Spreadsheet: 21d090e5-f78e-4074-a9eb-8d2674fabff8
Sheet: Sheet1

Student's Name: ____________[NAME]_________________________  OSIS #: ___123-456-789_______  Start Date: ____10/8/05_____ | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11
_____ OT   __X__ PT |  |  | [NAME]'s Name: ______[NAME]_________________________ |  |  |  |  |  | DATE of LAST IEP: ____10/8/05_____
IEP / ANNUAL GOALS: (Long term Objectives)
1 [NAME] will go up/down 1 flight of stairs with a reciprocal step pattern, without use of railing, at her own speed.
2 [NAME] will be able to independently push open school doors using hands only.
3. [NAME] will be able to participate in two or more games involving hitting a target (basketball, dodgeball, etc.) during gym class.
4
5
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
2005-10-15 00:00:00 | 1,2,3 | X | Gross Motor |  | Psychosocial | [NAME] was very energetic today. Performed stairs |  |  |  |  | JS
 |  | X | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning | training, leg strengthening, ball throwing and catching exs.
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual | She ascended 1 flight of stairs with reciprocal step pattern
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control | X | Strenghtening | without use of rails, but still hesitates on descent.
 |  | X | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
2005-10-20 00:00:00 |  |  | Gross Motor |  | Psychosocial | [NAME] is absent today. |  |  |  |  | JS
 |  |  | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control |  | Strengthening
 |  |  | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
2005-10-22 00:00:00 | 1,3 | X | Gross Motor |  | Psychosocial | [NAME] was only seen once this week. She was out sick on 10/20. |  |  |  |  | JS
 |  |  | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning | She reported she has a cold and that she still feels weak.
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual | PT limited this week to stretching exercises on the mat. [NAME]
 |  | X | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control |  | Strengthening | was able to participate in the modified PT sessions.
 |  |  | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
2005-10-27 00:00:00 | 1,2,3 | X | Gross Motor |  | Psychosocial | [NAME] reported feeling better this week. Performed step-up |  |  |  |  | JS
 |  | X | [NAME] |  | [NAME]
 |  |  | Sensory Processing | X | Motor Planning | and step-down exs. on an 8-inch high block for strengthening.
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual | Also completed obstacle course which includes jumps, walking
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control | X | Strengthening | on balance beam, crawling and throwing bean bags to target.
 |  | X | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
 |  |  |  |  |  |  |  |  |  |  | page 1
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
 |  |  | Gross Motor |  | Psychosocial
 |  |  | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control |  | Strengthening
 |  |  | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
 |  |  | Gross Motor |  | Psychosocial
 |  |  | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control |  | __________________
 |  |  | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
 |  |  | Gross Motor |  | Psychosocial
 |  |  | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control |  | __________________
 |  |  | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
 |  |  | Gross Motor |  | Psychosocial
 |  |  | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control |  | __________________
 |  |  | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
Date | Goal # (s) worked on | Therapeutic Activity |  |  |  | Progress / Student's Response |  |  |  |  | OT / PT Initials
 |  |  | Gross Motor |  | Psychosocial
 |  |  | [NAME] |  | [NAME]
 |  |  | Sensory Processing |  | Motor Planning
 |  |  | Handwriting |  | Fine Motor
 |  |  | Behavior |  | Cog/Perceptual
 |  |  | ROM/Stretching |  | Oral/Ther. Feeding
 |  |  | Postural Control |  | __________________
 |  |  | Coordination |  | __________________
 |  |  | Visual Motor |  | __________________
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