Goal:

Client will be able to use a consistent tripod pencil grasp while writing within 3
months of skilled OT.
Purpose:
This is an important skill for writing which is an essential part of education and IADL
occupations. Client currently switches his grasp frequently which affects the
legibility, quality, and efficiency of his writing and drawing.
Occupations:
IADLs
Communication Clients illegible writing will affect his ability to
communicate through written text.
Education
Formal education participation If Client cannot write legibly or had
and inefficient pencil grasp it will affect if participation in education.
Client Factors:
Values, Beliefs and Spirituality
Values Client does not currently value writing legibly, so his
motivation to do so is low.
Body Functions
Attention Client does not pay attention to where he is grabbing the
pencil
Performance Skills
Motor Skills
Grips Client has inconsistent grips while writing
Context and Environment
Contexts
Cultural This time next year Client will be expected to be able to write
legibly when he is in Kindergarten
Personal I does need to be taken into account Clients age (4) and the
level of writing that is expected.
Environments
Physical The height of table and chair that Client is using while
writing needs to be taken into account.
Social The presence of Clients friends who are playing are
contributing to Pauls inattention.
Materials needed:
Pencil

 Paper
Description of Treatment Session
All of the treatment plans focus on writing which falls under the occupation of
education. It will focus on fine motor skills, motor planning, grips, manipulation,
finger isolation, and finger strength, which are all essential parts of writing. I am
using Occupations and Activities while actually writing and prepatory methods for
the gel maze, sand letters/shapes, and playing with blocks. The intervention
approach is Prevention of Disability because if he continues with poor grips while
writing he will not be able to effectively write. The Primary Frame of Reference is
developmental.
Motor Skills 5 min Pushing a bead through a bag filled with soap through a maze.
Child will have 4 simple mazes to complete. It focuses on manipulation, finger
isolation, and finger strength because the child will need to use a finger to push the
bead through the maze accurately.
Motor Skills 5 min - Drawing shapes and letters in bag full of colored sand. Child will
have the letters of his name and 4 shapes to trace with a pencil (eraser end down).
This will work on motor planning, grips, and attention to how he is making the
shapes and letter and how he is holding the pencil.
Motor Skills 10 min - playing with blocks. Child will need to use fine motor skills,
motor planning, and attention in order to successfully stack the blocks.
Motor Skills 5 min Actually write. Child will have to write his name and if that is
easy I will have him write all the letters (or as many as he can). Child will need to
work on grips and attention while writing in order to be legible.
CPT Code: Therapeutic Activity 2 Units 97530
Megan Evans OTA/S