d3eizkexujvlb4.cloudfront.net · Web viewThe VMI examines a student’s visual motor integration...

Occupational Therapy EvaluationNAME: Student NameSCHOOL: School Name

Community Therapy ServicesTelehealth Occupational Therapy School-Based Evaluation

Student’s Name: Click or tap here to enter text.

Grade: Click or tap here to enter text.

DOB: Click or tap to enter a date.

Age: Click or tap here to enter text.

EVALUATOR’S NAME: Click or tap here to enter text.

POSITION: Occupational Therapist

Date of Evaluation: Click or tap to enter a date.

(Student Name) completed an occupational therapy evaluation using telehealth technology (specifically a videoconferencing platform) in order to determine if occupational therapy services are warranted to support the student’s special education programming. The remote testing environment appeared to be free of distractions and no significant technological problems were noted during administration.

AREAS OF ASSESSMENT:

☐ Fine Motor Skills ☐ Visual Motor Skills ☐ Visual Perceptual Skills

☐ Sensory Processing ☐ Executive Functioning ☐ Independent Living Skills

☐ Handwriting Skills ☐ Keyboarding Skills ☐ Mouse Skills

EVALUATION METHODS AND STRATEGIES:

☐ Observations ☐ Scientific, Research-Based Interventions ☐ Norm-Referenced Assessments

☐ Interview ☐ Curriculum Based Assessments ☐ Classroom Based Assessments

☐ Review of Records and Relevant Trend Data (School records, work samples, educational history)

SPECIFIC ASSESSMENT MEASURES:

Various sources of information were utilized to determine the impact of (Student Name)’s sensory processing, fine motor, visual motor, and visual perceptual skills on his/her ability to be successful in the educational environment. Information was obtained via the following methods:

Caregiver Interview/Input Therapist Observations

Created by Melanie Criss, OTD, OTR/LCopyright © 2020 TelehealthShare

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Beery-Buktenica Developmental Test of Visual Motor Integration, 6th Edition (VMI) Motor Free Visual Perception Test (MVPT-4) Test of Visual Perceptual Skills (TVPS-4) Print Tool Written productivity timed measurements and observations for handwriting and keyboarding Sensory Processing Measure 2 (SPM-2) Sensory Profile 2 Adolescent/Adult Sensory Profile Roll Evaluation of Activities of Life (REAL) Behavior Rating Inventory of Executive Function 2 (BRIEF-2)

INITIAL OBSERVATIONS:

Behaviors: Adequate rapport was established with the student via video and the student was cooperative and appropriately engaged in the instructed tasks throughout the evaluation. It can be presumed, based on these observations, that the student’s performance is likely an accurate reflection of his/her actual capabilities.

OR

Observation of the student’s participation and behaviors indicate that the student’s performance in this evaluation may not accurately reflect his/her full capabilities, and therefore, it may be difficult to accurately interpret standardized test results.

CAREGIVER FEEDBACK AND CONCERNS:Per caregiver report, (Student name) consistently has challenges in the following areas that may have an impact on educational performance:

Concern #1 Concern #2 Concern #3

MOTOR SKILLS:

Beery VMI, 6th Edition (Beery, 2010)

To assess visual motor skills, the Beery-Buktenica Developmental Test of Visual Motor Integration, 6th Edition (VMI) was administered. Average standard scores fall between 85-115 with the ranges of Very High (>145), High (130-144), Above Average (115-129), Average (85-114), Below Average (70-84), Low (55-69), Very Low (<55).

Test Raw Score Standard Score RangeBeery VMI (Overall) Choose an item.

Choose an item.Subtest:Visual Perception

Choose an item.

Choose an item.Subtest: Choose an item.





Motor CoordinationChoose an item.

NOTE TO THE THERAPIST (TO BE DELETED FROM REPORT): The scores above reflect the option described in the VMI manual to use standard deviations to describe average. In the VMI manual, it states the following:

“Average” can also be defined as one standard deviation above and below the mean, which would be standard scores of 85-115 and would include 68% of the age group. Accordingly, categories above and below this average can be defined by numbers of standard deviations, such as “Very High” defined as three standard deviations above the mean.

The chart in this template used above for the VMI scores is based on the standard deviation interpretation for performance levels. If you prefer to use the definition of average where average refers to 50% of the population, you would need to modify the report to indicate the following:

To assess visual motor skills, the Beery-Buktenica Developmental Test of Visual Motor Integration, 6th Edition (VMI) was administered. Average standard scores fall between 90-109 with the ranges of Very High (>129), High (120-129), Above Average (110-119), Average (90-109), Below Average (80-89), Low (70-79), Very Low (<70).

Test Raw Score Standard Score RangeBeery VMI (Overall) Choose an item.

Choose anitem.Subtest:

Visual Perception

Choose an item.

Choose anitem.Subtest:

Motor Coordination

Choose an item.

Choose an item.

The VMI examines a student’s visual motor integration skills by testing the student’s ability to imitate and copy various geometric shapes, which are sequenced to be progressively more challenging. (Student Name) scored in the (range description) range for the overall visual motor assessment. Below average scores indicate that students may struggle in the academic setting with eye-hand coordination tasks such as writing neatly and evenly, drawing geometric symbols and shapes, copying from a nearby or distant source, and creating art projects.

The subtests were administered to gather additional information to find out if he/she had any difficulties in the areas of visual perception or fine motor control.

On the Visual Perception subtest, the motor component is removed and the student is required to match two designs from choices of similar designs that get progressively more challenging. (Student Name) scored in the (range description) range on the visual perception subtest. Below average scores indicate that students may struggle in the academic setting with tasks such as discriminating between the size of letters and objects,





correcting errors in school work, and distinguishing similarities and differences in the formation of letters (which could lead to letter reversals as an example).

On the Motor subtest, the visual perceptual component is removed and the student is asked to follow a clear path in order to make various shapes without crossing the defined boundary. (Student Name) scored in the (range description) range on the motor subtest. Below average scores indicate that students may struggle in the academic setting with tasks that require precision and fine motor control such as handling a writing utensil with confidence and precision as well as writing in a small defined space.

VISUAL PERCEPTUAL SKILLS:

Visual perception is the ability to organize information our eyes receive and to, subsequently, interpret and make sense of that information. There are many different types of visual perceptual skills including visual discrimination (ability to notice differences between objects/forms and to identify if something does or does not belong), visual memory (ability to store visual details of what has been seen in short-term memory), visual spatial-relations (ability to orient body in space to perceive position of objects in relation to self or other objects), visual form constancy (ability to recognize forms, letters, or words regardless of their orientation), visual sequential memory (ability to recall a series or sequence of forms), visual figure-ground (ability to locate and identify shapes and objects embedded in a busy visual environment), and visual closure (ability to look at an incomplete shape, object or amount, and fill in the missing details in order to identify what it would be if it were complete).

MVPT-4 (2015)

To assess visual perceptual skills, the Motor-Free Visual Perception Test (4 th ed.) (MVPT-4) was administered using ATP approved digital plates during remote assessment. The MVPT-4 is an assessment of visual perceptual skills commonly used in everyday activities and includes evaluation of five types of visual-perceptual abilities including spatial relationships, visual discrimination, figure-ground, visual closure, and visual memory.

OR

To assess visual perceptual skills, the Motor-Free Visual Perception Test (4 th ed.) (MVPT-4) was administered using a non-standardized protocol during remote assessment (test plates were viewed by the student on video through a webcam where image quality and size could not be controlled); therefore, the results may not be valid and should be considered with caution. The MVPT-4 is an assessment of visual perceptual skills commonly used in everyday activities and includes evaluation of five types of visual-perceptual abilities including spatial relationships, visual discrimination, figure-ground, visual closure, and visual memory.

Test Raw Score Standard Score RangeMVPT-4 Choose an item.

TVPS-4 (2017)

To assess visual perceptual skills, the Test of Visual Perceptual Skills (4th ed.) (TVPS-4) was administered using ATP approved digital plates during remote assessment. The TVPS-4 is an assessment of visual perceptual skills





commonly used in everyday activities and includes evaluation of seven types of visual-perceptual abilities including visual discrimination, visual memory, spatial relationships, form constancy, sequential memory, visual figure-ground, and visual closure.

OR

To assess visual perceptual skills, the Test of Visual Perceptual Skills (4th ed.) (TVPS-4) was administered using a non-standardized protocol during remote assessment (test plates were viewed by the student on video through a webcam where image quality and size could not be controlled); therefore, the results may not be valid and should be considered with caution. The TVPS-4 is an assessment of visual perceptual skills commonly used in everyday activities and includes evaluation of seven types of visual-perceptual abilities including visual discrimination, visual memory, spatial relationships, form constancy, sequential memory, visual figure-ground, and visual closure.

Test Raw Score Scaled Score Standard Score RangeTVPS-4 Overall N/A N/A Choose an item.

Visual Discrimination Choose an item.Visual Memory Choose an item.

Spatial Relationships Choose an item.Form Constancy Choose an item.

Sequential Memory Choose an item.Figure-Ground Choose an item.Visual Closure Choose an item.

After gathering information from assessment, observations and caregiver report, it appears that (Student Name) may have some challenges with the following areas of visual perception:

Visual discrimination – ability to notice differences between objects/forms and to identify if something does or does not belong (Educational Relevance: Challenges in this area may lead to difficulties with matching/sorting objects, identifying/exchanging money, correcting errors in school work, distinguishing similarities and differences in the formation of letters [i.e., letter reversals])

Visual memory – ability to store visual details of what has been seen in short-term memory (Educational Relevance: Challenges in this area may lead to difficulties with producing figures from memory, mixing lower and uppercase letters, copying from a text or board [one letter at a time], replicating information on worksheets and tests, dialing a phone number, remembering sight words, remembering what was read, reproducing figures from memory)

Visual-spatial relations – ability to orient body in space to perceive position of objects in relation to self or other objects (Educational Relevance: Challenges in this area may lead to difficulties with letter and number reversals, confusion in sequencing letters in a word [e.g., was and saw], writing from left to right [trouble with left/right in general], using consistent sizing and spacing of letters, aligning numbers, writing on the line, adopting size for the space on a worksheet or form, understanding up/down, on top of, around, copying designs or reproducing shapes in relation to one another, misjudging moving body around a room and may bump into objects or people)…Possibly if student does poorly here, they may also have challenges with vestibular (balance and motion) sensory system.





Visual form constancy – ability to recognize forms, letters, or words regardless of their orientation (Educational Relevance: Challenges in this area may lead to difficulties with reading different styles of print font, style, or color, confusion between p, q, and g, b and d, transition to cursive, understanding volumetric concepts such as mass, amount, and quantity)

Visual sequential memory – ability to recall a series or sequence of forms (Educational Relevance: Challenges in this area may lead to difficulties with sequencing letters or numbers in word or math problems, remembering alphabet in sequence, copying from one place to another, remembering order of events after reading)

Visual figure-ground – ability to locate and identify shapes and objects embedded in a busy visual environment OR ability to attend to one activity without being distracted by other surrounding stimuli (Educational Relevance: Challenges in this area may lead to difficulties with completing visually cluttered worksheets, filtering out visual distractions like colorful bulletin board or movement in the room, sorting and organizing personal belongings [may appear disorganized or careless], over attending to details and missing the “big picture”, recognizing misformed letters and uneven spacing, finding hidden pictures, using visual search strategies, finding things in cluttered desk)

Visual closure – ability to look at an incomplete shape, object or amount, and fill in the missing details in order to identify what it would be if it were complete (Educational Relevance: Challenges in this area may lead to difficulties with completing worksheets or test forms that are poorly copied/scanned, completing art projects that require finishing partially drawn pictures, leaving out parts of words or entire words, identifying mistakes in written material, copying something if can’t see the complete presentation of what is to be copied)

Note: Information above was obtained from resource Visual Perception Related to School compiled by Deanna Iris Sava, MS, OTR/L

SENSORY PROCESSING:

Sensory processing is a normal brain function that takes place when sensations are received and organized in the brain so that the student can produce an appropriate response. Someone with sensory processing problems may not be able to organize sensory input and produce the best response for the task at hand (e.g., they may interpret a noise or touch that is not dangerous to be dangerous and respond inappropriately).

Sensory Processing Measure (Parham & Ecker, 2007)

The Sensory Processing Measure is a standardized evaluation tool for school-aged children that gather information from teachers/caregivers about a student’s sensory processing characteristics, social participation, and praxis in order to determine how they can affect the child’s classroom behavior and performance. Because most students in the virtual education setting complete classwork in the home environment, the Home Form was given to the caregiver to complete.

For this assessment measure, the standard score for each scale is assigned one of three ranges: Typical (typically functioning), Some Problems (mild to moderate problems or 1 Standard Deviation below the mean), or Definite Dysfunction (severe problems or 2 Standard Deviations below the mean). The higher the score the more likely the student has concerns in that area.





Score Area Description Score %

Interpretative Range

Social Participation Social Participation refers to how a student gets along with his/her peers and their ability to participate appropriately in classroom activities.

Choose an item.

Choose an item.Vision Vision category refers to visual processing challenges, such as being over or under responsive to visual input, unordinary seeking of visual input, and problems with perception and ocular motor function.

Choose an item.

Choose an item.Hearing Hearing category refers to auditory processing challenges of over or under responsiveness, seeking behavior, and perceptual difficulties.

Choose an item.

Choose an item.Touch Touch category refers to touch processing challenges such as tactile defensiveness, under responsiveness, and various tactile seeking behaviors.

Choose an item.

Choose an item.Body Awareness

Body Awareness refers to the proprioceptive system which is a child's ability to sense the position of space of muscles, joints, limbs, and other body parts without relying on vision. It is essential for coordinated movements like grasping a pencil.

Choose an item.

Choose an item.Balance and Motion

Balance and Motion refers to the vestibular system which is a child's ability to maintain balance and an upright posture by sensing where their body is in space in relation to gravity. Vestibular input is needed to execute and control coordinated body movements like running and jumping.

Choose an item.

Choose an item.Planning and Ideas

Planning and Ideas refers to praxis which is the ability to conceptualize, plan, and organize movements to complete unfamiliar motor tasks.

Choose an item.

Choose an item.Total Sensory Systems

Total Sensory Systems is a composite score from the five sensory scales (vision, hearing, touch, body awareness, and balance and motion) plus items for taste and smell processing.

Choose an item.

Choose an item.

While social participation is not a sensory system, it can be impacted by challenges with sensory processing. Difficulties in the area of social participation are evidenced by observations that (Student Name) (give specific examples from SPM).

Difficulties in the area of vision are not referring to visual acuity but are rather difficulties with visual processing as evidenced by observations that (Student Name) (give specific examples from SPM).

Difficulties in the area of sensory processing related to hearing are evidenced by observations that (Student





Name) (give specific examples from SPM).

Difficulties in the area of sensory processing related to touch are evidenced by observations that (Student Name) (give specific examples from SPM).

Difficulties in the area of body awareness (i.e., proprioceptive sensory system) are evidenced by observations that (Student Name) (give specific examples from SPM).

Difficulties in the area of sensory processing related to balance and motion (i.e., vestibular sensory system) are evidenced by observations that (Student Name) (give specific examples from SPM).

Difficulties in the area of planning and ideas (i.e., praxis) are evidenced by observations that (Student Name) (give specific examples from SPM). As described in the Sensory Processing Measure manual (Parham & Ecker, 2007), “praxis is not itself a sensory system, but rather it is a higher level cognitive function that depends on the integration of multiple sensory systems, particularly tactile perception and proprioception, in order to function efficiently.”

Sensory Profile -2 (Dunn, 2014)

The Sensory Profile 2 is a standardized evaluation tool for children that gathers information from teachers/caregivers about a student’s sensory and behavioral responses in order to determine how they can affect the child’s classroom behavior and performance.

Four quadrants are assessed including seeking, avoiding, sensitivity, and registration. Items assessing sensory processing in the areas of Auditory, Visual, Touch, Movement, Body Position, and Oral Sensory are distributed throughout the quadrants.

Sections

LESS THAN OTHERS

68% of population

MORE THAN OTHERS

Definite Difference

Probable Difference

Typical Performanc

e

Probable Difference

Definite DifferenceSensory Section

Auditory Processing

Visual Processing

Touch Processing

Movement Processing

Body Position Processing

Oral Sensory Processing

Behavioral Section





Conduct associated with sensory processing

Social Emotional responses associated with sensory processing

Attentional responses associated with sensory processing

Quadrant Section Summary Raw Score Percentile Range ClassificationSeeking/Seeker Choose an item.Choose an item.Avoiding/Avoider Choose an item.Choose an item.Sensitivity/Sensor Choose an item.Choose an item.Registration/Bystander Choose an item.Choose an item.Sensory & Behavioral Section Summary

Raw Score Percentile Range Classification

Sensory SectionAuditory Processing Choose an item.Choose an item.Visual Processing Choose an item.Choose an item.Touch Processing Choose an item.Choose an item.Movement Processing Choose an item.Choose an item.Body Position Processing Choose an item.Choose an item.Oral Sensory Processing Choose an item.Choose an item.Behavioral SectionConduct associated with sensory processing

Choose an item.

Choose an item.Social Emotional responses associated with sensory processing

Choose an item.

Choose an item.Attentional responses associated with sensory processing

Choose an item.

Choose an item.Seeking (“I like it – keep going”) reflects an individual’s preferences for pleasurablesensation. Avoiding (“Argh – I have to get away”) reflects an individual’s need to stay awayfrom certain sensory experiences. Individuals may find their environments to be too intense orvariable to support their sustained performance in activities of daily life. Sensitivity (“it bothers me”) is associated with an individual’s irritability to sensations. Individuals may attend to irrelevant stimuli to such an extent that it interferes with their focus on performing activities of interest. Registration (“what?”) can range from not noticing enough to noticing too much. Individuals may not be bothered by things that bother others, but they also may not respond when you call on them and have a harder time getting tasks completed in a timely manner.

Description of specific examples with which student struggles that attributed to challenges noted in the tables above include:

The Adolescent Sensory Profile (Dunn, 2006)





The Adolescent Sensory Profile was administered to determine whether aspects of sensory processing might be contributing to performance challenges in the school or home environment. The Adolescent Sensory Profile is a measure of an individual's responses to sensory events in daily life. The individual completes a Self Questionnaire assessing the frequency of responses to certain sensory processing and activity level events as described in 60 items. According to research, the Adolescent Sensory Profile can help identify an individual's sensory processing patterns; the results can then be used to consider how these patterns might be contributing to or creating barriers to performance in daily life.

The results are categorized into 4 Quadrants: Sensation Seeking, Low registration, Sensory Sensitivity, and Sensation Avoiding.

Quadrant Raw Score Cut Score Range Cut Score ClassificationLow RegistrationSensation SeekingSensation SensitivitySensation Avoiding

Sensation Seeking (“I like it – keep going”) reflects an individual’s preferences for pleasurablesensation. Sensation Avoiding (“Argh – I have to get away”) reflects an individual’s need to stay awayfrom certain sensory experiences. Individuals may find their environments to be too intense orvariable to support their sustained performance in activities of daily life. Sensation Sensitivity (“it bothers me”) is associated with an individual’s irritability to sensations. Individuals may attend to irrelevant stimuli to such an extent that it interferes with their focus on performing activities of interest. Low Registration (“what?”) refers to a pattern of sensory responses where an individual does not notice or detect changes in sensory situations at the same rate of others. Individuals may not be bothered by things that bother others, but they also may not respond when you call on them and have a harder time getting tasks completed in a timely manner.

Description of specific examples with which student struggles that attributed to challenges noted in the tables above include:

INDEPENDENT LIVING SKILLS:

REAL (The Roll Evaluation of Activities of Life) Rating Form

The Roll Evaluation of Activities of Life (REAL) was administered to determine success with Activities of Daily living compared to same aged peers. The REAL is a standardized rating scale that includes the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) most common among children ages 2 years to 18 years of age. Activities of Daily Living include basic life skills such as dressing, hygiene/grooming, feeding, toileting, and functional mobility; whereas, Instrumental Activities of Daily Living are more complex skills that are needed to navigate successfully in the community such as financial management, community mobility, health management, shopping, meal preparation and clean-up, and communication management. On the REAL, caregivers rate their child’s demonstration of various skills and the evaluation results in an ADL score and an IADL score.





Score Area Raw Score Total Possible

Score

Standard Score

ADLs IADLs

Areas of strength [ranked with 75% or greater success] for (Student Name) as described on the REAL for Activities of Daily Living (ADLs) are:

Dressing (putting on clothes, choosing clothing appropriate for time of day/season, adjusting clothing appropriately, obtaining clothing from storage area)

Hygiene (washing hands and face, gets in/out of bath/shower safely, washes body well, brushing hair, brushing/flossing teeth well, clipping nails, applying deodorant)

Feeding (eats various textures, uses utensils, pours liquids from pitcher to cup) Toileting (using the bathroom, toilet hygiene, toileting sequence of toileting/flushing/hand washing) Functional mobility (gets in/out of vehicles safely, manages safety belt use, obtains all items for

play/leisure, gets on/off furniture/chairs, accesses cooking appliances, obtains meal preparation items and foot items)

Below is a list of specific activities of daily living tasks (ADLs) from the REAL assessment that (Student Name) was reported to have consistent difficulty with at this time (reported either unable or seldom completes) that will be important skills to develop for independence in the community:

Dressing (putting on clothes, choosing clothing appropriate for time of day/season, adjusting clothing appropriately, obtaining clothing from storage area)

Hygiene (washing hands and face, gets in/out of bath/shower safely, washes body well, brushing hair, brushing/flossing teeth well, clipping nails, applying deodorant)

Feeding (eats various textures, uses utensils, pours liquids from pitcher to cup) Toileting (using the bathroom, toilet hygiene, toileting sequence of toileting/flushing/hand washing) Functional mobility (gets in/out of vehicles safely, manages safety belt use, obtains all items for

play/leisure, gets on/off furniture/chairs, accesses cooking appliances, obtains meal preparation items and foot items)

Areas of strength [ranked with 75% or greater success] for (Student Name) as described on the REAL for Instrumental Activities of Daily Living (IADLs) are:

Housework/Chores (picking up belongings, following written list of chores, identifying chores that need to be done and completing them independently, washing dishes, doing laundry)

Managing Money and Shopping (making a shopping list and purchasing correct items, depositing and withdrawing money from a bank account with assistance, managing money independently)

Meal Preparation (planning and preparing a full meal for himself or others, using kitchen knives safely) Personal Safety (notifying adult when injured or hurt, dialing 911 in case of emergency, following

stranger safety rules, following fire safety rules, knowing the difference between putting out paper and grease fire, cleaning up broken glass safely, knowing natural disaster plan for the geographic area)

Travelling (following verbal or written directions to a nearby location, using key to unlock doors, using community transportation)





School-Related Skills (bringing necessary materials or supplies to complete schoolwork, assignments, or projects, completing homework on time, using an organization system to keep track of assignments, tests, and projects)

Below is a list of specific instrumental activities of daily living tasks (IADLs) from the REAL assessment that (Student Name) was reported to have consistent difficulty with at this time (reported either unable or seldom completes) that will be important skills to develop for independence in the community:

Housework/Chores (picking up belongings, following written list of chores, identifying chores that need to be done and completing them independently, washing dishes, doing laundry)

Managing Money and Shopping (making a shopping list and purchasing correct items, depositing and withdrawing money from a bank account with assistance, managing money independently)

Meal Preparation (planning and preparing a full meal for himself or others, using kitchen knives safely) Personal Safety (notifying adult when injured or hurt, dialing 911 in case of emergency, following

stranger safety rules, following fire safety rules, knowing the difference between putting out paper and grease fire, cleaning up broken glass safely, knowing natural disaster plan for the geographic area)

Travelling (following verbal or written directions to a nearby location, using key to unlock doors, using community transportation)

School-Related Skills (bringing necessary materials or supplies to complete school work, assignments, or projects, completing homework on time, using an organization system to keep track of assignments, tests, and projects)

FUNCTIONAL FINE MOTOR OBSERVATIONS:

(Student Name) demonstrates good in-hand manipulation skills as evidenced by the following observations:

Success with/difficulty with moving small objects from finger to the palm given one object at a time [Typically mastered by 2 years old]

Success with/difficulty with moving small objects from finger to palm given multiple objects in the hand at one time [Typically mastered before 4 years old]

Success with/difficulty with moving small objects from palm to fingertips given one object at a time [Typically mastered before 3 years old]

Success with/difficulty with moving small objects from palm to fingertips given multiple objects in the hand at one time [Typically mastered before 6 years old]

Success with/difficulty with using simple rotation to complete a task such as flipping a penny over with the fingertips [Typically mastered before 3 years old]

Success with/difficulty with using complex rotation with the non-dominant hand to rotate objects between the fingers to complete a task such as flipping a pencil from the tip to the erase end and all the way back around [Typically mastered before 7 years old]

Success with/difficulty with shifting the index finger and thumb together (back and forth) with the dominant hand to complete tasks such as moving the fingers with one hand from the pencil tip back to the eraser [Typically mastered before 5 years old]

(Student Name) demonstrates good finger isolation skills as evidenced by the following observations:





Success with/difficulty with isolating fingers to imitate basic finger movements made by the evaluator for simple patterns such as pointing and thumb/finger opposition

Success with/difficulty with isolating fingers to imitate more complex finger movements made by the evaluator for patterns such as the I love you sign and the #3 in sign language

Success with/difficulty with isolating fingers to imitate finger movements without relying on viewing the hands to ensure completed correctly

Success with/difficulty with separating the two sides of the hands (thumb/index/middle finger and ring/pinky finger sides) to complete tasks such as stabilizing small objects with ring/pinky finger while using the thumb/index/middle finger or moving the thumb/index/middle fingers into extension while curling the ring finger/pink into flexion into the palm

HANDWRITING OBSERVATIONS:

Student name uses a right/left handed Choose an item. grasp when using a writing utensil for drawing and writing.

Grasp (Reference: Fine Motor Olympics, 2016)

CHOOSE ONE picture above and one description below:

Radial Cross Palmar/Shovel: Pencil held in a fist with the thumb towards the ground; uses whole arm movements to write; often observed around 3 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Palmar Supinate/Dagger: Pencil held in a fist with thumb towards ceiling; uses whole arm movements to write; often observed around 3 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Digital Pronation: Pencil held in the palm with the index finger extended downward along the pencil shaft; uses whole arm movements to write; often observed around 3 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Brush/3-Jaw Chuck: Pencil held with the fingers but the eraser end of the pencil is touching the inside of the palm and the hand is turned in a downward position similar to how you would paint with a brush; uses whole arm movements to write; often observed around 3 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.





Grasp with Extended Fingers: Pencil held with extended fingers; wrist is straight; hand is turned downward; forearm does most of the movement during writing; often observed around 3 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Cross Thumb: Pencil held with fingers loosely into the palm to make a fist; rests pencil between the inside of the index finger and the thumb that is crossed over/wrapped around the pencil; wrist and fingers do the movements; forearm positioned on table; often observed around 4 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Four Finger: Pencil held with four fingers opposing thumb; uses wrist and finger movements to write; forearm positioned on table; often observed around 4 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Static Quadripod: Pencil held by resting on the inside of the tip of the ring finger; held by thumb, index, and middle fingers pinching the pencil; circular shape formed by the index finger and thumb; hand moves as a unit (as opposed to the fingers making most of movement as you would see with a dynamic quadripod); often observed around 4 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Static Tripod: Pencil held by resting on the inside of the tip of the middle finger; held by thumb and index fingers pinching the pencil; circular shape formed by the index finger and thumb; hand moves as a unit (as opposed to the fingers making most of movement as you would see with a dynamic tripod); often observed around 4 years of age. Dynamic tripod and lateral tripod grasps are typically considered common and desirable writing grasps and are typically observed by the age of 5 years old in 75% of the population.

Lateral Tripod: Pencil held between the thumb and index finger (under the tip of the index finger with the thumb wrapping around and crossing the side border of the index finger for stabilization); wrist slightly bent up; ring and little fingers bent into palm; fingers do the movement during writing; Developmentally, this grasp (or the dynamic tripod grasp) is typically observed by 5 years of age in 75% of the population.

Dynamic Quadripod: Pencil held by resting on the inside of the tip of the ring finger; held by thumb, index, and middle fingers pinching the pencil; circular shape formed by the index finger





and thumb; forearm rests on the table; fingers do the movement when writing. Developmentally, this grasp is often observed around 5 years of age.

Dynamic Tripod: Pencil held by resting on the inside of the tip of the middle finger; held by thumb and index fingers pinching the pencil; circular shape formed by the index finger and thumb; forearm rests on the table; fingers do the movement when writing. Developmentally, this grasp (or a lateral tripod grasp) is typically observed by 5 years of age in 75% of the population.

Other: (Describe):

Sample observation paragraph:

(Student Name) used a right-handed dynamic tripod grasp. He/She was observed to stabilize the paper with the non-dominant hand, used correct paper placement for (RIGHT or LEFT from checkbox earlier)-handedness, rested his/her pencil hand on the paper when writing, and used an adequate pressure on the paper when writing. (Student name) showed some errors with memory for letter formation with 58% accuracy (15/26 letters correct) and had some errors in orientation with 74% accuracy (reversed b, d). Additionally, (Student name) used good alignment when writing with 90% accuracy, had poor spacing between words with 20% accuracy (2/10 correct), good spacing between letters within a word with 94% accuracy, and some errors with fine motor letter control (extra lines, gaps that should be closed) with 75% accuracy. When looking at letter size, (Student name) had poor size differentiation of letters where tall letters and short letters were not distinguishably different and wrote large letters that crossed multiple lines on paper (crossed up to 4 lines on wide ruled paper).

If you choose to actually use The Print Tool:

The Print Tool

The Print Tool™ is used to evaluate printing skills. It scores various skill components for capitals,lowercase letters and numbers.

Memory Orientation

Placement Size Start Sequence Control Letter Spacing

Word Spacing

CapitalLowercaseNumber

Capitals Total

Lowercase Total

Numbers Total

Capital + + = Overall Total CorrectLowercase + + = Overall Total Attempted





Number + + =Overall Score (Overall Total Correct / Overall Total Attempted)

CHOOSE APPROPRIATE OPTION BELOW:

Students by the age of six (6) should meet the following suggested targets for these areas according to the Handwriting Without Tears Print Tool Assessment: Memory – 85%, Orientation – 85%, Letter placement on the line – 80%, Size – 70%, Start – 85%, Sequence – 80%, Fine Motor Letter Control – 75%, Spacing between lowercase letters - 80%, and Spacing between words – 80%.

Students by the age of seven (7) should meet the following suggested targets for these areas according to the Handwriting Without Tears Print Tool Assessment: Memory – 90%, Orientation – 90%, Letter placement on the line – 85%, Size – 75%, Start – 90%, Sequence – 85%, Fine Motor Letter Control – 80%, Spacing between lowercase letters - 90%, and Spacing between words – 90%.

Students age of eight (8) and older should meet the following suggested targets for these areas according to the Handwriting Without Tears Print Tool Assessment: Memory – 100%, Orientation – 100%, Letter placement on the line – 95%, Size – 85%, Start – 95%, Sequence – 95%, Fine Motor Letter Control – 95%, Spacing between lowercase letters - 100%, and Spacing between words – 100%.

Writing Skill Areas which are indicated to be below age level expectations include: ability to stabilize the paper with non-dominant hand, pressure on paper, memory recall for letters, orientation, alignment, spacing, fine motor letter control, letter size, and legibility.

If you chose to use observations of written productivity as part of your handwriting observations:

Written Productivity

Gathering data on handwriting and keyboarding is useful when making decisions about a student’s written productivity. To gather data, students complete similar tasks using handwriting and keyboarding. It is important to determine which form of written communication would enhance a student’s ability to compose his/her ideas to the greatest potential. A comparison of handwriting and keyboarding speeds can assist in making an informed decision as to whether using technology as an alternative writing medium will be beneficial for a student who may struggle with the task of handwriting.

(Student Name)’s handwriting speeds were compared to his/her keyboarding speeds and it was noted that he/she has the ability to handwrite sentences from a model at 2 words per minute and type sentences from a model at a speed of 1.5 words per minute. When examining keyboarding more closely, it was noted that (Student Name) used a two-handed index/middle finger hunt and peck approach during typing tasks.

According to the Handwriting Assessment Protocol (2009), across various published research sources, there is much variation for handwriting speeds; therefore, the resource shares a range of handwriting speeds for each grade level based on existing evidence.

Grade Handwriting LPM (WPM)





1 15-32 (3-6.4) 2 20-35 (4-7) 3 25-47 (5-9.4) 4 34-70 (6.8-14) 5 38-83(7.6-16.6) 6 46-91 (9.2-18.2)

In first grade, speeds for handwriting should be at least 4-7 words per minute to be functional for success in the classroom and (Student Name) did/did not demonstrate the ability to produce written work at these speeds during this particular assessment. When using typing as a method for written expression, the ability to type at speeds at least equal to or faster than handwriting speeds is important.

See expectations per grade level below from a 2017 research study (Connelly, Gee, and Walsh) that compared handwriting and typing speeds for a copying task for children ages 4-11 years old.

Grade Handwriting LPM (WPM) Keyboarding LPM (WPM) Kindergarten 16 (3.2) 7 (1.4)

1 33 (6.6) 12(2.4) 2 33 (6.6) 13 (2.6) 3 45(9.0) 24 (4.8) 4 57 (11.4) 31 (6.2) 5 65(13.0) 47 (9.4)

The HW21 Educational Summit Committee has proposed a set of national standards based on developmentally appropriate, research-based indicators for handwriting and keyboarding for grades K-8. (Student Name) did/did not demonstrate the ability to complete handwriting tasks at these grade level expectations. (Student Name) did/did not demonstrate the ability to complete keyboarding tasks at these grade level expectations.

Grade Handwriting KeyboardingKindergarten Print most individual uppercase and lowercase

letters within 5–6 seconds after dictated by the teacher.

Print numerals 0 to 9 in order within one minute, with or without dictation by the teacher

Fluency assessment begins in grade 3.

Grade 1 Print individual uppercase and lowercase letters accurately within 3–4 seconds after dictated by the teacher.

Print numerals 0 to 9 in order within 20 seconds, with or without dictation by the teacher.


Grade 2 Print copied text at a rate of at least 25 letters per minute.


Grade 3 Print copied text at a rate of at least 45 letters per minute.

Type 5–10 words per minute from copy.

Grade 4 Write copied text at a rate of at least 60 letters per minute.






Grade 5 Write copied text at a rate of at least 70 letters per minute.

Type 15–20 words per minute from copy

Grade 6 Write copied text at a rate of at least 80 letters per minute using cursive or manuscript cursive hybrid.



Type at least 25 words per minute from copy, looking almost exclusively at the screen or copy.


Type at least 30 words per minute from copy, looking almost exclusively at the screen or copy.

Reference: HW21 Community. Written-Language Production Standards for Handwriting & Keyboarding (Grades PreK-8) © 2014, used with permission. For more information on the Standards, please see www.hw21summit.com .

In order to be successful in the virtual education environment, it is also important to ensure that students are successful with navigating technology tools independently. In addition to efficient keyboarding skills, mouse skills are essential for independent success with technology. Observation indicated that (Student Name) is able to independently complete the following tasks:

Opening a computer application independently Scrolling down the page using a mouse Maintaining a hold with the mouse Moving and stop cursor at target Keeping cursor still while activating mouse click Click/Drag (maintain hold on mouse button while moving cursor, then release button)

Observation indicated that (Student Name) is not yet independent with the following tasks:

Any from above?

EXECUTIVE FUNCTIONING SKILLS:

The Behavior Rating Inventory of Executive Function, (BRIEF) was administered to gather information about (Student Name)’s executive function ability as it may impact educational performance. The BRIEF assesses executive function behavior in home and school environments and looks at eight different areas including inhibit, shift, emotional control, initiate, working memory, plan/organize, organization of materials, and monitor.

On this assessment, higher raw scores, percentiles, and T scores indicate greater degrees of executive dysfunction. For all the BREF clinical sales and indexes, T scores at or above 65 should be considered as having potential clinical significance (mean T score = 50, standard deviation = 10).

Behavior Rating Inventory of Executive Functioning (Parent Form)Index/Scale Raw Score T-Score Percentile Interpretation

(clinically significant =




http://www.hw21summit.com/


greater than or equal to T score 65)

Inhibit Choose an item.Choose an item.Self-MonitorBRI (Behavioral Regulation Index)

Choose an item.

Choose an item.Shift Choose an item.Choose an item.Emotional Control

Choose an item.

Choose an item.ERI (Emotional Regulation Index)

Choose an item.

Choose an item.Initiate

Choose an item.

Choose an item.Working Memory

Choose an item.

Choose an item.Plan/ Organize

Choose an item.

Choose an item.Task-Monitor

Choose an item.

Choose an item.Organization of Materials

Choose an item.

Choose an item.CRI (Cognitive Regulation Index)

Choose an item.

Choose an item.GEC (Global Executive Composite, BRI + MI)

Choose an item.

Choose an item.According to the BRIEF manual, various scales measures assessing specific areas of executive functioning are described below.

The Inhibit scale assesses inhibitory control (i.e., the ability to inhibit, resist or not act on an impulse), and the ability to stop one’s own behavior at the appropriate time. This is often the core deficit in ADHD. The Self-Monitor scale assesses awareness of the impact of one’s own behavior on other people and outcomes.The Shift scale assesses the ability to move freely from on situation, activity, or aspect of a problem to another as the circumstances demand. Key aspects of shift include the ability to make transitions, problem-solve flexibly, switch or alternate attention, and change focus from one mindset or topic to another. The Emotional Control scale addresses the manifestation of executive functions within the emotional realm and assess a child’s ability to modulate emotional responses. Children with difficulties in this domain may have overblown emotional reactions to seemingly minor events.





The Initiate scale reflects a child’s ability to begin a task or activity and to independently generate ideas, responses, or problem-solving strategies. Poor initiation does not typically reflect non-compliance or disinterest in a specific task. The Working Memory scale measures the capacity to hold information in mind for the purpose of completing a task. It is a critical skill for carrying out multiple step directions.The Plan/Organize scale measures the child’s ability to manage current and future-oriented task demands. The plan component of this scale relates to the ability to anticipate future events, set goals, and develop appropriate steps ahead of time to carry out a task or activity…It often requires sequencing or stringing together a series of steps. The organization component relates to the ability to bring order to information and to appreciate main ideas or key concepts when learning or communicating information. The Task-Monitor scale assesses task-oriented monitoring or work-checking habits. The scale captures whether a child assesses his or her own performance during or shortly after finishing a task to ensure accuracy or appropriate attainment of a goal. The Organization of Materials scale measures orderliness of work, play, and storage spaces. Children who have difficulties in this area often cannot function efficiently in school or at home because they do not have their belongings readily available for their use.

The validity of the data above is determined by Negativity, Inconsistency, and Infrequency Scales. The Negativity Scale measures the extent to which the respondent answers selected BRIEF items in an unusually negative manner relative to the clinical samples. A higher raw score indicates a greater degree of negativity. Scores on the Inconsistency Scale indicate the extent to which the respondent answers similar BRIEF items in an inconsistent manner relative to the clinical samples. The Infrequency scale measures the extent to which the respondent endorsed items in an atypical fashion. The scale includes three items that are likely to be endorsed in one direction by most respondents. Marking Sometimes or Often to any of the items is highly unusual, even in cases of severe impairment.

Validity Scale Raw Score Percentile Protocol ClassificationNegativity Choose an item.Choose an item.Inconsistency

Choose an item.

Choose an item.Infrequency

Choose an item.

Choose an item.

Behavior Rating Inventory of Executive Functioning (Self-Report)Index/Scale Raw Score T-Score Percentile Interpretation

(clinically significant = greater than or equal to T score 65)

Inhibit Choose an item.Choose an item.Self-MonitorBRI (Behavioral Choose an item.





Regulation Index)Choose an item.Shift Choose an item.Choose an item.Emotional Control

Choose an item.

Choose an item.ERI (Emotional Regulation Index)

Choose an item.

Choose an item.Task-Completion

Choose an item.

Choose an item.Working Memory

Choose an item.

Choose an item.Plan/ Organize

Choose an item.

Choose an item.CRI (Cognitive Regulation Index)

Choose an item.

Choose an item.GEC (Global Executive Composite, BRI + MI)

Choose an item.

Choose an item.According to the BRIEF manual, various scales measures assessing specific areas of executive functioning are described below.

The Inhibit scale assesses inhibitory control (i.e., the ability to inhibit, resist or not act on an impulse), and the ability to stop one’s own behavior at the appropriate time. This is often the core deficit in ADHD. The Self-Monitor scale assesses awareness of the impact of one’s own behavior on other people and outcomes.The Shift scale assesses the ability to move freely from on situation, activity, or aspect of a problem to another as the circumstances demand. Key aspects of shift include the ability to make transitions, problem-solve flexibly, switch or alternate attention, and change focus from one mindset or topic to another. The Emotional Control scale measures the impact of executive function problems on emotional expression and assesses an individual’s ability to modulate or control his or her emotional responses. The Initiate scale relates to beginning a task or activity, as well as independently generating ideas, responses, or problem-solving strategies. Poor initiation does not typically reflect non-compliance or disinterest in a specific task. The Task Completion scale reflects the ability to finish or complete tasks appropriately and/or in a timely manner, emphasizing difficulties with the production of work or performance output.The Working Memory scale measures the capacity to hold information in mind for the purpose of completing a task. It is a critical skill for carrying out multiple step directions.The Plan/Organize scale measures perceived ability to manage current and future-oriented task demands. The scale has two components: Plan and Organize. The Plan component captures the ability to anticipate future events, to set goals, and to develop appropriate sequential steps ahead of time to carry out a task or activity. The Organize component refers to the ability to bring order to information and to appreciate main ideas or key concepts when learning or communicating information.





The validity of the data above is determined by Negativity, Inconsistency, and Infrequency Scales. The Negativity Scale measures the extent to which the respondent answers selected BRIEF items in an unusually negative manner relative to the clinical samples. A higher raw score indicates a greater degree of negativity. Scores on the Inconsistency Scale indicate the extent to which the respondent answers similar BRIEF items in an inconsistent manner relative to the clinical samples. The Infrequency scale measures the extent to which the respondent endorsed items in an atypical fashion. The scale includes three items that are likely to be endorsed in one direction by most respondents. Marking Sometimes or Often to any of the items is highly unusual, even in cases of severe impairment.

Validity Scale Raw Score Percentile Protocol ClassificationNegativity Choose an item.Choose an item.Inconsistency

Choose an item.

Choose an item.Infrequency

Choose an item.

Choose an item.

EVALUATION SUMMARY

(Student Name) showed various strengths and areas for growth as evidenced by observations during this evaluation. Strengths noted include:

Visual Motor Skills Fine Motor Skills Visual Perceptual Skills ADLs IADLs Executive Functioning Sensory Processing Emotional/Self-Regulation

Challenges, and therefore areas for growth, include:

Visual Motor Skills Fine Motor Skills Visual Perceptual Skills ADLs IADLs Executive Functioning Sensory Processing Emotional/Self-Regulation

Description of Educational Needs:





Educational areas affected that need further development:

Handwriting Typing Manipulating classroom materials Participation and Attending to tasks Organization/independent living/pre-vocational/job readiness skills

Specific educational tasks impacted by challenges with visual motor skill and visual perceptual skills that are below age level expectations:

Legibility Letter size Spacing Line Orientation Confusing left/right direction Copying missing letters/letters out of order Letter reversal Number reversals Word reversals (e.g., saw, was) Writing uphill or downhill

Specific educational tasks impacted by challenges with fine motor skills that are below age level expectations:

Controlling the writing utensil with mature grasp Writing speed Keyboarding speed Fine motor letter control

Activities of daily living that are below age level expectations:

Dressing Hygiene Eating Toileting Functional Mobility

Instrumental activities of daily living below age level expectations:

Housework Managing money Shopping Meal preparation Personal safety Travelling





Specific educational tasks impacted by challenges with executive functioning skills that are below age level expectations:

Planning Organizing Initiating Pacing Working memory Goal-setting Prioritizing Inhibition Shift/Flexibility

Specific sensory processing or self-regulation skills that may be impacting the student in the educational environment:

Anxiety Distractibility Anger management Following directions Visual processing Auditory processing Touch processing Body awareness Balance and motion

Implications for Instruction and Progress Monitoring:

School-based occupational therapy services include interventions to support student needs in the areas of sensory, fine motor, visual perceptual, visual motor, and/or adaptive living skill development for students that receive special education services. School-based occupational therapy services are not warranted if challenges in these areas do not have an impact on student performance in the educational setting.

Criteria for the team to consider when determining if related service support is needed: 1) The student displays a moderate to severe need for intervention based on occupational therapy evaluation and teacher report, 2) The student needs are not already being met by classroom curriculum or other existing services, and 3) The student demonstrates a need for occupational therapy services in order to promote successful participation and performance in the existing educational environment.

Criteria to consider for dismissing a related service: 1) The student has met occupational therapy goals from the IEP; 2) There are not any new concerns and the student has been evaluated (through session observations and/or formal assessment) in the previous areas of concern; 3) The student no longer displays a moderate to severe need for occupational therapy services; and 4) The student has been successful in the educational environment given accommodations and modifications.





The decision regarding the provision of specific related services, such as occupational therapy, is the responsibility of the IEP team and discussion will occur to consider whether the student has met criteria for school-based occupational therapy services in order to support special education programming. While the IEP team will collectively, given all the evaluation data, make the determination regarding whether or not occupational therapy services are warranted, based upon data and observations from the occupational therapy assessment, it appears that (Student Name) [Select one: may benefit from occupational therapy services; may benefit from continued occupational therapy services; may not benefit from occupational therapy services; may not benefit from continued occupational therapy services]. Based on the observations made in this evaluation, it appears as if some suggestions or modifications in the educational environment could be beneficial for (Student Name) in the following areas including:

NOTE: If you use this wording in the above sentence about suggestions/modifications needed in the educational environment, include a list above of things that you are confident are an educational necessity and/or trialed already with student during sessions because the recommendations will may possibly need to be listed as part of the IEP. For a more exhaustive list of general recommendations to consider, please include a SEPARATE APPENDIX/ADDENDUM with additional comments so you do not overwhelm the family or teacher with a large number of optional recommendations to consider.

Additional recommendations that the family may want to consider include:

Independent Living Skills: Practice life skills at home: https://www.thehomeschoolmom.com/homeschool-lesson-plans/life-skills/ , Practice steps of hygiene at home: http://www.teacherneedhelp.com/homehy/ Review online money management resources:

https://www.practicalmoneyskills.com/teach/kids_money_guide , https://www.practicalmoneyskills.com/teach/lesson_plans, online bill pay simulation http://www.otiadl.net/BillPay/ (Tools needed here: http://health.utah.edu/occupational-recreational-therapies/colleagues-clinicians/)

Review Youth Emergency Preparedness curriculum at https://www.fema.gov/media-library/assets/documents/34411

Executive Functioning: Have child keep track of assignments [Ensure independence with Planner/Agenda in Connexus] Practice making lists – e.g., shopping lists, to do lists, things needed for projects or classes

o http://www.scholastic.com/parents/blogs/scholastic-parents-learning-toolkit/lets-encourage-kids- to-write-lists

o http://writingfix.com/left_brain/Personal_Lists1.htm o http://learningworksforkids.com/2013/10/apps-for-adhd-top-reminder-to-do-list-apps/

Review organization strategies – Check out https://sethperler.com/child-page/ for ideas and videos for child for organization. Videos made specifically for parents can be found here: https://sethperler.com/index/

o Organize papers and homework: https://sethperler.com/one-phenomenal-organizational-tip-for-papers-homework-and-more/




https://sethperler.com/one-phenomenal-organizational-tip-for-papers-homework-and-more/

https://sethperler.com/one-phenomenal-organizational-tip-for-papers-homework-and-more/

https://sethperler.com/index/

https://sethperler.com/student-page/

http://learningworksforkids.com/2013/10/apps-for-adhd-top-reminder-to-do-list-apps/

http://writingfix.com/left_brain/Personal_Lists1.htm

http://www.scholastic.com/parents/blogs/scholastic-parents-learning-toolkit/lets-encourage-kids-to-write-lists

http://www.scholastic.com/parents/blogs/scholastic-parents-learning-toolkit/lets-encourage-kids-to-write-lists

https://www.fema.gov/media-library/assets/documents/34411

http://health.utah.edu/occupational-recreational-therapies/colleagues-clinicians/

http://health.utah.edu/occupational-recreational-therapies/colleagues-clinicians/

http://www.otiadl.net/BillPay/

https://www.practicalmoneyskills.com/teach/lesson_plans

https://www.practicalmoneyskills.com/teach/kids_money_guide

http://www.teacherneedhelp.com/homehy/

https://www.thehomeschoolmom.com/homeschool-lesson-plans/life-skills/


o Use of planners: https://sethperler.com/planner-haters/ o Use of Post-Its: https://sethperler.com/how-post-its-can-help-you-get-on-top-of-school/ o Planning for projects and exams: http://sethperler.com/backwards-planning-101/o Tips for the organizationally challenged: https://sethperler.com/organizationally-challenged-

video-13/, https://sethperler.com/organizationally-challenged-video-23/, https://sethperler.com/organizationally-challenged-video-23-2/

o Doing a backpack or desk overhaul (video for parents): https://sethperler.com/backpack-overhaul-101-new-best-friend/

o Check out fantastic ideas in Modifications and Interventions for School Reporting Forms from Your Therapy Source, with a couple examples of ideas below)

Tips for keeping work or desk area organized Remove or have child remove all unnecessary materials, papers or books from

work area Set aside time daily or weekly to organize work and clean up Use containers to organize pencils, pens, etc. Place a sack on chair or desk to organize books when not in use Using colored tape, mark off a rectangle on desktop indicating where books

should go Break down long projects or tasks into smaller parts – provide materials at desk

needed for each part rather than the entire project Give assignments one at a time (e.g., one worksheet at a time)

Tips for organizing information efficiently (e.g. homework assignments, to do lists) Provide a written list of required assignments Use colored folders or binders to organize information Use highlighters, colored chalk or colored paper to provide extra cues for

important information Provide an example of completed work or project Keep written material covered that is not being discussed or utilized by providing

the child with paper to cover up irrelevant information

Handwriting: The use of a handwriting checklist as a reference during required handwritten assignments and for proof

reading/corrections Daily practice with developmentally sequenced handwriting program (e.g., Handwriting Without Tears,

Size Matters) to work on letter formation Exploration of keyboarding as an alternative for writing to increase written productivity and child

confidence for written communication (e.g., Multisensory keyboarding program to develop confidence, speed, and accuracy for typing)

Explore using a speech recognition program (e.g., Google Docs Voice Typing, Windows speech recognition, Siri with notes option on Apple device) to improve written productivity

Use of a scribe for written assignments Use of mechanical pencil and/or slant board (e.g., can use thick 3 ring binder as slant board) to help

decrease amount of pressure placed on pencil when writing may be beneficial. Other options are to use a flimsy book or Styrofoam as the pencil will poke through the paper if the child presses too hard. Sometimes, a notecard taped to the desk that displays the words, “Too Dark, Just Right, and Too Light” with the appropriate pressure used to write each can be a nice visual cue for the child.

Use of spacer tool to assist with improved spacing between words Use of notecard or word window (cut from a manila folder) to assist with letter placement on the line,

blocking out other math problems, and/or keeping place when copying or reading a passage




https://sethperler.com/backpack-overhaul-101-new-best-friend/

https://sethperler.com/backpack-overhaul-101-new-best-friend/

https://sethperler.com/organizationally-challenged-video-23-2/

https://sethperler.com/organizationally-challenged-video-23/



http://sethperler.com/backwards-planning-101/

https://sethperler.com/how-post-its-can-help-you-get-on-top-of-school/

https://sethperler.com/planner-haters/


Use of graph paper to help with spacing of letters or math problems Turn lined notebook paper sideways to help with alignment of math problems Use of a letter strip on the child’s desk to help with letter and number formation recall Consider strategies for child that have difficulty copying from a distant location

o Seat child close to the location for copyingo Write larger or use larger fonto Remove any non-essential visual material from the location of referenceo Consider contrasting background and font colors o Provide child with some written information but not all (e.g., give outline of what will be

discussed and child must write some information but not all)o Provide child with a vertical book holder at desk to copy from

Keyboarding: Additional typing instruction may be of benefit to increase typing speed and accuracy with finger

placement. There are several free typing resources/games/instructions online such as http://www.typingclub.com, http://www.freetypinggame.net/play.asp and http://www.bbc.co.uk/schools/typing/.

Sensory and Self-Regulation: Physical activity and exercise are recommended to continue to improve body awareness, focus, strength,

and coordination ability

For difficulty tolerating transitions:o Follow a structured, predictable routineo Provide detailed but simple instructionso Create a visual aid for daily scheduleo Set a timer to alert child to transition (visual timers work great)o Practice transitions with she child and reduce number of transitions if neededo Have next activity ready to go for the child to avoid any “down time”o Add physical activity between activitieso Use positive reinforcement when the child transitions successfully

For challenges due to auditory sensitivity or distractibility:o For regular situations where being around loud noise is unavoidable, gradually increase time

required for child to participate in those activitieso Eliminate background noise by turning off radios and TVs and closing windows and doors in an

effort to decrease noise levelo Encourage use of headphones or earplugs in loud situations when possibleo Use soft music or other “good” sounds to block out “negative” sound (consider something like a

portable music device)o Start an instruction from the beginning uninterrupted. When child is expected to listen to

instructions and an unexpected noise is present, wait until the noise is finished and start the instruction again (i.e., child interrupting, telephone rings, etc.)

o Have a quiet place to retreato Place child near the source of information (close to the teacher, learning coach, computer, etc.)o Provide child with written directions and instructions to supplement verbal direction and

instructions.

For challenges due to visual sensitivity or distractibility:




http://www.bbc.co.uk/schools/typing/

http://www.freetypinggame.net/play.asp

http://www.typingclub.com/


o Do not insist on eye contact, but do require child to look in your directiono Consider keeping one wall or area more plaino If possible, don’t use fluorescent lights but use natural sunlight or lamps insteado Do not hold instructional materials close to your face. It may be difficult for some individuals to

concentrate on two things at the same time. o Modify worksheets so they aren’t as busyo Use a study carrel (an enclosed area or partition off around a table with a tri-fold poster board)to

reduce distractionso Place child near the source of information (close to the teacher, learning coach, computer, etc.)o Reduce reverberation (e.g., echoes, sound bouncing of walls and floors) by adding room dividers,

bookshelves, acoustic tiles, carpet, wall hangings, and bulletin boards

For challenges due to touch sensitivity:o Allow child to observe rather than participating at firsto Allow child to use household objects (e.g., spoon, paintbrush, popsicle stick) touch items instead

of using handso Put messy textures inside of plastic bag for play timeo Encourage child to play with various textured materials (e.g., finger paints, water, shaving cream,

sand) to increase toleranceo Allow child to wash hands after touching objects that he dislikeso Avoid approaching and/or touching the child from behindo Use firm, sustained pressure contact whenever you need to touch the childo Encourage child to participate in desensitizing activities that may help reduce sensitivity

(pressing both palms together firmly and holding for a few minutes, placing palms down on desk and pressing firmly and repeat by placing one hand over the other)

For challenges due to taste sensitivity:o Subtle and bland tastes and smells are encouraged with food. Neutral or soothing smells can

reduce negative reactions (e.g., vanilla, apple sauce, baking bread). Foods that are sour, bitter or strong could cause negative reactions.

o Attempt to identify why the child refuses to eat (e.g., texture, temperature, taste, smell, or combination).

o Attempt to identify if child has any negative reactions to feeding utensils (e.g., plastic, metal, wooden). Usually, children will tolerate utensils in the following order: fingers, plastic, metal, wooden.

o Gradual introduction of oral sensory sensations is encouraged. Introduce foods child avoids by changing only one component of the food at a time. For example, if the child has difficulty with soft, cold food like yogurt, you could gradually process with this plan as an example:

o Firm, neutral foods like a granola baro Semi-firm, warm foods like sausageo Soft, warm foods like mashed potato

o If child has difficulty with firm, crunchy textures like crackers, start with integrating some extra texture into soft textures that child will tolerate (e.g., with the yogurt example, introduce texture to the yogurt such as diced fruit pieces, raisins, then crispy rice cereal…then introduce more firm texture such as a chewy granola bar).





o Allow child to control the intake of the food when introducing new textures. Encourage child to feel the food to explore textures and temperature with the fingers first.

o Perform desensitization activities prior to introducing a variety of foods and textures which may reduce oral sensitivity and enable greater tolerance to certain sensations and textures. For example, use a textured ball, finger, cotton swab, or nuk brush to FIRMLY touch the face around mouth/face prior to eating (e.g., middle of top lip around to middle of bottom lip for both sides, corner of lip and over cheek bone toward ear for both sides, beside ear toward jaw for both sides, middle of forehead around to chin for both sides of face).

For difficulty sitting still or with seeking out movement to the point that it interferes with daily routine:o Encourage frequent changes in positions during work that facilitates changes in head position

(e.g., sitting, standing, lying on stomach)o Consider alternative seating surfaces for seat work such as a therapy ball, swivel chair, or rocking

chairo Send child on errands to increase physical activityo Tie exercise band or resistive tubing around the legs of a chair for child to exercise legs while

sittingo Try to teach with a multisensory approach (e.g., incorporate movement activities with learning

new concepts)o Experiment to see if child is able to focus attention on tabletop work after vestibular stimulation

(e.g., prepare movement activities prior to tabletop activity, allow child to sit on a swivel chair on large ball while performing tabletop activities)

o Limit the length of time child is expected to sit still in one position and provide frequent breaks from seat work for physical activity

o Assign chores that require exerting of physical energy (“heavy work”)o Provide a variety of sensory experiences that involve rapid horizontal, vertical, and rotary

stimulation Spinning in a swivel chair Somersaults, rolling down hill or log rolling in the yard Jumping on mini-trampoline Hang upside down on monkey bars Lie on tummy on swing so speed is controlled with feet Jump roping Pretend to be airplanes (spinning around with arms extended) Scooter activities (sitting or laying on stomach)

o When it is time work following an active motor time: Dim the lights and play quiet relaxing music Create a quiet space for child to calm down (e.g., tent or cardboard box with pillows,

blankets, and stuffed animals) Complete slow, quiet, calm activities prior to tabletop activities. If movement activities

are completed prior to tabletop activity, it would most likely be most effective if the last movement activity involved some sort of ‘heavy work’ or calming activity

Wall push-ups, chair push-ups Slow animal crawls (e.g., crab, worm or turtle) Adult places heavy hand on child’s shoulders




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