The TARGET is a comprehensive format for collecting and organizing assessment data from tests, observations, histories and questionnaires.  This format helps the therapist see the relationships between original concerns and underlying causes, prioritize areas that need addressing in treatment and plan the sequence of treatment. Goals can then be generated together and progress tracked together.  The TARGET is composed of 4 pages, each of which is a category of like areas of function. They are titled:

• Page 1 is Modulation
• Page 2 is Postural Development and Outcomes
• Page 3 is Learning how to Learn and Remember 
• Page 4 is Integrated Brain Activity, Emergent Processes and End Products.
  

The following case demonstrates issues and concerns on all 4 pages and reflects the assessment and treatment planning outcomes.

Case Example
E is a 6.9 year old beautiful little girl with a smile on her face most of the time.  Her history includes an unremarkable pregnancy and delivery at term.  There were no major issues other than difficulty attaching to and remaining attached to the breast.  This was reportedly difficult until she weaned herself at 8 months and switched to a sippee cup. No particular problems were noted until her preschool teachers told the parents they had some concerns about her language organization and some speech concerns.  They also noted her motor skills were a bit awkward and she avoided the slide, climber and swings on the playground.  Peer interaction was minimal (her preference was to play or sit in class by herself) but all thought that was because of her speech and language issues.
By the first grade these concerns remained and an OT consult was recommended which was followed by assessment and recommendation for a treatment intensive.  A speech and language evaluation was also recommended and she began receiving services about the same time an OT intensive was scheduled.  

This blog was contributed by Nancy Lawton-Shirley, OTR/L who will be teaching the two-day Session H. CranioSacral Applications in Pediatrics. Nancy owns Points of Stillness, which offers occupational therapy at Healing Waters Health Center in Hudson, WI.

1. Be sure your child has physical activity after school. Time outside is ideal. Free time to just play can really recharge a child's brain from a day of structure. Self-directed play is a great way to work the creativity parts of the brain!
2. Have snacks available during study time. Things to chew, suck and crunch actually help the brain to pay attention, focus and learn.
3. Do memory tasks while a child does rhythmic movement, i.e. sitting on a ball and bouncing or jumping up and down while they spell a word or learn math. Rhythm lays down memory faster!
4. Try watching the MeMoves DVD! Have the family do one set of the exercises on the DVD. It very quickly calms everyone down, and gets the brain ready to learn. This is good for preschool- through high school-aged children!
5. Some children need absolute quiet to concentrate. Other children really benefit from playing music with a consistent beat. Ideas:Baroque for Modulation, Sacred Earth Drums, Calming Rhythms.

And remember your child has been working hard all day!