OCCUPATIONAL THERAPY

Treatment Session Plan

Client’s Name: S Supervising Therapist: Carrie Saks, OTR/L

Student OT Practitioner(s): Linda Ng, OTS
Date: 11/28/18 Time in/out: Units: Safety Issues/Precautions:
Clients Goals to Address in Session: (DDDM, Step 1, 6, & 8 -Identification of Participation Challenges, Goals & Measures)
1 Emotional Regulation Proximal GAS Scale
Client, within 4 months, will demonstrate improved emotional regulation skills, as demonstrated by Measures (Distal)
identifying, choosing, and completing 3 movement tasks, calming tasks, or using other calming tools
when frustrated, anxious or upset with no more than 1 verbal prompts, in 4/5 trials (per parent report).
2 Attention Date: Date:
Client, within 4 months, will improve attention to non-preferred tasks and ability to sequence
and complete a multiple step task, by completing a 6+ step fine motor activity that is non-
preferred while remaining at the table top and following written directions for task, with no
more than 2 verbal prompts, in 4/5 trials.
3 Handwriting Date: Date:
Client, within 4 months, will improve his ability to use writing tools to produce legible writing
by copying 3 sentences from far sight distance of 4’ while maintaining 90% legibility, sizing of
letters of ½” size, 85% accuracy in line placement and spacing between letters and words, in
4/5 trials
4 Proprioceptive/Vestibular Date: Date:
Client, within 4 months, will improve his proprioceptive and vestibular processing skills by
completing an 8-step obstacle course, without LOB, tripping or falling more than 1x, and
without physical prompts or demonstration of tasks, in 4/5 trials.
Clients Occupations to be treated include: (Check all that apply; DDDM, Step 7-Design Intervention)
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 Skills Sensory Skills Social Skills
Core Stability Manipulation Temperature Pressure Engages/Approaches Others
Endurance X Coordination Hearing Taste Concludes/Transitions/Takes turns
Position/Aligns X Motor Planning Vestibular Smell X Communicates (verbal/non-verbal)
Joint Mobility Reaching/grasp X Tactile Pain Looks/Turns (Makes eye-contact)
Joint Stability Reflexes Proprioceptive Visual Emotional Expression
Tone & Strength Controlled Discrimination Modulation Physical behavior (regulates movement,
Movement position, touch)
Other Other Other
Processing/Cognitive/Mental functions: Visual Perceptual/Visual Motor Skills
X Attends Experience of self & time Oculomotor Skills Object Perception
Memory X Emotional regulation Visual Attention Eye-hand Coordination
Sequences Tasks Energy & drive Visual Discrimination Copying Shapes
Executive Functions Notices/responds to cues Visual Motor Speed Spatial Relations
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Treatment Session Plan

Chooses/Uses materials Pacing of activities X Visual Memory Form Constancy

Locates/Gathers materials Organizes Materials Depth Perception Visual Acuity
Adjusts/Accommodates Navigates Environment Visual Closure Sequential Memory
Initiates/Continues/Termina Orientation to self, other, Figure Ground Visual Closure
tes Tasks/Activities time & place
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): Client will begin session with motor activity, in which he finds activity cards
throughout the open area of the clinic to build better balance, coordination, and core strength. Client will then complete a memory game
with handwriting, in which he identifies matches of facedown cards, and writes down the word with a pencil on a paper at table top. Client
will then participate in a size of the problem activity and identify calming techniques that he can use. Lastly, Client will play a social game with
a peer to promote social skills and emotional regulation.

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

-Proximal Outcomes: balance, coordination, attend to multi-step task, emotionally regulate in non-preferred tasks
-Distal Outcomes: participate appropriately in games with peers, attend to class work, play on playground at school with min falls

Identify How you will Measure Outcomes and Collect data on Intervention Outcomes:
Monitor progress, perform occupations
Space Intervention Description & Time Approach: Type: Practice Model: Goal(s)
(OTPF Table 8) (OTPF Table 6) Motor addressed:
Establish/Restore Training acquisition (goal #) 4
Open Activity 1: (10 Minutes) Activity Demands (OTPF table 7) Anticipated Activity Outcome:
area Sequencing: steps to complete tasks Client will improve body regulation
-Name of activity: Stations with tasks (yoga Body functions/structures: mobility and attention to task, as
pose, jumping, ball toss, slide) and body parts needed to do tasks demonstrated by following the
-Ways to grade up: - client gets choice on next Performance skill: motor – align, sequence of tasks and completing
move – provide choices within each task stabilize, position, reach, grip, the activity
-Ways to grade down: - predetermined order – coordinate, moves; process – pace,
model tasks attend, sequences, terminates
gathers, organizes
Materials: yoga cards, ball, slide

Room Activity 2: (20 Minutes) Approach: Type: Practice Goal(s)

Establish/Restore Training Model: addressed:
-Name of activity: memory game handwriting Handwriting (goal #) 2, 3
with handwriting checklist acquisition
-Ways to grade up: - finding match, cannot use
visual reference Activity Demands (OTPF table 7) Anticipated Activity Outcome:
-Ways to grade down: - can look at word to Sequencing: steps to complete task Client will follow instructions, attend
copy – small room with few distractions Body functions/structures: mobility to, and finish handwriting task at an
and body parts needed to jump and acceptable level of accuracy
Materials: crossword puzzle, lined paper, pencil, move across environment
tape, handwriting checklist Performance skill: motor – align,
stabilize, position, reach, grip,
coordinate, moves; process – pace,
attend, sequences, terminates
gathers, organizes
Sensory Activity 3: (20 Minutes) Approach: Type: Practice Model: Goal(s)
room Establish/Restore Training Behavioral addressed:
-Name of activity: Size of the Problem and Acquisitional, (goal #) 1, 2, 4
strategies Sensory
-Ways to grade up: - jump on trampoline to Integration
place cards – have client come up with personal Activity Demands (OTPF table 7) Anticipated Activity Outcome:
situations Attention, looks, appropriate social Client will participate and accurately
-Ways to grade down: - move to quiet demeanor, regulates gauge the “size of the problem.”
treatment room if sensory room becomes Client will demonstrate ability to
distracting – model calming techniques complete and verbalized
understanding of calming strategies
Materials: color (zones) circles, situation cards
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Treatment Session Plan

with tape on the back, trampoline?

Sensory Wrap up/Cool Down: (10 minutes) Approach: Type: Practice Model: Goal(s)
room Establish/Restore Training Social addressed:
-Name of activity: Social skills game Participation (goal #) 1
-Ways to grade up: - add vestibular/balance
requirements – have client teach activity to Activity Demands (OTPF table 7) Anticipated Activity Outcome:
peer Performance skills: processing and Client will engage with peer in
-Ways to grade down: - give pillow engaging with environment appropriate way with minimal
squishes/pressure before – model activity Social demands: rules of the game, emotional outbursts
before client completes it turn taking, appropriate demeanor

Materials: social skills board game

Home Program/Homework (DDDM, 11): Give parents list of calming techniques Client has identified as helpful, review
them at home, and remind him to use it if he becomes dysregulated

Student Therapist Signature: Date:

Supervising Therapist Signature: Date: