OT GOAL LIST Fine/Visual Motor Child will demonstrate increased fine motor skill by being able to imitate vertical, horizontal and circular line independently,4 out of 5 out of opportunities. Child will demonstrate improved fine motor and dexterity skills as evidenced by her ability to initiate a raking grasp to obtain small pellets independently on 4 of 5 attempts. Child will demonstrate improved fine motor skills as evidenced by her ability to display an emerging pincer grasp (thumb-fingertips) when obtaining a pellet on 4 of 5 attempts. Child will stack six blocks, 3 out of 4 opportunities. Child will imitate a circle, 3 out of 4 opportunities. Child will demonstrate improve visual/fine motor skills as evidenced by her ability to voluntarily release 4 of 5 1-inch cubes into a cup. Child will demonstrate improved fine motor, perceptual and voluntary release skills as evidenced by his ability to independently drop a small object into a large container on 4/5 attempts. Coordination/motor planning/postural control Child will demonstrate improved postural control and motor planning as evidenced by her ability to sit independently while engaged in play activities for 5 minutes without falling. Child will demonstrate improved fine motor and dexterity skills as evidenced by his ability to transfer toys from one hand to the other on 4 of 5 attempts. Child will demonstrate improved visual motor and bilateral coordination, as evidenced by her ability to transfer objects from one hand to the other independently, without dropping, on 4/5 attempts In order to demonstrate improved postural control/endurance, Child will be able to engage in a 10 minute table top activity, maintaining an erect posture, with no more than 1 cue to adjust slouched position. Child will demonstrate improved bilateral coordination as evidenced by her ability to bring objects to midline in order to make a sound, on 4 of 5 attempts. Child will demonstrate improved motor planning as evidenced by her ability to transition from sitting to hands and knees on 4 of 5 attempts. Child will demonstrate improved bilateral coordination and upper extremity strength, as evidenced by his ability to hold his bottle with moderate assistance during functional feeding, 4/5 opportunities. Self-Care Child will demonstrate improvements in attention, motor planning, and self-care skills as evidenced by an ability to independently don socks on 3 of 4 opportunities In order to display improved attention to task, fine/visual motor and self-care skills, Child will demonstrate the ability to independently complete the first knot of a shoe tying sequence, 3 of 4 opportunities. Child will display improved fine motor praxis skills and organization of behavior by being able to tie his shoelaces with minimal assistance and/or cues, 4 of 5 opportunities. Child will demonstrate improved self-care and bilateral motor coordination by being able to tie his shoelaces with moderate physical assistance, 2/3 opportunities. Child will demonstrate improved fine motor dexterity and attention to task as evidenced by his ability to independently complete a shoe tying sequence, 4 of 5 opportunities, in order to increase overall independence with self-care skills. Child will demonstrate improved hand/digit strength and fine motor manipulation skills, as evidenced by his ability to don/doff a button down shirt independently, 4/5 opportunities. Child will demonstrate improved fine motor and self-care skills by being able to unbutton and button his pants independently, 4 of 5 attempts. Child will demonstrate improved motor planning and self-care skills as evidenced by his ability to assist with dressing (lifting arms/legs on both sides) on 4 of 5 attempts. Child will demonstrate improved visual motor coordination and bilateral coordination by being able to don clothing with buttons independently, 4 of 5 opportunities. In order to demonstrate improved endurance for and attention to self-care tasks, Child will complete an entire dressing sequence (including socks, shoes, shirt and pants) independently with no more than 1 re-directive cue on 4/5 opportunities. In order to promote attention to task and improved self-care abilities, client to independently initiate and complete an entire 4-5 step toileting routine with minimal verbal cuing and SBA only, 3 of 4 opportunities To demonstrate improved self-care skills and attention to multi-step tasks, Child will complete a toileting routine with no more than one verbal cue to complete all tasks of the routine (washing hands, wiping, flushing toilet etc.), 4/5 opportunities Child will demonstrate self-tooth brushing abilities to be able to brush teeth with supervision. Child will demonstrate an improved tolerance for self-care tasks as evidenced his ability to complete a tooth-brushing sequence for 2 minutes with no more than 1 re-directive cue or protest behavior. Attention/organization of behavior In order to demonstrate improved regulation of behavior, child will be able to continue through a 5-step obstacle course despite unexpected/unwanted outcomes (particularly with preferred activities), 3/4 opportunities, as evidenced by minimal need for redirection and no crying/tantruming. Child will demonstrate an improved frustration tolerance as evidenced by his ability to transition from preferred to non-preferred activities with little to no displays of disorganized behavior (such as crying, screaming or outbursts of anger), 4 of 5 opportunities. Child will demonstrated improved organization of behavior as evidenced by an overall improvement in his ability to remain engaged (decreased tantrums and escape behaviors) during cooperative/competitive and prolonged ADL tasks (shoe tying, dressing, grooming, feeding) despite difficulties or unfavorable outcomes (losing at a game, being unable to complete a task on the first attempt, etc.) Child will demonstrate improved organization of behavior, sensory processing and attention to task as evidenced by his ability to complete a 10-15 minute table-top activity with no more than 1 re-directive cue, incorporating appropriate self-directed sensory strategies independently, on 4 of 5 attempts. Child will improve state of modulation (attention / behavior/ sustained participation and ability to transition) to allow for improved routines and habits that support functional age appropriate independence across environments as demonstrated by decreased fear/distress from noisy sounds (such as toilet flushing or vacuum) and increased calming response by a reduction in disorganized behaviors, 3 of 4 opportunities. Child will demonstrate increased organization of behavior and attention to task by being able to attend to a novel non-familiar 2-step activity for 10 minutes, 3 out of 5 opportunities. To demonstrate improved attention to task and organizational behavior, Child will be able to sit through a 2-3 step arts and crafts activity with minimal cuing or redirection In order to demonstrate improved attention to task and sensory modulation, child will be able to independently complete a 4-5 step table top activity with minimal need for redirection, 4/5 tries. Tactile defensiveness Child will demonstrate improved tactile processing by being able to start and finish an arts and crafts activity with 2-3 tactile medias (i.e. glue, paint, crayons, glitter…) with minimal verbal cues, 3 out of 5 opportunities. child will demonstrate improved tactile defensiveness by being able to tolerate “messy” textures to complete one activity (i.e. finger painting) with minimal verbal cues, 3/5 opportunities. Child will engage in a variety of activities incorporating wet and/or dry tactile media without resistance, for 3 minutes, 3 out of 4 opportunities. Executive Functioning Child will demonstrate improved organizational skills for medication management, incorporating appropriate cues/reminders to adhere to regiment with 85-100% accuracy/consistency. Child will demonstrate improved initiative and organizational skills as evidenced by his ability to list strategies and implement a plan to keep bedroom organized on a consistent basis. Child will demonstrate an ability to plan for adulthood by setting up and working toward 5 SMART (specific, measurable, attainable, relevant, and timely) long-term goals. Child will improve processing speed as evidenced by completing timed table top activities (homework, puzzles, pencil/paper tasks) according to age-appropriate standards on 4 of 5 opportunities. Body/safety awareness Jason will demonstrate improved body/safety awareness and proprioceptive regulation/adaptation skills, as evidenced by his ability to complete a novel, 4-step adult-directed obstacle course independently and without safety modification verbal cues, in order to complete toileting outside of the home environment, 3/4 opportunities. Child will demonstrate increased sensory processing and body awareness by being able to utilize and navigate through the playground structure independently without falling, 4 out of 5 opportunities. Child will demonstrate increased sensory processing and body awareness by being able to navigate through a 3-4 step obstacle course without falling and minimal verbal cues, 4 out of 5 opportunities. Feeding Child will demonstrate improved tactile processing and oral motor skills by being able to tolerate 3 variety textured food (with parent’s consent) without displaying an aversive reaction, 2 out of 5 opportunities. Child will demonstrate improved feeding skills by being able to take 5-10 spoonfuls of preferred food items independently Once Child has been approved to transition to oral feeding, she will demonstrate the ability to swallow purred foods with a closed lips on 4 of 5 opportunities Child will demonstrate improved visual motor and bilateral coordination, resulting in improved feeding skills, as evidenced by his ability to hold/stabilize his bottle with both hands throughout a feeding activity on 4/5 attempts Child will engage in play or exploratory activities (smell, lick, kiss, etc.) using 1-2 non-preferred foods, 3 out of 4 therapy sessions. Child will taste 3 new foods (meat or vegetables), in preparation for expanding diet. In order to demonstrate improved self-feeding skills, Child is will be able to safely use a fork and knife in order to effectively cut soft food and feed himself bite-sized portions on 4 of 5 attempts. In order to demonstrate and expanded diet, in the next 6 months, Child will be able to incorporate 3 new textured foods (including at least one vegetable) into his diet with little to no protest behaviors (spitting out, refusal, etc). In order to demonstrate improved oral sensory modulation and to expand dietary preferences, in the next 3 months Child will incorporate 3 new vegetables into his diet, unblended and nonpureed. Child will demonstrate improved oral sensory processing skills by incorporating 3 new food types/textures into his diet, with minimal aversive responses (such as spitting out), 4/5 opportunities. Child will bite, chew, and swallow at least three non-preferred textured foods without pocking and/or spitting out food Child will reduce total bottle use frequency by at least 2/3rds in order to facilitate an increased variety of solid food intake. Child will demonstrate improved oral sensory processing resulting in an expanded diet as evidenced by the incorporation of 3 new food types/textures (including at least one vegetable) into his diet over the next 6 months. Child will demonstrate improved head/neck/trunk control and strength, as evidenced by his ability to independently hold his head/trunk upright during functional feeding, 4/5 opportunities. Child will demonstrate improved fine motor and perceptual skills as evidenced by his ability to self-feed a bite-sized portion of food utilizing an inferior pincer grasp on 4/5 opportunities. Social-Emotional/Play Skills Child will demonstrate improved praxis skills by participating in imitation activities (Simon Says, hand gestures for songs, etc.), with fair accuracy (resembles actual movement/gesture), 3 out of 4 opportunities. Child will demonstrate improved social/play skills as evidenced by her ability to remain engaged in a simple game (i.e. peek-a-boo) for 5 minutes. . Child will demonstrate improved organized behavior, attention to task and play skills, in a social setting, as evidenced by his ability to remain engaged in a 2-step activity with peer with minimal facilitation, 4/5 opportunities. Parent Education Parent to learn and demonstrate and verbally express understanding of home program that supports performance in daily life and promotes greater independence and ability to participate in home and community environments. Parent will demonstrate successful implementation of sensory support or accommodation reporting a 50% increase in client’s ability to display regulated sensory processing throughout the day (as evidenced by decreased sensory seeking tendencies, improved frustration tolerance, etc.) .
