Cognitive Orientation to daily Occupational Performance

WHAT IS IT?

Cognitive Orientation to daily Occupational Performance (CO-OP) is an approach to intervention that uses a cognitive, or problem-solving approach to learning new skills for the successful performance of daily activities. It is a verbally-based approach that provides the child with problem-solving skills and verbal strategies that can be generalized to other challenging situations.

WHAT IS IT FOR?

The purpose of CO-OP is to allow children to improve their performance in everyday tasks and activities, by teaching them a method to think their way through learning new motor tasks.

There are 3 important objectives for the child:

1. Skill Acquisition 
- To develop skills in daily tasks which the child needs, wants, or is expected to do at home, school, and in play. Some examples include: writing, skipping, cutting food, bicycling, typing, etc.
2. Cognitive Strategy Development
- To learn a cognitive problem solving framework that the child can use to acquire and improve skills.
3. Generalization and Transfer
- To generalize and transfer the problem solving strategies and skills that have been learned in therapy into everyday life.

WHAT IS INVOLVED?

In most situations, it is recommended that the child and parent attend 10-12 weekly intervention sessions. Parent participation is an essential ingredient.

Key aspects covered during the course of CO-OP intervention are as follows:

1. The child identifies tasks that are difficult for them that they would like to improve on.

2. The therapist and child together analyze the child’s performance and identify where the child is getting stuck. Often video can be helpful.

3. The child is taught a “global” strategy [Goal, Plan, Do, Check] that is applied to all subsequent learning situations. The child learns the process of identifying a problem, setting goals, identifying possible solutions, selecting a strategy and evaluating its success.

4. The child is helped to “discover” specific strategies that will help them to perform tasks more successfully.

5. The child learns to perform the tasks that they have selected.

 Although the task and skills will, in fact, be learned, teaching the approach to learning and problem solving is the primary focus of intervention.

6. The child learns to generalize and transfer skills and strategies to other tasks and situations outside of the therapy environment. 

7. The child develops an increased sense of confidence to try new activities.

PARENT ROLE

The CO-OP approach works best when parents are involved! The role of the parent in CO-OP is to assist with generalization and transfer of the child’s newly acquired skills and strategies, and to support the child in the achievement of new skills beyond the treatment environment. You are the bridge! By using the same language and problem solving method throughout the child’s day, parents reinforce the learning and help the child to apply the strategies to daily activities.

Here are a few ideas to help with this:

1. Make learning and trying new things fun!
- Be playful and encourage the child to participate in games and activities that are interesting and motivating for them.

2. Reward the child’s effort and use of problem solving strategies.
- This will help to empower the child to see the connection between the use of cognitive problem solving and successful performance.

3. Use and reinforce the language ‘goal-plan-do-check’.

4. When the child is having difficulty with a task or activity, help them to discover successful strategies by providing hints, clues and examples rather than telling them what to do.

5. Encourage the child to “talk it through” when they seem to be struggling with a task or activity.

6. Focus on one thing at a time.