OCCUPATIONAL THERAPY

Treatment Session Plan

Client’s Name: Patient Supervising Therapist: Kristine Barrios

Student OT Practitioner(s): Brady Donner
Date: Time Units: Safety Issues/Precautions: Peanut allergy
12/15/17 in/out:10:00/11:00 4
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 Engages/Approaches Others
Stability e
X Endurance X Coordination Hearing Taste X Concludes/Transitions/Takes turns
X Position/Alig X Motor X Vestibular Smell Communicates (verbal/non-verbal)
ns Planning
Joint Mobility Reaching/gr X Tactile Pain Looks/Turns (Makes eye-contact)
asp
Joint Stability Reflexes X Propriocepti Visual X Emotional Expression
ve
X Tone & X Controlled Discriminati 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 Experience of self & Oculomotor Skills X Object Perception
time
Memory X Emotional Visual Attention X Eye-hand
regulation Coordination
X Sequences Tasks Energy & drive Visual Discrimination Copying Shapes
X Executive Functions X Notices/responds to Visual Motor Speed X Spatial Relations
cues
X Chooses/Uses Pacing of activities Visual Memory Form Constancy
materials
 OCCUPATIONAL THERAPY
Treatment Session Plan

Locates/Gathers Organizes Materials Depth Perception X Visual Acuity

materials
Adjusts/Accommodate Navigates Visual Closure Sequential Memory
s Environment
X Initiates/Continues/Ter Orientation to self, Figure Ground Visual Closure
minates other, time & place
Tasks/Activities
Other Other
 OCCUPATIONAL THERAPY
Treatment Session Plan

Intervention: (Briefly describe planned intervention; DDDM, Step 7,9-Design and Conduct
Intervention)
Brief Description of Intervention (DDDM, 7-Design Intervention) : Utilizing training, preparatory tasks,
and activities/occupations to improve fine motor skills, emotional regulation, sensory processing,
and ADLs.

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

-Proximal Outcomes: increasing strength in upper extremities, increasing fine motor skills through cutting
activity and reduce anxiety tied to food through food and sensory play.
-Distal Outcomes: Independence in paper cutting, and eating 10 more foods.

Identify How you will Measure Outcomes and Collect data on Intervention Outcomes: How long he is
able to stay around unfamiliar or non-preferred foods and how well he can cut on a line.
(DDDM, 10,11-Collect, Display, Analyze Data, Monitor Progress)

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

e Time (OTPF Table 8) (OTPF Table 6) Model: addressed:
Maintain Preparatory Sensory (goal #) 3
task Integration
Gros Warm up: (5 Minutes) Activity Demands (OTPF Anticipated Activity
s -Name of activity: Coloring Activity table 7) Outcome:
Patient will color with 3 different Relevance: receive vestibular,
moto crayons before taking a sensory tactile, visual, and
Enhance occupational
r performance:
break on the swings. After his break, proprioceptive sensory input to By receiving his sensory
gym/ Patient will return to the activity one help prepare for intervention. input needs, Patient will
sens more time and color with an Space Demands: Space to enhance his therapy
ory additional 3 colors. swing. experience and participation.
-Ways to grade up: Patient will use Objects: Using the swing and/or
more crayons and focus on the bubble tube for sensory input. If the therapist helps the
activity for longer. Crayons and paper to color. child attain and maintain
-Ways to grade down: Patient will Required actions: pushing appropriate levels of
only use 2 colors. himself on the swing. alertness and affective state,
Body functions: gross motor then the child will be more
Materials: Therapy swing, crayons coordination & control, motor likely to sustain engagement
and a coloring sheet. planning, strength, endurance, in therapeutic activities
core stability, organizing
sensory systems, attention to
task, following directions.
Body structures: executive
functions & core, upper, and
lower extremity structures.
Timing and Sequencing:
coloring with 3 crayons before
he can swing.
Gros Activity 1: (15 Minutes) Approach: Type: Practice Goal(s)
s Establish Activity/Trainin Model: addressed
-Name of activity: Maze g
moto cutting/tearing
Motor :
r Patient will tear along a line in order control/ (goal #)4
gym to help him understand where to cut motor
when he uses the scissors. Then he learning
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Treatment Session Plan

will cut along a line to connect two Activity Demands (OTPF Anticipated Activity
cartoon characters. table 7) Outcome:
Improved occupational
-Ways to grade up: Patient will cut on Relevance: This activity performance in cutting with
a more difficult line. pertains directly to one of his scissors will be achieved by
-Ways to grade down: Patient will cut goals and skills for his learning and practicing the
a small slices around the outside of education. entire occupation.
the paper Objects: learning to use
scissors
Materials: Pictures to cut out, scissors Process Skills: grips paper and
scissors
Required body function: Joint
mobility in hand and cognition.
Required body structures:
hands, fingers, eyes.
Gros Activity 2: (If needed) (15 Minutes) Approach: Type: Practice Goal(s)
s Establish/Rest Activity Model: addressed
-Name of activity: Play dough sheets ore
moto The purpose of this activity is to
Motor :
r develop fine motor skills and help Control/ (goal #) 1,4
gym Patient get used to different tactile Motor
input to help him work on his feeding learning
goal. Activity Demands (OTPF Anticipated Activity
-Ways to grade up: using tools to
table 7) Outcome:
form play dough, use both hands to
form play dough-Ways to grade Relevance: fun activity
down: use one hand to form play to address fine motor Improved occupational
dough skills. performance in fine motor
tasks.
Social demands:
Materials: play dough, play dough following directions,
mats
interacting with
student therapist.
Body functions: fine
motor control &
manipulation,
finger/hand strength,
core stability, attention
to task, following
directions
Body structures: upper
extremity and core
structures, executive
functions
Gros Activity 3: (15 Minutes) Approach: Type: Practice Goal(s)
s Establish` Occupation/Acti Model: addressed
-Name of activity: Water beads, jello, vity
moto and whipped cream
Sensory :
r Integrati (goal #) 1
gym on
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Treatment Session Plan

Patient will play with water beads in Activity Demands (OTPF Anticipated Activity
a container with jello and whipped table 7) Outcome:
cream. Relevance: Activity designed to
-Ways to grade up: Patient will smell help Patient feel more
the mixture.
Improvement of
comfortable with food.
-Ways to grade down: Patient will just Space Demands: small surface
occupational
sit in the room with the food mixture to work on and place supplies performance of self-
and do a coloring activity. Social demands: follow feeding through sensory
directions and prompts from modulation
Materials: Jello, whipped cream, therapist.
water beads, Two bowls, pudding, Body functions: attention to
color crayons, and a coloring sheet. task, fine motor control &
manipulation, motor planning,
bilateral coordination,
emotional regulation, visual
perception, and postural control
Body structures: core, upper
extremity structures, and
executive functions

Gros Wrap up/Cool Down: (5 minutes) Approach: Type: Practice Goal(s)

s Maintain Occupations Model: addressed
-Name of activity: Go for a walk
moto Patient has a difficult time
Sensory :
r transitioning at the end of therapy. To Integrati (goal #) 3
gym ease the transition he will take a walk ons
in the hallways to allow the session Activity Demands (OTPF Anticipated Activity
to end seamlessly. table 7) Outcome:
-Ways to grade up: Patient will have a Relevance: receive vestibular,
sensory break instead of going for a tactile, visual, and Enhance occupational
walk. proprioceptive sensory input to performance:
-Ways to grade down: Patient will help prepare for intervention. By receiving his sensory
conclude therapy with a sensory Space Demands: Space to input needs, Patient will
break and then go for a walk with swing. Hallway to walk in. enhance his therapy
therapist and his mother and brother. Objects: Using the swing and/or experience and participation.
bubble tube for sensory input.
Materials: Sensory swing and bubble Required actions: pushing If the therapist helps the
tube himself on the swing. child attain and maintain
Body functions: gross motor appropriate levels of
coordination & control, motor alertness and affective state,
planning, strength, endurance, then the child will be more
core stability, organizing likely to sustain engagement
sensory systems, attention to in therapeutic activities.
task, following directions.
Body structures: executive
functions & core, upper, and
lower extremity structures.

Home Program/Homework (DDDM, 11):

Student Therapist Signature: Date: 12/15/2017

Supervising Therapist Signature: Date: