HARRISON CENTRAL SCHOOL DISCTRICT SPECIAL EDUATION DEPARTMENT 50 UNION AVENUE HARRISON, NEW YORK 10528 Telephone: 914-630-3068

Fax: 914-777-0237 RELATED SREVICE PROGRESS REPORT

AREA: OT: STUDENT:

PT:

ANNUAL REVIEW:

3/27/12

Sydney Macchia

SCHOOL: Parsons Memorial School Date: 3/9/12

SERVICE PROVIDER: Maria Tissier PROGESS SUMMARY:

Sydney has made good progress this year towards meeting her Occupational Therapy goals. She has demonstrated an increase in her ability to search for objects or letters moving from left to right or top to bottom as evidenced in her ability to complete word searches in an organized, efficient and predictable pattern. She continues to demonstrate increased hand strength as evidenced by her ability to hold and maintain adequate pressure during writing activities. She is printing all letters of the alphabet in upper and lower case letters with better accuracy and legibility with occasional cues. Sydney continues to require verbal cues to initiate activities and to maintain attention to task. She is provided with various sensory opportunities so she may integrate information more efficiently to produce a satisfactory motor output, however, she is inconsistent in her ability to use proper sizing and spacing when writing, especially when writing longer assignments.

RECOMMENDATIONS: Occupational therapy services are recommended for the 2012-2013 school year at a frequency of 1 time per cycle. It is recommended that services be provided in a group setting.

PLEASE NOTE THAT WITHOUT A PRESCRIPTION SERVICES CANNOT BE PERFORMED

Maria Tissier, cota 3/9/2012 SIGNATURE OF SERVICE PROVIDER/DATE

HARRISON CENTRAL SCHOOL DISCTRICT SPECIAL EDUATION DEPARTMENT 50 UNION AVENUE HARRISON, NEW YORK 10528 Telephone: 914-630-3068 Fax: 914-777-0237 RELATED SREVICE PROGRESS REPORT

AREA: OT: STUDENT:

PT:

ANNUAL REVIEW:

3/27/12

Jeremiah Ferreira

SCHOOL: Harrison Avenue School Date: 3/19/12

SERVICE PROVIDER: Maria Tissier PROGESS SUMMARY:

Jeremiah has made good progress this year towards meeting his Occupational Therapy goals. He is able to write 5 lines of manuscript on 1-inch lined paper within 10 minutes with 70% accuracy on 2 separate occasions. He continues to require verbal cues to remain focus on task within a group setting. He has a great imagination and enjoys writing about his favorite things. Jeremiah demonstrates some difficulty in his ability to use proper sizing and spacing when writing, especially when writing longer assignments. He is able to organize written material with 70% success however, continues to require cues to correctly place his letters and words on the paper.

RECOMMENDATIONS: Occupational therapy services are recommended for the 2012-2013 school year at a frequency of 1 time per cycle. It is recommended that services be provided in a group setting.

PLEASE NOTE THAT WITHOUT A PRESCRIPTION SERVICES CANNOT BE PERFORMED

Maria Tissier, cota 3/19/2012 SIGNATURE OF SERVICE PROVIDER/DATE

Service Projections for 2012-13 Case Manager: Susan Coby Service Provider: Maria Tissier Student: Jeremiah Ferreyra

Current Level of Service

___ Counseling _X__ OT ____ Speech & Language ____ PT

Ratio Group 5:1

Frequency 1/cycle

Duration 30 minutes

Recommended Level of Service

___ Counseling _X__ OT ____ Speech & Language ____ PT

Ratio Group 5:1

Frequency 1/cycle

Duration 30 minutes

Service Projections for 2012-13 Case Manager: Susan Coby Service Provider: Maria Tissier Student: Sydney Macchia

Current Level of Service

___ Counseling _X__ OT ____ Speech & Language ____ PT

Ratio Group 5:1

Frequency 1/cycle

Duration 30 minutes

Recommended Level of Service

___ Counseling _X__ OT ____ Speech & Language ____ PT

Ratio Group 5:1

Frequency 1/cycle

Duration 30 minutes