We typically start with an observation and if the obs shows we need to look at things closer, we can

move to an eval. The observation can be completed over a couple sessions/settings to get a full picture
If we are talking about sensory needs we provide suggestions and ideas to the teachers who implement
the strategies in the classroom.

School based model doesn’t typically allow for the intensity needed
Sensory breaks can support participation but they aren’t going to suddenly change the student and
provide them with what they need to participate when theres a mismatch between their needs and the
environment.
Not all dysregulation is sensory related. Sensory streategies may be beneficial to some to some
degree but if the behavior continues, there are other unmet needs

Steps Required to Write a Sentence.

1. Student needs to create the thought.
2. Student needs to formulate that thought into a complete sentence.
3. Student needs to remember all parts of the sentence while trying to
remember how to write the letters, where to place them on the line, and
how to apply the rules of grammar.

ADHD
Children with ADHD struggle with executive functioning skills. These
include:
 Self-monitoring (keeping track of what you’re doing) is required
for neat and legible handwriting.
o Poor executive functioning skills can impact a child’s
ability to self-monitor or pace his/herself while writing. In
other words, impulsive behavior or acting without thinking
about the outcome can result in a child rushing to finish
writing just to be done with it. This can have a huge impact
on legibility. It’s not that the child doesn’t know how to
write neatly, but rather has a really hard time pacing
his/herself in the moment to do so.
Is the child in kindergarten?
This is a crucial time where intervention can have the greatest impact. Work
with the child by providing extra support. The following suggestions will
help with motor planning, muscle memory, and visual memory.
 Have the child verbalize the stroke sequence for each letter while
writing it
 Have the child write the letter with eyes closed in the air
 Provide sensory input by forming letters with various mediums
(shaving cream, pudding, whipped cream, sand, Play-Doh, etc.)
 Always Use Primary Paper
 Children this age need the structure and visual guidelines
provided by primary paper.
 some kids need additional sensory input.
 There are many forms of modified paper that offer sensory
input. Providing paper with color contrast and visuals
assists children with learning how to orient letters on the
line and letter placement skills. For example, the Smart
Start paper featured below has a top blue line with a picture
of the sun and clouds. This helps children with the
placement of tall letters like t, l, and f. The baseline is green
with a picture of a flower that represents grass. This helps
children to learn that all letters need to be grounded on the
baseline. Provide even more support by providing auditory
cues like “tall letters start on the blue sky”. Some children
need tactile input. Providing paper that offers raised lines
allows kids to see and feel where letters should be placed
on the line.

What can you do if the child is in first or second grade?

occupational therapy evaluation. If the child is experiencing problems in
other areas as well, additional testing may be recommended to determine if
your child needs specialized instruction

What can you do if the child is already in 3rd grade or higher?

At this grade level, children are no longer expected to learn how to write but
to write to show what he or she has learned.
 Sometimes reducing or eliminating the manual aspect of
handwriting is necessary if you want a true assessment of what
the child can express.
 Getting thoughts out of one’s head and onto the paper is the
ultimate goal.
 Eliminating the need to think about how to form letters, how to
spell many of the words, and how to apply the rules of grammar
will help the child focus on the content they’d like to write
about.
 Typically the intervention teams will use their expertise to
determine what modifications or accommodations would be
appropriate and most beneficial.
o Graphic Organizers
o AT
o Sentence Starters (ex What excited me was….)
o Sentence Frames (ex My favorite ____________ is
____________ because _____________.)
o Word Banks
o Expect neat handwriting ONLY when copying a final draft
o Build Keyboarding Skills
What are the 4 components of letter recognition?
The four components of letter recognition are:

1. Visual Discrimination: Visual discrimination refers to the ability to

perceive and differentiate visual details and characteristics of letters. It
involves recognizing and distinguishing the unique features and shapes
of individual letters from one another. This component helps
individuals identify the differences between similar-looking letters,
such as “b” and “d,” or “p” and “q.”
2. Letter Naming: Letter naming is the ability to associate the correct
name or sound with each letter of the alphabet. It involves knowing the
names of uppercase and lowercase letters and being able to identify and
name them accurately. For example, recognizing the letter “A” and
saying its name as “ay” or “ah.”
3. Letter Formation: Letter formation refers to the ability to write or
reproduce letters with proper shape, proportion, and direction. It
involves the motor skills required to create each letter using appropriate
strokes and sequence. Mastery of letter formation enables individuals to
accurately write letters when engaging in handwriting tasks.
4. Letter-Sound Correspondence: Letter-sound correspondence involves
understanding the relationship between letters and the sounds they
represent in spoken language. It is the connection between letter
recognition and phonemic awareness. This component helps
individuals associate specific sounds or phonemes with each letter,
which is essential for reading and decoding words.

These four components of letter recognition—visual discrimination, letter

naming, letter formation, and letter-sound correspondence—work together to
develop a comprehensive understanding of letters and their role in language
and literacy.
By mastering these components, individuals can effectively identify, name,
write, and connect letters with their corresponding sounds, forming a solid
foundation for reading and writing skills.

Here are a few reasons why letter recognition is important in OT

occupational therapy:

1. Preparing for academic skills: Letter recognition is a foundational

skill for reading and writing. Occupational therapists often work with
children who are preparing to enter school or are struggling with early
literacy skills. By focusing on letter recognition, therapists can help
children develop the visual perception and cognitive abilities necessary
for reading and writing tasks.
2. Enhancing fine motor skills: Letter recognition activities often
involve fine motor skills, such as using pencils, markers, or other
manipulatives to trace or write letters. Engaging in these activities can
help children improve their hand-eye coordination, pencil grip, and
overall fine motor control, which are essential for tasks like
handwriting and other fine motor tasks.
3. Visual perception and discrimination: Letter recognition requires the
ability to visually discriminate between different letters, identifying
their unique shapes and forms. Occupational therapists may incorporate
activities that strengthen visual discrimination skills, such as matching
letters, sorting letter cards, or identifying differences and similarities
between letters. These activities can help improve a child’s ability to
recognize and differentiate letters accurately.
4. Cognitive skills development: Letter recognition tasks involve
cognitive processes like attention, memory, and sequencing.
Occupational therapists may use letter recognition activities to support
the development of these cognitive skills. For example, asking a child
to identify letters in a specific order or recalling letters from memory
can help strengthen their attention and memory abilities.
5. Building confidence and motivation: Mastering letter recognition can
boost a child’s self-confidence and motivation for further learning.
Occupational therapists often incorporate engaging and interactive
letter recognition activities that make the learning process enjoyable for
children. By providing positive reinforcement and tailored
 interventions, therapists can help children develop a sense of
accomplishment and motivation to continue their literacy development.

Overall, letter recognition is a foundational skill that contributes to various

areas of development, including academics, fine motor skills, visual
perception, cognitive abilities, and self-confidence. Occupational therapists
utilize letter recognition activities to support children in developing these
skills, setting them up for success in their educational journey.

Additionally, OTs often work on fine motor skills including handwriting. To

learn handwriting, it is essential that you have letter recognition skills.