OCCUPATIONAL THERAPY

Treatment Session Plan

Client’s Name: XXX C. Supervising Therapist: Jessica Kahn MOTR/L

Student OT Practitioner(s): Meghan Berry
Date12/3/1 Time in/out: 12:15p- Units: Safety Issues/Precautions: n/a
7 1:15p pm 4
Clients Goals to Address in Session: (DDDM, Step 1-Identification of Participation Challenges
and Goals)
1 XXX will sit for an age appropriate fine motor game or task for 7-10 minutes with 2
verbal redirections allowed, ¾ trials.
2 XXX will demonstrate improved fine motor skills by demonstrating the following:
1. Consistent hand dominance 100% of the time, no prompts.
2. Using a tripod grasp to copy horizontal and vertical lines, and simple shapes, as well as
upper case letter of his name M, A, X, ¾ trials.
3. Cutting paper in half with age appropriate scissor grasp, 1-2 physical prompts 3/4 trials
3 XXX will tolerate tactile messy play for 5-10 minutes with no adverse reactions or need for
redirection, 3/4 trials

4 XXX will incorporate one new food into his diet every 1-2 weeks with no adverse reactions,
75% of the time, no prompts. XXX will I utilize a fork and spoon 95% of the time

5
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
X Core X Manipulation Temperatur Pressure X Engages/Approaches Others
Stability e
Endurance X Coordination Hearing Taste Concludes/Transitions/Takes turns
X Position/Alig Motor Vestibular Smell X Communicates (verbal/non-verbal)
ns Planning
Joint Mobility X Reaching/gr X Tactile Pain X Looks/Turns (Makes eye-contact)
asp
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Treatment Session Plan

Joint Stability Reflexes X Propriocepti Visual X Emotional Expression

ve
X Tone & Controlled Discriminati X Modulati X Physical behavior (regulates
Strength Movement on on movement, position, touch)

Other Other Other

Processing/Cognitive/Mental functions: Visual Perceptual/Visual Motor Skills
X Attends X Experience of self & Oculomotor Skills Object Perception
time
Memory X Emotional X Visual Attention X Eye-hand
regulation Coordination
Sequences Tasks Energy & drive Visual Discrimination Copying Shapes
X 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
Adjusts/Accommodate Navigates Visual Closure Sequential Memory
s Environment
X Initiates/Continues/Ter Orientation to self, Figure Ground X Visual Closure
minates other, time & place
Tasks/Activities
Other Other
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Treatment Session Plan

Intervention: (Briefly describe planned intervention; DDDM, Step 7,9-Design and Conduct
Intervention)
Brief Description of Intervention (DDDM, 7-Design Intervention) : See

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

-Proximal Outcomes: decrease level of assistance needed during age-appropriate activities, introduce new
foods, improve FM strength as well as attention to task
-Distal Outcomes: increase participation in age-appropriate FM and GM activities, increase sensory
modulation, and increase diet

Identify How you will Measure Outcomes and Collect data on Intervention Outcomes: Per Parent
Report, Observation, and
(DDDM, 10,11-Collect, Display, Analyze Data, Monitor Progress)

Spac Intervention Description & Approach: Type: Practice Goal(s)

e Time Establish/Rest Activity Model: PEO, addressed:
ore Sensory 1,2
Processing,
Biomechanic
al
Gros Warm up: (5 Minutes) Activity Demands (OTPF Anticipated Activity
s -Name of activity: Prone Scooter table 7) Outcome:
board, body bowling
Moto XXX will propel self on scooter board Required Actions and
r off of wall while in prone position into Performance Skills: Min A to complete course,
Roo Mod-XXX VP for attention to
bowling pins set up core strength (medial) to
-Ways to grade up: have the bowling task
m assist with fine motor skills
pins further away from the wall so he (distal)
has to push harder and further to
reach them
-Ways to grade down: therapist can
facilitate propulsion and assist to
reach target

Materials: scooter board, bowling

pins (or cups), wall
Kitche Activity 1: (15 Minutes) Approach: Type: Practice Goal(s)
n Establish/Rest Occupation Model: addressed
-Name of activity: Eat lunch using ore
age-appropriate feeding utensils
PEO, :
-Ways to grade up: use two utensils Sensory 4
at once, one to stabilize and one to Processin
cut g
-Ways to grade down: only use one Activity Demands (OTPF Anticipated Activity
utensil in easier textured food, spoon
in yogurt
table 7) Outcome:

Materials: lunch, feeding utensils

Required Actions and Mod-XXX VP to attend to task
Performance Skills – pacing, and complete meal in an
manipulating, gripping, appropriate time
calibrating
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Treatment Session Plan

Kitche Activity 2: (15 Minutes) Approach: Type: Practice Goal(s)

n Modify Activity Model: addressed
-Name of activity: Edible chocolate
puffy paint
PEO, :
Sensory 3, 4, 2
-Ways to grade up: using hands to processin
help create the mixture, and eating g,
some of it Biomecha
Grade down: using plastic bag to
squeeze paint out onto paper nical
Activity Demands (OTPF Anticipated Activity
Materials: flour, salt, water, cocoa table 7) Outcome:
powder Required Actions and Hand over hand to interact
Performance Skills (fine with the edible paint and eat
motor skills addressed in some
mixture and manipulation of Mod-XXX VP to engage in
paint) task
Gripping, manipulation,
aligns, initiates, attends,
continues, terminates
Sensory modulation – tactile
processing
Fine Activity 3 (if needed): (15 Minutes) Approach: Type: Practice Goal(s)
Motor Modify Activity/Occupa Model: addressed
Room -Name of activity: Cutting Activity Establish/Rest tion
with Letters of Name
PEO, :
ore
Have XXX cut out squares that Biomecha 1,2
contain letters of his name – and nical
then run to put them on the board in Activity Demands (OTPF Anticipated Activity
correct order table 7) Outcome:
-Ways to grade up: Use thicker paper
so harder to cut Required Actions and Mod-XXX A/VP for XXX to
-Ways to grade down: Have thicker Performance Skills – paces, complete this task
lines on thin paper so easier to cut
attends, manipulates,
Materials: paper with letters of sequences, stabilizes,
name, scissors, board with magnets continues, terminates
Gym Wrap up/Cool Down: (5 minutes) Approach: Type: Practice Goal(s)
Establish/Rest Activity Model: addressed
-Name of activity: Platform Swing ore
-Ways to grade up: n/a
PEO, :
-Ways to grade down: n/a Sensory All
Processin
Materials: Platform Swing g
Activity Demands (OTPF Anticipated Activity
table 7) Outcome:
End the session on a positive
Required Actions and note that provides XXX with
Performance Skills – calming/regulating sensory
regulation, notices/responds input

Home Program/Homework (DDDM, 11): Edible paint recipe given to mom

 OCCUPATIONAL THERAPY
Treatment Session Plan

Student Therapist Signature: Meghan Berry Date: 12/1/17

Supervising Therapist Signature: Date: