Cognitive orientation to daily occupational performance (CO-OP): part III--the protocol in brief.

Parts I and II of this series introduced the Cognitive Orientation to daily Occupational Performance (CO-OP), a new approach to intervention that is based on the premise that cognition plays an important role in the acquisition of occupational skills and the development of occupational competency. Developed for use with children who have occupational performance deficits, CO-OP is an individualized, client-centred approach focused on strategy-based skill acquisition. This third paper in this series presents a brief description of the actual CO-OP protocol including its objectives, prerequisites and key features.

Cognitive orientation to daily occupational performance (CO-OP): part I--theoretical foundations.

This paper is the first in a series of three papers that present the systematic development and evaluation of Cognitive Orientation to daily Occupational Performance (CO-OP). CO-OP is a cognitively based, child-centred intervention that enables children to achieve their functional goals. In Part I, the breadth of literature that provides the theoretical underpinnings for the approach is reviewed. Parts II and III provide a description of the approach and present the evidence to support its use with children with developmental coordination disorder.

Clinical description of children with developmental coordination disorder.

Occupational therapists working within School Health Support Services are receiving increasing numbers of referrals, relative to past rates, for children who are experiencing motor problems and may have developmental coordination disorder. Based upon clinical experience, therapists indicate that these children are typically referred in the early school years and that most have handwriting difficulties; to date, however, there has been little empirical evidence to support these observations. In this paper, descriptive information is presented for 556 children who may be presumed to have developmental coordination disorder and who had been referred to school-based health services in two centres. Typical reasons for referral, co-morbidity information, and assessment practices are presented. Findings confirmed the presence of many occupational performance issues in this population, including handwriting difficulties, and challenge therapists to broaden the current scope of school health assessment and intervention practices.

A clinical trial of the process-oriented treatment approach for children with developmental co-ordination disorder.

The process-oriented treatment (POR chi) approach is a time-limited programme aimed at increasing the kinaesthetic performance of children with mild motor problems in order to improve their motor performance. The approach was compared with a traditional or general motor approach and with no treatment in a randomized clinical trial of 75 children with developmental co-ordination disorder. The children were assessed before and after treatment and after a six-week follow-up period. The results were mixed. The study provides evidence of the severity of so-called 'mild' motor problems of children referred to occupational therapy. The data suggest that these children do not improve spontaneously, and that their motor problems are very resistant to treatment. The data also suggest that an appropriate treatment strategy might be one that involves direct, repetitive training of a specific skill.