Cassie Beam

Intervention Plan 1 for Schools

Clients Initials and Age: C., age 8 Time allotted for session: 20-30 minutes Date implemented: 10/18
Diagnosis: Specific Learning Disability
Precautions: May need to explain activity in a different way, grading of activity can promote success
Goal/s being addressed: Letter formation, legibility of written work, legibility of signature
Activity Demands (setting, Results (link to activity
Specific Objectives for this Modifications (provided
Intervention Activities materials, and social objectives; include objective
activity during the activity and
(5) requirements) measures of performance
(5) planned for next session) (5)
(5) when possible) (5)
Results: Once the directions
What went well: Client
Wet, Dry, Try for cursive L Activity demands: While were given to client, client
Objectives: ability to follow reported having better
to A (~10 minutes): Using client is seated, place the was able to independently
directions, time spent doing understanding of going from
activity from Learning chalkboard on the table with remember and follow
activity, number of times l an l to an a. Client
Without Tears, practice l all the materials within reach directions and trace the
to a was traced reported that she liked the
to a connection in cursive of the client. Activity is taking letters 3 times with wet, dry,
activity and would like to do
by taking a small sponge place at size appropriate and try. Client used a tripod
Reason for activity: Client has this for other letters in her
(after wringing water out of table for client in OT room grasp with all 3 objects to
difficulty progressing from a name in future treatment
it) to trace the written letters without classroom trace letter formation
cursive l to a when sessions.
on a chalkboard, then distractions. without any verbal cues.
writing signature. Using a
crumple up a small piece of Client repeated activity 10
mass practice approach with What did not go well:
paper towel and dry the Materials: Learning Without times within 10 minutes.
3 different techniques on a Overall, the entire activity
letters, each time follow to Tears small chalkboard, tiny
chalkboard increases the went well, but I feel that I
the progression from l to sponge, small cup of water, Perceptions on performance:
establishment of motor could have explained how to
a. Then using a small piece paper towel, small pieces of Client demo ability to follow
memory and enforces use of transition into an a better
of chalk, trace the now dry chalk directions and remember the
tripod grasp with small using known language from
letters. Repeat as many times sequence of wet, dry, try
pieces of tracing materials. handwriting without tears.
as needed or until client feels Grade up: decrease the size without need for verbal cues.
The activity also requires
they have committed of traceable letters, add lines Client demo ability to
client to follow multiple What would you change: I
progression to motor on chalkboard that client continue use of tripod grasp
directions and enforces use would use a similar approach
memory for increased must stay on for various tools without
of problem solving skills to of this activity again, but start
legibility for cursive cueing. Client demo slower
remember which method of on the chalkboard to allow
signature. With each item, Grade down: do activity on a processing for cursive a to
tracing is next in the the client to use larger
have the client practice a larger chalk board, trace only remember to go up and
sequence. strokes and body movements
tripod grasp when tracing. the drawn letters follow pattern back down to
to cross midline and then
create a c then close off
Cassie Beam
Intervention Plan 1 for Schools
Write cursive name on big
paper (~10 minutes): Using
large pieces of construction
paper with pre-drawn
baselines across the paper,
have the client practice their
and bringing a tail back move to the smaller
down. chalkboard.
Did you change something:
This activity was pulled from
the Learning Without Tears
activities and was not
changed.
How can you better support
the clients performance or
get more effort and skill from
the client: Adding more
repetitions and more specific
letter formation and
progressions within the
clients full name would
increase the success of being
able to write her whole name
in cursive. It would also
increase the ability to
generate the motor planning
for specific letter formation.
Adding a similar activity to a
larger chalkboard or making
the traceable letters smaller
adds different components
to writing letter formation,
but still promotes success as
it is mass practice and is a
continued tracing activity.
Objectives: number of times Results: Client wrote first What went well: After
Activity demands: While
cursive name was written, name 2x on large paper practicing her name 12 times
client is seated, place all
number of times the letters without baseline with 17% with a baseline, client
materials within reach on the
went below given baseline, accuracy for letter alignment progressively improved
table. Activity is taking place
letter formation and sizing and sizing. With baselines legibility of signature and
at size appropriate table for
added, client performed letter sizing. Client also said
Cassie Beam
Intervention Plan 1 for Schools
first name in cursive using a
large marker to force use of
large movements for
increased motor planning.
Reason for activity: Client has
difficulty appropriately sizing
letters in cursive name and
using a consistent size among
all letters. Practicing on large
paper allows client to use
more movements in
completing task so that there
is increased self-awareness
of task and the movements
needed to complete a
signature. It also gives the
client to integrate the
connection between l and
a on a different surface,
but similar sizes to increase
use of generalization.
client in OT room without
classroom distractions.
Materials: 5-8 large pieces of
construction paper, large
markers
Grade up: draw smaller lines
that client must stay within
when writing name, use
smaller marker or pencil to
force dynamic tripod grip
Grade down: practice cursive
name on larger chalkboard,
make pre-drawn baselines
larger, provide additional
lines for visual cues for letter
sizing, provide model
activity 10x with 50%
accuracy for letter sizing and
alignment. Client used
dynamic tripod grasp for
entire activity. Client
practiced l to a had difficulty with no
progression in cursive 5x on
provided baseline for
increased processing of letter
formation.
Perceptions on performance:
Client demo increased ability
to use dynamic tripod grasp
without fatigue. Client demo
difficulty writing name
without baseline as guide.
Client also demo difficulty
sizing r relative to other
letters. Client demo slower
processing for cursive a to
remember to go up and
follow pattern back down to
create a c then close off
and bringing a tail back
down.
that she was proud of her
last one because it was the
most legible.
What did not go well: Client
baseline, but baselines were
quickly added to promote
success.
What would you change: I
would start out with
baselines predrawn. I would
also have the client write
their name large on a white
board, smart board or chalk
board to start the activity to
practice crossing midline and
use big movements for motor
planning.
Did you change something:
When originally starting the
activity, I did not give
baselines, but client demo
difficulty where to bring the
letter formation to. After two
tries without a baseline, I
added many baselines and
the legibility of the signature
increased.
How can you better support
the clients performance or
get more effort and skill from
the client: Adding more
repetitions of the l to a
Cassie Beam
Intervention Plan 1 for Schools
Objectives: number of times
name was written with
correct letter formation and
sizing, number of times name
exceeds lines, number of
verbal cues given to correct
letter sizing
Write cursive name on wide
ruled notebook paper (~5-10
Reason for activity: From an
minutes): Using wide ruled
educational standpoint, the
notebook paper, have client
client is going to be using
practice writing first and last
ruled notebook paper for
name in cursing with a
much of their schooling.
dynamic tripod grasp on a
Practicing cursive on wide
pencil to assess appropriate
ruled paper allows the client
letter sizing and spacing
to start being successful at
between letters.
this task and progressing to
college ruled if time is
allotted before dismissal. As
the client progresses through
life, the spacing for
signatures are going to
decrease, thus providing
progression would allow for
continued success. Also,
adding more letters to
practice would increase the
ability to commit certain
letter formation to motor
memory. Another way to
promote success would be to
have guide lines on the
chalkboard for the client to
visualize the letter size
throughout the mass practice
to allow for generalization to
occur on lined paper.
Activity demands: While What would you change:
client is seated, place all Rather than free handing the
materials within reach on the clients signature, I would
table. Activity is taking place have the client trace her full
at size appropriate table for name 3-5 times to get an
client in OT room without understanding of sizing on
classroom distractions. the paper.
Materials: pencils, wide ruled How can you better support
notebook paper the clients performance or
Client did not perform this
get more effort and skill from
activity due to time
Grade up: use college ruled the client: Rather than going
constraint and need to go
paper, decrease available size from large paper and large
back to class on time.
to write name, provide movements to smaller lines
distraction like in classroom and movements, use a
progressive approach and
Grade down: provide work gradually work down to
additional lines for visual wide or college ruled paper
cues for letter sizing, use with less visual and verbal
larger lined paper, provide cues for letter formation and
additional cues for letter sizing. With each type of
sizing, provide model, allow lined paper given, have the
client to trace and then copy client trace their full name in
Cassie Beam
Intervention Plan 1 for Schools

feedback from the size on cursive 2 or 3 times to

notebook paper could allow understand formation and
for generalization to occur. sizing then have the client
freehand their name.

S/OT name: Cassie Beam

Peer-reviewed Article:

Case-Smith, J. (2002). Effectiveness of school-based occupational therapy intervention on handwriting. American Journal of Occupational Therapy, 56(1), 17-25.

Abstract: OBJECTIVE: This study investigated the effects of school-based occupational therapy services on students' handwriting. METHOD: Students 7 to 10
years of age with poor handwriting legibility who received direct occupational therapy services (n = 29) were compared with students who did not receive
services (n = 9) on handwriting legibility and speed and associated performance components. Visual-motor, visual-perception, in-hand manipulation,
and handwriting legibility and speed were measured at the beginning and end of the academic year. The intervention group received a mean of 16.4 sessions
and 528 min of direct occupational therapy services during the school year. According to the therapists, visual-motor skills and handwriting practice were
emphasized most in intervention. RESULTS: Students in the intervention group showed significant increases in in-hand manipulation and position in space
scores. They also improved more in handwriting legibility scores than the students in the comparison group. Fifteen students in the intervention group
demonstrated greater than 90% legibility at the end of the school year. On average, legibility increased by 14.2% in the students who received services and by
5.8% in the students who did not receive services. Speed increased slightly more in the students who did not receive services. CONCLUSION: Students who
received occupational therapy services demonstrated improved letter legibility, but speed and numeral legibility did not demonstrate
positive intervention effects.

Justification: Overall, there have been many studies on different parts of handwriting, different programs, and with different age groups. Using occupational
therapy to address fine motor and visual motor deficits that are affecting handwriting have been successful, as shown by this article. When I first met this client,
her cursive writing was broken sometimes, such as letters were not connected as client would have difficulty moving along the progression of cursive. Client also
demo difficulty with letter sizing. Client would always capitalize the first letter, but the rest of the letters in her name would match that size, even if they were
lowercase cursive letters. According to the research, occupational therapy intervention for handwriting can increase legibility. Client demo difficulty writing slow
which increase the chances for ineligibility. With the research, OT interventions did not increase speed, but this is appropriate for this client as she has the
speed, but the letter formation and alignment is poor, especially with printed school work. Dr. Case-Smith spoke of what interventions were used within OT in
the schools: vibrating or resisted writing, writing on vertical sources, behavioral and motor learning techniques, frequent communication with teachers and staff
to increase carryover. Most of these interventions are appropriate for this client as she does have difficulty with visual-motor integration, but the primary
concern is letter formation. With continued practice in a variety of different mediums, the client can continue to gain legibility and improve processing skills
needed for handwriting. Dr. Case-Smith determined that occupational therapy services in the school can improve handwriting among 2nd, 3rd, and 4th graders as
those not getting serves did not have a change in legibility in their writing.

Total: 32 points