter formation.

Space
Intervention Description & Time
Approach:
Establish
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Treatment Session Plan

Type:
Occupational activity

Practice Model:
PEO, motor control/learning, sensory processing
Goal(s) addressed:
4, 5
Gross motor gym or front play area
Warm up: (5 Minutes)
-Name of activity: Astronaut Training. Client will use scooter, bridge, stone steps and push octagon pad to
help incorporate gross motor and proprioception input for focusing. Client will also put buttoned boy scout
shirt on
-Ways to grade up:
-Ways to grade down: Limit the amount of items that Client uses

Materials: stepping stones, bridge, scooter, buttoned vest

Activity Demands
-Relevant and important to client with goals of gross motor and dressing with buttoned
clothing.
-Objects used and their
properties: See materials
-Space demands: See space
-Social demands: Be an astronaut (imaginative play)
-Sequencing and timing: Complete
obstacle course in an appropriate
amount of time and in the
sequence identified by therapist.
-Required actions: Stabilization
-Required Body structures/functions: gross motor control
Anticipated Activity Outcome:
-Client will complete obstacle course to improve gross motor control and provide proprioceptive sensory
input. He will also perform dressing by buttoning up jacket.
Fine motor room
Activity 2: (_15__ Minutes)

-Name of activity: Digging in the moon sand. Using a small toy rake, Client will dig through the sand to look
of letters buried in the sand. Once he finds a letter, he will need to pick that letter up with modified
chopsticks. Once he has the letter, he will write the letter in rainbow paper. Those letters will be the code
to fix his spaceship.
-Ways to grade up: Have more letters Client has to use, have him pick them up one by one
-Ways to grade down: lower the number of letters used, pick up all the letters at once, use fingers instead
of chopsticks

Materials: Moon sand, toy rake, cut out letters, modified chopsticks, rainbow paper, wooden point to
scratch letters in paper.
Approach:
Establish

Type:
Occupation
Practice Model:
PEO, motor control/learning, sensory processing
Goal(s) addressed:
1, 2
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Treatment Session Plan

Activity Demands
-Relevant and important to client due to goals of fine motor and handwriting.
-Objects used and their
properties: See materials
-Space demands: See space
-Sequencing and timing: Use rake to remove sand, use chopsticks to pick up one letter at
a time. Write letter on rainbow paper.
-Required actions: motor planning, manipulates, grips, hand-eye coordination
-Required Body structures/functions: fine motor control
Anticipated Activity Outcome:
-Client will complete activity by using fine motor skills and attention to improve letter formation for writing.
Fine motor room
Activity 1: (_10__ Minutes)

-Name of activity: Cutting out objects of a space ship and gluing them on a popsicle stick.
-Ways to grade up: have Client cut out all pieces independently.
-Ways to grade down: Cut most of the shapes out or have them started. Paste the paper on the popsicle
sticks. Use of weighted blanket

Materials: Paper, scissors, glue sticks, popsicle sticks.

Approach:
Establish

Type:
occupation
Practice Model:
PEO, motor control/learning, sensory processing
Goal(s) addressed:
2, 3

Activity Demands
-Relevant and important to client to goal of paper cutting.
-Objects used and their
properties: See materials
-Space demands: See space
-Sequencing and timing: Cut out objects then glue on popsicle
-Required actions: Coordinates, manipulates, grips, handling
-Required Body structures/functions: fine motor control
Anticipated Activity Outcome:
-Client will complete activity by using bilateral coordination and hand-eye coordination to cut out objects,
thus improving fine motor skills. He will also use attention and heeding to complete task.
Front area or gross motor area
Wrap up/Cool Down: (5 minutes)

-Name of activity: Spaceship reconstruction. Using the octagon pad, exercise balls, and other equipment in
the gross motor gym, Client will build his spaceship again
-Ways to grade up: have Client gather the materials from the gross motor gym to the front room.
-Ways to grade down: give only 3 objects for him to build.
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Treatment Session Plan

Materials: Gross motor room equipment.

Approach:
Establish

Type:
occupation
Practice Model:
PEO, motor control/learning, sensory processing
Goal(s) addressed:
4

Activity Demands
-Relevant and important to client for gross motor goals.
-Objects used and their
properties: See materials
-Space demands: See space
-Sequencing and timing:
-Required Body structures/functions: Gross motor control
Anticipated Activity Outcome:
-Client will improve gross motor control and balance through spaceship construction

Home Program/Homework (DDDM, 11): Continue to have mom implement activities of

cutting and writing. Especially focus on hand-eye coordination and bilateral control by
maneuvering/stabilizing paper with opposite hand

Student Therapist Signature:

Date:
Supervising Therapist Signature:
Date: