Cognitive Orientation To Daily Occupational Performance Approach Research Articles

The effect of cognitive orientation to daily occupational performance in children with attention deficit hyperactivity disorder: A pilot randomized controlled study

This single-blind randomized controlled trial (RCT) study was planned to examine the effect of the Cognitive Orientation to Daily Occupational Performance (CO-OP) intervention on occupational performance and executive functions through daily routines children with attention deficit hyperactivity disorder (ADHD). Using a simple random method, the children were divided into two groups: n = 15 in the CO-OP group (4 girls, 11 boys) and n = 15 in the control group (3 girls, 12 boys). CO-OP intervention included 12 sessions (2 sessions per week, each lasting 1 hour, 6 weeks in total) focusing on teaching cognitive strategies to improve daily living activities. These sessions involved personalized goal setting, performance analysis, and the application of cognitive strategies to enhance executive function and occupational performance in children with ADHD. The data were collected by assessing the children with the Canadian Occupational Performance Measure, Goal Attainment Scaling, and Executive Functions and Occupational Routines Scale at the beginning and end of the study. When comparing the pre- and post-evaluations of the CO-OP group, statistically significant improvements were noted in occupational performance and satisfaction (p < 0.001), occupational performance goals (p < 0.001), and executive functions through daily routines (p < 0.05). Test results for differences in posttest scores between the two groups showed that the CO-OP group had significantly better activity performance and satisfaction (p < 0.001), as well as gains in social routines for executive skills (p < 0.05), compared to the control group. The findings suggest that the CO-OP approach represents a promising and effective method for facilitating skill acquisition in various activities among children diagnosed with ADHD. Trial registration: This research was registered to clinical trials with the code NCT05125120.

Cognitive Orientation to daily Occupational Performance to improve occupational performance goals for children with executive function deficits after acquired brain injury.

To determine the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach in improving the occupational performance goals of children and young people with executive function deficits after acquired brain injury (ABI) (e.g. etiologies such as stroke, encephalitis, brain tumor, and traumatic brain injury). A replicated single-case experimental study using a randomized multiple baseline design across participants and goals was used. Three clusters of four participants (12 participants, nine males and three females, aged 8-16 years) were included. The intervention consisted of 14 individual CO-OP sessions. Each participant chose four goals; three goals were trained during the intervention sessions and a fourth goal served as the control. The Goal Attainment Scale (GAS) was used as a repeated measure to determine goal achievement while the Canadian Occupational Performance Measure (COPM) was used to identify the perceived goal achievement of children, young people, and their parents. For 26 of the 35 trained goals, the intervention led to statistically significant improvements in the GAS. Perceived occupational performance and satisfaction improved significantly for the trained goals (30 out of 35 goals for the COPM performance and satisfaction of participants; 26 out 31 goals for the COPM performance of parents; 24 out of 31 goals for the COPM satisfaction of parents) and were maintained at the follow-up. Almost all COPM control goal results were significant, but these changes were not supported by the GAS measures or the statistical analysis. The generally positive results of this study provide evidence of the benefits of using the CO-OP approach with this population.

Cognitive orientation to daily occupational performance approach in people with multiple sclerosis: A pilot study.

Multiple sclerosis is the most important cause of non-injury-related disability in young adults. The disease has unknown causes and distresses and affects daily activities. While therapeutic interventions mainly focus on body function and structure to reduce impairment, Cognitive Orientation to Daily Occupational Performance (CO-OP) is a cognitive approach that provides intervention at the level of activity and participation. We aim to examine the effects of CO-OP approach on fatigue, quality of life, occupational performance, and satisfaction in people living with multiple sclerosis; and to examine whether they could transfer strategies and skills learned during CO-OP to untrained goals. A pre-post design was used. Assessment tools included Montreal Cognitive Assessment, Multiple Sclerosis Impact Scale, Fatigue Impact Scale and the Canadian Occupational Performance Measure. Six individuals living with multiple sclerosis participated in 10 CO-OP sessions twice a week. The sessions were held in an environment of the participants' choice, along with an extra session added to determine the goals. The study was registered in the ethics committee of University of Social Welfare and Rehabilitation Sciences (IR.USWR.REC.1399.089). The performance improved (2-point positive change) in 12 out of 18 trained goals and in three out of six untrained goals (self-report). The improvement was maintained at a 3-month follow-up assessment. There was a statistically significant difference in Canadian Occupational Performance Measure (χ2 = 11.565, p= 0.003 same for performance and satisfaction scores), Fatigue Impact Scale (χ2 =7.000, p= 0.030), and Multiple Sclerosis Impact Scale scores over time (χ2 =9.478, p= 0.009) respectively. The CO-OP approach has the potential to improve daily activity performance, reduce pain, and improve the quality of life for people living with multiple sclerosis. A definitive randomised controlled trial is required.

Effectiveness of Cognitive Orientation to Daily Occupational Performance in Parkinson’s Disease: A Case Report

Introduction: Parkinson’s disease is a chronic progressive neurodegenerative disorder causing impaired motor function and various non-motor symptoms. One of the most common problems in Parkinson’s patients is occupational performance problems. The cognitive orientation to daily occupational performance (CO-OP) is one of the client-centered and problem-solving approaches in occupational therapy evaluations and interventions. This study aims to determine the effectiveness of the CO-OP approach on perceived satisfaction and occupational performance in a 62-year-old woman with Parkinson’s disease.&#x0D; Case Description: The client was a 62-year-old woman with moderate cognitive impairment, stage 3 on the Hoehn and Yahr scale, and signs of depression. In our case study, the outcome measures were the Canadian occupational performance measure (COPM), functional independence measure (FIM), Montreal cognitive assessment (MOCA), and Beck depression inventory-II (BDI-II). We administered the CO-OP intervention for six weeks. Sessions were performed twice a week for one hour per session.&#x0D; Results: The results indicate that the CO-OP intervention improves the client’s satisfaction, occupational performance, and functional independence. Although the results from this single case cannot be generalized, the findings suggest that CO-OP intervention may help improve satisfaction and occupational performance in adults with Parkinson’s disease. Further investigation is necessary.&#x0D; Conclusion: These results suggest that CO-OP can be a valuable occupational therapy interventions for individuals with Parkinson’s disease. We recommend that occupational therapists consider using this approach in their practice to improve the occupational performance of their patients with Parkinson’s disease.

Intervention with the CO-OP Approach leads to a transfer effect over time to untrained goals for children with cerebral palsy or spina bifida

Purpose This study aims to investigate whether the treatment effects, in terms of goal attainment, transfer effects and impact on executive functions, of an intervention in children with cerebral palsy or spina bifida using the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach are maintained over time, from immediately after the intervention to three months afterwards. Method A three-month follow-up study, from an intervention using CO-OP. Thirty-four children (7–16 years) each identified four goals (one untrained to examine transfer) and participated in an eleven-session intervention. Assessments were performed at baseline, immediately after the intervention and at a three-month follow-up using the Canadian Occupational Performance Measure and the Performance Quality Rating Scale. Executive function and self-rated competence were assessed at the same timepoints. Results Statistically significant and clinically relevant improvements in goal achievement were demonstrated for both trained and untrained goals after the intervention and were maintained at follow-up. The clinically relevant improvement in untrained goals continued to increase until follow-up. Self-rated competence increased after the intervention and was maintained at follow-up. Conclusion The CO-OP intervention was effective in achieving and maintaining the children’s own goals over time. The transfer effect was confirmed by higher goal attainment for the untrained goals.

Cognitive Orientation to Daily Occupational Performance: A Randomized Controlled Trial Examining Intervention Effects on Children with Developmental Coordination Disorder Traits.

Children with traits of developmental coordination disorder (DCD-t) may experience occupational performance problems that go unrecognized and therefore may not be adequately supported. The cognitive orientation to daily occupational performance (CO-OP) approach has been effective in interventions for developmental coordination disorder (DCD). Based on an open-label, randomized controlled trial design, this study evaluated the effects of CO-OP on the occupational performance and motor skills of older kindergarten children with DCD-t using the School Assessment of Motor and Process Skills (S-AMPS) and the Movement Assessment Battery for Children, Second Edition. Children with a total DCDQ score of less than 40 or M-ABC2 scores in the 5th to 16th percentile were considered to have DCD-t. Furthermore, children with DCD-t and S-AMPS process skills less than 0.7 were considered to have DAMP (Deficits in Attention, Motor control and Perception)-t. After 3 months of CO-OP intervention, the performance and motor skills of children with DCD-t improved significantly. However, there were no significant changes noted in the motor skills of children with DAMP-t, although their occupational performance improved. These results suggest that CO-OP is effective even for older kindergarten children with DCD-t. However, further improvement of the CO-OP approach or a different strategy is required for children with ADHD comorbidity.

Efficacy and Feasibility of the CO-OP Approach in Parkinson's Disease: RCT Study Protocol.

Background. Parkinson's disease (PD) leads to cognitive dysfunction which limits participation and occupational performance. Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is effective in other adult neurological populations and warrants investigation in PD. Purpose. To describe a study protocol evaluating the preliminary efficacy and feasibility of CO-OP approach in PD. Method. A randomised controlled trial (RCT) with adults with PD was assigned to either: CO-OP training-intensive (CO-OP-I, 20 sessions) or waitlist control (WLC) followed by CO-OP-standard (CO-OP-S, 10 sessions). Outcomes. Occupational performance and satisfaction of adults with PD in chosen goals. Measures will be obtained at baseline, post-intervention, and 3-month follow-up. Implications. As the first RCT focused on CO-OP in PD, this trial will provide evidence for the potential of this approach in PD and lay the groundwork for future large-scale trials. Trial Registration. New Zealand Clinical Trials Registry, ACTRN12621001483842. Registered November 1, 2021; retrospectively registered 3 months after commencement.

Terapia motora cognitiva: descrição e análise clínica de crianças com Transtorno do Desenvolvimento da Coordenação (TDC),

Abstract Introduction It is estimated that 6% of school-age children have Developmental Coordination Disorder (DCD), characterized by motor difficulties that restrict participation at home, in the community and at school. The Cognitive Orientation to Daily Occupational Performance Approach (CO-OP) is effective in improving the functional performance of these children, but there is little clinical data on variations in the response to the intervention. Objective To identify and describe the most relevant characteristics of children with DCD that influence their response to CO-OP. Method Case study conducted with four children with DCD who underwent CO-OP: the two who had the highest gain and the two who had the lowest gain with the intervention. The data obtained in this study were categorized and synthesized to compose a clinical description of the participants’ characteristics. Results Parents of children with better performance showed better parenting style. Unstructured observation of the researchers during the collections showed that the families of the children with greater progress attended the collections more often and were more engaged. Greater family support seems to provide children with more confidence, as well as increase motivation to achieve goals in therapy. Conclusion The support offered by parents is a relevant factor for the good performance of children with DCD in the intervention using the CO-OP. The clinical description of children with DCD assists in the reasoning during professional practice because it identifies characteristics that can influence progress in the intervention.

Cognitive Orientation to daily Occupational Performance (CO-OP) for Older Adults After a Hip Fracture: A Pilot Study

In-home therapy provides the opportunity for rehabilitation intervention to be completed in the context of the patient's natural environment. However, most studies have focused on the effects of physical exercise, leaving a gap in understanding the effectiveness of a more task-oriented intervention that addresses individual preferences. To assess the feasibility and preliminary efficacy of the Cognitive Orientation to daily Occupational PerformanceTM (CO-OP) approach, delivered at home with older adults after a hip fracture to improve functional outcomes. Single-arm quasi-experimental design. Patients' home. Nine participants (age ≥60 yr) being discharged home from an inpatient rehabilitation ward in a geriatric hospital in a central city in Israel. Up to 10 1-hr weekly face-to-face sessions in using the CO-OP approach. The Canadian Occupational Performance Measure was used to measure performance and satisfaction with the patients' level of participation in daily functioning. A 30% recruitment rate, an 81% retention rate, were observed, with 88% of the participants expressing high to very high overall satisfaction with the intervention. Friedman test results indicated statistically significant improvements in occupational performance and satisfaction on trained and untrained goals (p < .01). The findings suggest that a home-based CO-OP intervention is feasible and potentially beneficial for older adults who are returning home after a hip fracture. What This Article Adds: This study shows that a task-oriented intervention can be effective in helping older adults return home successfully after a hip fracture.

The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach is superior to ordinary treatment for achievement of goals and transfer effects in children with cerebral palsy and spina bifida – a randomized controlled trial

Purpose Children with cerebral palsy (CP) or spina bifida (SB) often have executive dysfunction affecting activity performance. With the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach, children find their own way to perform activities, using problem-solving strategies and meta-cognitive thinking. The present study aimed to investigate the effectiveness of the CO-OP Approach in children with CP or SB, compared with conventional rehabilitation, in achieving self-identified activity goals, and to explore any generalization and transfer effects. Method Randomized controlled trial, CO-OP versus treatment as usual, 38 children (7–16 years) participated. Each child identified four goals (to study generalization and transfer, one remained untrained). Primary outcomes: Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS). Secondary outcomes assessed executive functions and self-rated everyday-life competence. Results Self-rated goal attainment (COPM) was significantly greater for both trained and untrained goals in the CO-OP group compared with the control group. The rating of observed performance (PQRS) was significantly higher for trained goals in the CO-OP group. The CO-OP group experienced fewer problems in everyday life after treatment. Executive functions did not differ significantly between groups. Conclusion CO-OP is more effective than ordinary treatment in achieving both trained and untrained goals. IMPLICATIONS FOR REHABILITATION CO-OP enables children with CP (MACS levels I–III) or SB without intellectual disabilities to reach self-identified goals. CO-OP shows transfer effects to new activities and situations, which may enhance children’s self-efficacy. CO-OP is an important complement to conventional rehabilitation services for children with CP and SB.

Exploring the use of the Cognitive Orientation to daily Occupational Performance approach (CO-OP) with children with executive functions deficits after severe acquired brain injury: A single case experimental design study.

to assess whether the use of CO-OP could be of interest in children with EF deficits after ABI, to improve their occupational performance, their executive functioning in everyday life and their cognitive processes constituting EF. This was a single case experimental study with multiple baselines across individuals and behaviors. We included 2 children at least 6 months after severe ABI. The children received 14 individual sessions of the CO-OP intervention. Each child set 3 goals by using the Canadian Occupational Performance Measure; 2 goals were trained and the third was a control goal. The achievement of the goals was measured by using repeated measures of Goal Attainment Scales (GASs). Ecological assessments of EF included the Children's Cooking Task and parent and teacher ratings of the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire. both children improved their performance on both trained goals (and, to a lesser extent, on untrained goals). We found significant improvement on tests of EF and on the BRIEF questionnaire, reflecting executive functioning in everyday life, at home and at school. these results are encouraging and suggest the feasibility and effectiveness of CO-OP for children with EF deficits after ABI. They should be replicated in a larger number of cases. ClinicalTrials.gov (NCT04718688).

Efficacy of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach with and without parental coaching on activity and participation for children with developmental coordination disorder: A randomized clinical trial

BackgroundCognitive Orientation to daily Occupational Performance (CO-OP) is recommended for its effectiveness in improving activity performance in children with Developmental Coordination Disorder (DCD). Since parental support is a key element in CO-OP, parental coaching seems relevant to be investigated. AimsCompare the efficacy of the CO-OP Approach with and without additional parental coaching to improve activity and participation in children with DCD. Methods and proceduresRandomized clinical trial with 7–12-years-old children with DCD, randomly assigned to experimental (E-group) or active control (AC-group) groups, with 11 children each. Both groups received traditional CO-OP, E-group received four additional parental group-coaching sessions. Occupational performance and satisfaction on intervention goals were measured at baseline, post-intervention, and follow-up. Participation, motor performance and executive function were assessed at baseline and post-intervention. Outcomes and resultsCO-OP with and without additional parental coaching resulted in improved occupational performance according to children, parents, and external evaluators. Children showed statistically significant gains in motor performance and cognitive flexibility. Participation measures did not change. Conclusions and implicationsAs coaching did not add additional gains, parent’s required participation in CO-OP might be enough to support children’s occupational performance.

Cognitive Orientation to Daily Occupational Performance Approach in Iranian Elderly Without Cognitive Impairment: A Single-Subject Study

Objective: The elderly population in Iran is growing. Aging is a natural phenomenon that causes changes in brain structures, including the frontal lobe and its connections, which are responsible for the brain’s executive functions. These structural changes lead to problems in cognitive and physical functioning. Older people face problems such as decreased performance in daily activities of life and participation in social activities. In cognitive orientation to the daily occupational performance approach, the participants learn to improve their motor performance using cognitive strategies. The effectiveness of this approach has been reported in stroke, Traumatic Brain Injury (TBI), and some childhood disorders. This study aimed to investigate this approach’s feasibility and its effect on the Iranian elderly without cognitive problems. Materials &amp; Methods: A single-subject study A-B design with follow-up was conducted. The participants were two older adults referred to Ramsar Health Center, Ramsar City, Iran. Before the intervention, to examine the participants’ cognitive status, we used Digit Span Forward to measure attention and Digit Span Backwards and Digit Symbol to measure working memory. The participants’ executive function was also assessed by the Wisconsin Card Sorting Test and Independence in Activity of Daily Living (ADL) with Functional Independent Measure (FIM). Each participant selected three functional goals by Canadian Occupational Performance Measure (COPM) for the focus of the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention. After two weeks of evaluating participants’ performance on selected goals using the Performance Quality Rating Scale (PQRS) to determine baseline performance, the intervention period began. During this period, a total of 8 to 10 sessions were held for each participant. In these sessions, the participants were first taught global problem-solving strategies (Goal, Plan, Do, Check), and then they were introduced to domain-specific strategies and their importance in executing activities. Afterward, through guided discovery during implementation, they were directed to use these strategies in their execution by guided discovery. During this period, the participant’s performance on the selected goals was assessed five times by the PQRS. At the end of the intervention, to evaluate the long-term impact of the intervention, the participant’s performance on the selected goals was re-evaluated by the PQRS three times. Results: The PQRS results showed that the performance of the first participant in each of the three selected activities improved. The results of the PQRS for the second participant showed a significant improvement in performance on the two selected goals. However, one of the selected goals did not show a significant change, which may be related to this goal’s nature. Participants’ net scores in FIM and COPM showed improved performance and satisfaction on selective goals, and performance independence remained constant. Conclusion: The CO-OP approach is feasible in the Iranian elderly population, and the preliminary results indicate the positive impact of this approach on improving the performance in the trained goals. However, given the study limitations in interpreting the results, it is recommended that future studies with a larger sample size be conducted to evaluate the effectiveness and efficacy of this approach. It is also recommended to use alternative tools instead of PQRS to evaluate the results, given the different cultural contexts.

Parents' Experience with the CO-OP Approach: A Consolidation of Three Qualitative Investigations.

In the cognitive orientation to daily occupational performance (CO-OP) approach, parent involvement is critical for transferring skills from therapeutic settings to everyday contexts. This study aimed to gain insight into the experience of parents whose children with developmental coordination disorder participated in CO-OP intervention. This consolidation of three small qualitative studies investigating parents' experience involved an inductive qualitative content analysis of 10 parent interviews and 1 parent focus group. Four overarching themes emerged as depicting parents' experience. Although parents recognized the improvements their children made with the intervention, they also expressed several challenges, such as incorporating CO-OP tasks into daily routines, shifting of parent-child relationship and feeling self-efficacious with the approach. This study highlights that parent observation of intervention sessions is not enough to support parents applying CO-OP at home. Research is needed to understand how to best engage parents in the CO-OP approach.

Increasing Generalization and Caregiver Self-Efficacy Through Cognitive Orientation to Daily Occupational Performance (CO-OP) Training

Abstract Date Presented 03/28/20 Generalization and caregiver involvement are core concepts of the CO-OP approach; however, no research to date has studied the interplay between them. Caregivers of children who received CO-OP intervention participated in an approach-specific training program that aimed to increase their self-efficacy in assisting their child to acquire new skills and measure their child’s ability to generalize the learned strategies to the home. Primary Author and Speaker: Rebecca Pierpont Additional Authors and Speakers: Eliza Berman Contributing Authors: Mary Hildebrand

Minimal Clinically Important Differences in Functional Independence After a Knowledge Translation Intervention in Stroke Rehabilitation

ObjectiveTo examine the odds of persons with stroke achieving minimal clinically important difference (MCID) in functional independence during inpatient rehabilitation relative to cognitive impairment (CI) severity, site, and rehabilitation teams’ exposure to a Cognitive Orientation to daily Occupational Performance (CO-OP) knowledge translation (KT) intervention. DesignA pre-post observational study was conducted using data from a centralized referral system. Our research team implemented a CO-OP KT intervention as part of a larger study aimed at training teams to use the CO-OP approach. SettingFive inpatient rehabilitation units. ParticipantsCases extracted from a centralized referral system from the 5 participating units. InterventionsNot applicable. Main Outcome MeasuresThe FIM instrument data from 12 months preintervention and 6 months postintervention were analyzed. A logistic regression was performed to determine the odds ratios (ORs) for achieving MCID based on sample cohort (historical control not exposed to CO-OP KT vs post-CO-OP KT intervention), controlling for site and severity of CI. ResultsA model that considered the intervention, admission score, CI severity, and site was the best fit for the cases analyzed. Those with severe CI were less likely to achieve FIM total MCID compared to those with no CI (P=<.001; OR=.18; 95% confidence interval, .09-.39). Taking site and CI into account, cases post CO-OP KT intervention were significantly more likely to achieve MCID on FIM motor (P=.048; OR=1.4; 95% confidence interval, 1.00-1.98) than historical controls. ConclusionThe CO-OP KT intervention is associated with increased odds of achieving MCID in the FIM motor subscale in inpatient stroke rehabilitation.

Cognitive strategy on upper extremity function for stroke: A randomized controlled trials.

Cognitive orientation to daily occupational performance (CO-OP) is a task-specific training applied using a cognitive behavioral approach to improve performance in daily activities and to enable the patient to overcome limitations related to them. The purpose of this study was to investigate the effects of the CO-OP approach in comparison with task-specific upper extremity training (TUET) on performance related to daily and functional activities in individuals with chronic hemiparetic stroke. Forty-nine participants diagnosed with stroke for the first time underwent 30 minutes of either the CO-OP approach or TUET 5 days a week for 4 weeks. We evaluated their performance on the box-and-block test (BBT), Canadian occupational performance measure (COPM), and community integration questionnaire (CIQ) and Wolf motor function test-functional score (WMFT-F) before and after the training. Our results show a significantly improvement in the WMFT-F, COPM-P, COPM-S, BBT, and CIQ scores after training in the CO-OP group, but only COPM-S score was significantly improvement after training in TUET group (p < 0.05). This study also found higher increases in the mean WMFT-F, COPM-P, COPM-S and BBT scores in the CO-OP group than in the TUET group, but CIQ score did not have a significantly higher increase between-group after training. The results of this study suggest that the CO-OP approach resulted in a positive therapeutic effect on self-selected occupational performance and daily and functional activities in individuals with chronic hemiparetic stroke.

Cognitive approach to rehabilitation in children with hyperkinetic movement disorders post-DBS.

This proof-of-concept feasibility trial examined the potential of the Cognitive Orientation to daily Occupational Performance Approach (CO-OP) to augment deep brain stimulation (DBS) outcomes in childhood-onset hyperkinetic movement disorders (HMD) including dystonia and dyskinetic cerebral palsy. This is a single case experimental design using multiple baseline as n-of-1 trial comprising 10 intervention sessions, with replications across participants (n = 10). Treatment focused on 3 participant-selected goals. Transfer was assessed on 2 additional untreated goals. Individuals enrolled were 6-21 years of age and had DBS in situ and sufficient manual ability. Primary outcome was functional performance change on the Performance Quality Rating Scale-Individualized (PQRS-i) measured before, during, and posttreatment, and at 3-month follow-up. Assessors of outcome were blinded to time of assessment, number of intervention session, and treatment allocation. To measure effect size, a nonoverlapping index, Tau-U, was used. Feasibility measures were captured. One participant withdrew before baseline assessment. Effect sizes of at least 0.66 were seen at both posttreatment and follow-up with all participants showing improvements in at least one trained goal in PQRS-i. Six participants improved on all 3 goals and 2 improved on 2 trained goals. Two children showed deterioration in one trained goal each. Transfer to untrained goals was observed in 3 participants for a total of 5 goals. CO-OP was feasible and acceptable to all participants. A cognitive-based, task-oriented approach to support performance of personally relevant functional skills enabling participation is acceptable in childhood-onset HMD post-DBS. Further, preliminary efficacy to improve outcomes and proof of concept with CO-OP has been established in this population. This study provides Class IV evidence that for children with HMD who had undergone DBS, CO-OP improves performance of personally relevant functional skills.

Feasibility and Effects of the CO-OP Approach™ in Postconcussion Rehabilitation.

We determined the feasibility and effects of the Cognitive Orientation to daily Occupational Performance (CO-OP) ApproachTM on activity performance and satisfaction, symptoms, and mood of adolescents with persistent postconcussion symptoms. In a prospective case series, 3 participants with persistent symptoms 3 mo after concussion and difficulties resuming activities were taught to use a metacognitive strategy (Goal-Plan-Do-Check) to work toward occupation-based goals in a 7-wk intervention (10 sessions, 30-60 min each). Participants were assessed pre- and postintervention and at 3-mo follow-up. Feasibility was determined by positive changes on study measures, ease of administration, and acceptability to participants. Clinically significant, positive changes were found in participants' activity performance and satisfaction. All participants had decreases in symptoms and improved mood scores at posttest. The CO-OP Approach to rehabilitation for youth postconcussion is feasible and may make a positive contribution to recovery.

Potential benefits of the cognitive orientation to daily occupational performance approach in young adults with spina bifida or cerebral palsy: a feasibility study

Purpose: People with cerebral palsy (CP) or spina bifida (SB) often struggle to perform everyday-life activities. Both groups frequently also have difficulties in creating and using strategies effectively when performing tasks. The cognitive orientation to daily occupational performance (CO-OP) Approach combines the learning of cognitive strategies with task-specific approaches through a client-centred procedure. The aim of this study was to investigate whether the CO-OP Approach is feasible for and potentially beneficial to adolescents and young adults with CP or SB in Sweden by analysing four areas of feasibility (acceptability, efficacy, adaptation, and expansion).Methods: Exploratory multiple-case study using mixed methods. Ten persons aged 16–28, five with each condition, participated in an intervention period. Assessments were performed on three occasions: baseline, post-intervention, and six-month follow-up.Results: The result demonstrates that the CO-OP Approach has the potential to enable adolescents and young adults with either condition to achieve personal goals and to enhance their planning skills and their ability to use strategies when performing activities. This approach is also compatible with the core values of habilitation in Sweden and was found by the participants to be highly meaningful and useful.Conclusions: The CO-OP Approach is feasible for adolescents and young adults with SB or CP in Sweden.Implications for rehabilitationThe Cognitive Orientation to daily Occupational Performance• is a feasible approach for adolescents and young adults with spina bifida and with cerebral palsy.• is a promising approach when it comes to enabling the achievement of personal goals.• might have potential to enhance executive functioning through strategy use.• is in line with the fundamental core values of disability rights of inclusion, empowerment, and participation.