OCCUPATIONAL THERAPY

Treatment Session Plan

Client’s Name: XXX Supervising Therapist: Kristine Barrios, MOT,

OTR/L
Student OT Practitioner(s): Kayla Jensen, OTS
Date: Time in/out: Units: Safety Issues/Precautions:
11/06/2017 4
Clients Goals to Address in Session: (DDDM, Step 1, 6, & 8 -Identification of Participation
Challenges, Goals & Measures)
1 Within 6 months, client will Proxmial Measures GAS
demonstrate increased self-regulation Date: 10/02/2017
Scale
and emotional regulation in order to (Prox,
Participation:
participate in classroom activities per 1) 3 verbal prompts Dist)
2) 10 minutes
parent and teacher report with no 3) 2 activities Date: 10/02/17
more than 2 verbal prompts for Regulation: (-1) Used 3
behavior and regulation in 4/5 trials. 1) 1 verbal prompt verbal prompts
2) 5 minutes to self-regulate
and participate
in task
2 Within 6 months, client will increase Date: Date:

his food repertoire by at least 15 new

foods through food play and oral
exploration with no more than 1 verbal
prompt in 4/5 trials in order to
increase participation in self-feeding

3 Within 6 months, client will Date: 10/02/17 Date: 10/02/17

independently use and access sensory Learn Sensory Strategies:

(-1) Took less
time to
strategies as trained to remain calm 1) Recall of 4 sensory regulation strategies
2) 30 seconds to remember information
remember
sensory tools.
and focused throughout his school day 3) Used 1 sensory strategy to self-regulate Had some
and eliminate episodes of anger and Episodes of Anger: N/A
difficulty with
remembering
rage with no more than 3 verbal specific tools.

prompts in 4/5 trials in order to

increase participation in all school
and home occupations.

4 Within 6 months, client will write with Date:10/02/17 Date: 10/02/17

90% accuracy for spacing, sizing, line Spacing (-2) Required

1) 1 inch moderate
adherence, and control in 4/5 trials in 2) 15 letters cueing to
analyze the
order to increase participation in Control letter spacing
school occupations. 1) thumb wrap grasp
2) 5 letters
and size. Large
spaces between
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Treatment Session Plan

3) 10 minutes letters.

5 Within 6 months, client will Date: 10/02/17 Date: 10/02/17

demonstrate increased sequencing Organization (-1) Required

1) 3/5 items mod. Cueing to
and organization skills in order to 2) 2 verbal prompts follow directions
(may be to
complete home management tasks Sequencing inattention).
with no more than 2 verbal prompts in 1) 2 directions at one time
2) 2 verbal prompts
Less verbal cues
required than
4/5 trials. typical.

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 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 X Motor Vestibular Smell X Communicates (verbal/non-verbal)
ns Planning
X Joint Mobility Reaching/gr X Tactile Pain Looks/Turns (Makes eye-contact)
asp
Joint Stability Reflexes Propriocepti Visual X Emotional Expression
ve
X Tone & X Controlled Discriminati X Modulati X Physical behavior (regulates
Strength Movement on on movement, position, touch)

Other Other Other

Processing/Cognitive/Mental functions:
X Attends Experience of self &
time
Memory X Emotional
regulation
X Sequences Tasks X Energy & drive
X Executive Functions X Notices/responds to
cues
Chooses/Uses X Pacing of activities
Visual Perceptual/Visual Motor Skills
Oculomotor Skills Object Perception
X Visual Attention X Eye-hand
Coordination
Visual Discrimination Copying Shapes
Visual Motor Speed Spatial Relations
Visual Memory Form Constancy
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Treatment Session Plan

materials
X Locates/Gathers X Organizes Materials Depth Perception Visual Acuity
materials
Adjusts/Accommodate Navigates Visual Closure Sequential Memory
s Environment
X Initiates/Continues/Ter X Orientation to self, Figure Ground 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): Client will participate in a gross motor
activity to receive proprioceptive input and heavy work to regulate sensory system and to increase attention to
later tasks. He will then complete a handwriting task with a fun element to encourage the client to engage in the
task, although not preferred. This task will also require the client to elicit creativity and allows for a less structured
component to his writing. Emphasis will be placed on line adherence, sizing, control, and spacing to ensure
accuracy and transfer to school work. Client will learn about oral desensitization exercises and tools to be used
before meal time, especially when eating non-preferred foods. Strategies are to be implemented to decrease
aversion, gaging response, and power struggle during meal time and increase client’s food repertoire. Client will
follow a recipe to make a sensory tool (peanut butter playdough) to receive tactile input and self-regulate and
engage in food play. At the end of the session, client will be given time to interact with sensory tool or play an
activity of choice for reward of participation and to regulate sensory systems for preparation to go home.

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

-Proximal Outcomes: participation, regulation, learn sensory strategies, encourage social engagement with
others, handwriting control, sequencing, following step by step directions
-Distal Outcomes: self-regulation, utilize sensory tools/strategies, complete home management tasks

Identify How you will Measure Outcomes and Collect data on Intervention Outcomes:
(DDDM, 10,11-Collect, Display, Analyze Data, Monitor Progress) Monitor progress on goals, observe interaction
and use of sensory tools, parent report, client report on use of sensory tools and strategies
Spac Intervention Description & Approach: Type: Practice Model: Goal(s)
(OTPF Table 8) (OTPF Table 6) (e.g.,MoHo, addresse
e Time Establish/Rest Occupation/Acti Acquisitional, d:
Cognitive Behavioral,
ore vity 1, 3, 5
OA, SI, NDT)
Preparatory Sensory
Processing/Integr
ation
Social
Participation
Gross Warm up: (10 Minutes) Activity Demands (OTPF Anticipated Activity
Motor table 7) Outcome:
Name of activity: FACES (Gross
Gym Motor Activity Card Game) Relevance: relevant to the
client’s goals to utilize sensory Implement sensory and heavy
Client and therapist will take turns strategies and heavy work to work activities to provide
choosing a card from a deck and allow for attention to various proprioceptive input to
each suit will represent a different tasks increase attention to less-
activity/movement. Ex: Spades – preferred tasks that require
push therapy ball, hearts – frog Objects: Deck of cards, chair, higher level skill.
jumps, clubs – wall push-ups, and table
diamonds – chair dips. The person
who draws the card will complete Space Demands: Gross motor
the activity that correlates with the gym; large enough for
suit and complete the number of table/chair, exercises on floor
reps stated on the card. Ace (1) – 10.
Social Demands: Engage in
game, ask questions and/or for
clarification, take turns
-Ways to grade up: Have the client
remember the suits/activities,
Sequencing/Timing: Time
provide a timer for the
number of reps
exercise/activity (1 min.), choose
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Treatment Session Plan

more than 1 card at a time

-Ways to grade down: provide a
visual reminder of suit and related
activity, have the client only perform
1 rep of the exercise
Actions/Performance Skills:
Sensory modulation,
proprioception, attention to
task, vestibular control, motor
planning, balance

Materials: Deck of cards, chair, Body Functions/Structures:

table joint mobility, UE/LE use, core
strength, muscle
power/endurance
Small Activity 1: (15 Minutes) Approach: Type: Practice Goal(s)
Room Establish/Rest Occupation/Acti Model: address
Name of activity: Roll – a – Story ore vity
Writing Activity (Thanksgiving)
Handwriting ed:
4
Client will be encouraged to write a Activity Demands (OTPF Anticipated Activity
creative story while engaging in a table 7) Outcome:
fun activity. He will roll a di and the
number the di lands on will correlate Relevance: relevant to the Client will participate in an
to a part of the story that he will client’s goals to improve activity that incorporates
write. Ex: roll 1 – character, roll 2 – handwriting accuracy with handwriting to practice
setting: time, roll 3 – setting: place, focus on line adherence, size, improving accuracy by utilizing
roll 4 – conflict/plot. He will need to control, and spacing to strategies as taught to engage
include additional words to connect participate in classroom in classroom tasks.
the individual parts and complete expectations.
the story. Writing strategies and
tools will be implemented to Objects: pencil, roll – a – story
increase accuracy with attention to worksheet, dice
line adherence, control, size, and
spacing. ** Attachment # 1 Space Demands: Small room;
few distractions
-Ways to grade up: Give the client
a set time to complete the writing Social Demands: Engage in
exercise, have the client write using activity, ask questions and/or
his best handwriting for clarification

-Ways to grade down: Allow the Sequencing/Timing: Time

client to write until he finishes, have number of reps
the client write as quickly as
possible with no attention to Actions/Performance Skills:
accuracy, provide a pencil grip attention to task, handwriting

Materials: pencil, roll – a – story Body Functions/Structures:

worksheet, dice joint mobility, UE use, core
strength, postural control, fine
motor, muscle
power/endurance (hand),
cognition, creativity
Small Activity 2: (15 Minutes) Approach: Type: Practice Goal(s)
Room Establish/Rest Occupation/Acti Model: address
Name of activity: Oral ore vity Sensory
Desensitization Strategies and
ed:
Preparatory Processing/Integr 2
Tools task ation

Oral motor exercises will be taught
to the client to be utilized before
eating non-preferred foods. The
client will practice some of these
skills during the session (massaging
mouth, rubbing gums, chewing gum,
blowing bubbles, blowing/sucking
through a straw, brushing tongue,
etc.). He will also be taught various
strategies that can be implemented
at home to encourage him to try
new foods (eating at least 5 bites of
every item on plate, having one item
that the client likes to eat on the
plate, not eating/drinking
beforehand).
-Ways to grade up: Have the client
try a food that he does not like,
increase time for oral sensory tool,
increase # of bites of each food item
-Ways to grade down: Try one
new oral sensory tool and focus on
that one for the week, decrease # of
bites of each food item
Materials: chewing gum, straw,
pomp om balls, bubbles, cup
Kitche Activity 3 (if needed): (10
n Minutes)
Name of activity: Peanut Butter
Playdough
OCCUPATIONAL THERAPY
Treatment Session Plan
Activity Demands (OTPF Anticipated Activity
table 7) Outcome:
Relevance: relevant to the
Encourage the Use of oral
client’s goals to increase food desensitization exercises
repertoire by trying new foods
before mealtime to lessen
with little oral aversion aversion to new foods and
increase food repertoire.
Objects: chewing gum, straw,
pomp om balls, bubbles, cup
Space Demands: Small room
Social Demands: Express how
various sensory tools/strategies
make him feel, Ask
questions/clarification
Sequencing/Timing: Pace
during use of tools, implement
appropriate # of reps for each
sensory strategy
Actions/Performance Skills:
Sensory modulation, motor
planning
Body Functions/Structures:
joint mobility, core strength,
muscle power/endurance,
respiratory function
Approach: Type: Practice Goal(s)
Establish/Rest Occupation/Acti Model: address
ore vity Sensory ed:
Processing/Integr
3, 5
ation

Client will follow directions to a
recipe for edible peanut butter
playdough. He will be encouraged to
gather all supplies, measure the
appropriate amount, and mix the
ingredients (preferably with his
hands to receive tactile input) to
regulate his sensory system.
**Attachment # 2 - Recipe
-Ways to grade up: Have the client
use his hands to mix the ingredients,
follow verbal instructions (given
once), estimate the appropriate
amount of ingredient without
measuring cups, client will gather all
necessary ingredients
-Ways to grade down: Client can
use spoon to mix ingredients,
provide written instructions, have
supplies out on table with exact
measurements ready to mix
Materials: Large bowl, spoon,
measuring cups, peanut butter,
powdered sugar, honey
Wrap up/Cool Down: (5 minutes)
Name of activity: Client will
choose preferred activity
(sensory tool, swinging,
OCCUPATIONAL THERAPY
Treatment Session Plan
Activity Demands (OTPF Anticipated Activity
table 7) Outcome:
Relevance: relevant to the
By implementing a sensory
client’s goals to utilize sensory activity and offering tactile
strategies and heavy work to
input as well as heavy work
increase self-regulation through mixing, client will learn
to regulate sensory system. He
Objects: Large bowl, spoon, will also be encouraged to use
measuring cups, peanut butter, similar strategies while at
powdered sugar, honey home and school that he finds
calming.
Space Demands: Kitchen
Social Demands: Ask
questions, express
emotions/feelings about tactile
input and sensory needs
Sequencing/Timing: Follow
directions to recipe in order
given
Actions/Performance Skills:
Sensory modulation, attention
to task, organizing, sequencing,
motor control, motor planning
Body Functions/Structures:
cognition, joint mobility, UE
use, core strength, muscle
power/endurance
Approach: Type: Practice Goal(s)
Establish/Rest Occupation/Acti Model: address
ore vity
Sensory ed:
Preparatory Processing/Integr 3
ation

vestibular/proprioceptive input)
Give 3-5 options to assist the client
in choosing an activity/tool of
interest dependent upon what is
available at that time. Discuss with
parent about session and upcoming
“homework” or activities to try at
home.
-Ways to grade up: Choose
activity for client
-Ways to grade down:
Materials: Self-selected
Home Program/Homework (DDDM, 11):
- Try oral desensitization exercises at home before at least one meal and compare the
outcome to other meal times to see if and what is most effective.
- Try to write a synopsis about daily events (journal) and encourage client to write in best
handwriting.
Student Therapist Signature:
Supervising Therapist Signature:
OCCUPATIONAL THERAPY
Treatment Session Plan
Activity Demands (OTPF
table 7)
Relevance: Encourage self-
regulation and confidence in
selecting activities of interest
Objects: Self-selected
Space Demands: Varies
Social Demands: expression
of what activity/tool he is
interested in
Sequencing/Timing:
Actions/Performance Skills:
Attention to task, sensory
processing
Body Functions/Structures:
Gross motor, fine motor
Anticipated Activity
Outcome:
Client will have the agency to
choose an activity or tool of
interest to interact with to
regulate his sensory system to
prepare for tasks that require
increased attention. By offering
time with object of interest,
client can provide himself the
necessary input his body
seeks.
Date:
11/01/2017
Date:
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Treatment Session Plan
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Treatment Session Plan

Attachment #1: Thanksgiving Roll – a – Story

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Treatment Session Plan

Attachment #2: Peanut Butter Playdough Recipe

Ingredients

 1 cup creamy peanut butter

 2 cups powdered sugar
 1/4 – 1/2 cup honey (just enough to make it stick together)