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. Issue 5 (27th February 2023)

• Record Type: Journal Article
• Authors: Peny-Dahlstrand, Marie; Hofgren, Caisa; Lindquist, Barbro; Bergqvist, Lena; Himmelmann, Kate; Opheim, Arve; Sjöwall, Douglas; Brock, Katarina; Öhrvall, Ann-Marie
• Is Part Of: Disability and rehabilitation. Volume 45:Issue 5(2023)
• Page Start: 822
• Page End: 831
• Publication Date: 2023-02-27
• Subjects: Cerebral palsy -- spina bifida -- metacognition -- executive function -- person-centred intervention -- goal-directed; People with disabilities -- Periodicals; Rehabilitation -- Periodicals; 617.03
• DOI: 10.1080/09638288.2022.2043459
• Languages: English
• ISSNs: 0963-8288

Abstract

Abstract: 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.