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

Abstract

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 COOP 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 COOP 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 COOP Approach is feasible for adolescents and young adults with SB or CP in Sweden. ä IMPLICATIONS FOR REHABILITATION The 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.

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

“…Another innovation has been to test the feasibility, acceptability, and preliminary efficacy of a cognitive-based intervention known as cognitive orientation to occupational performance (CO-OP) [270]. CO-OP was originally designed for the developmental coordination disorder population where dyspraxia is the most important clinical sign [270], but now has promising evidence of efficacy for cerebral palsy, especially the dystonic type where treatment options are lacking [73][74][75][76]. In CO-OP, children set their own goals and are guided to discover and individualize strategies for successfully carrying out their goals, via a global problem-solving strategy "goal-plando-check" [270].…”

“…Once the child has self-identified a successful strategy, they practice the real-life task at high intensity, similar to other motor learning approaches [98]. Four studies have now been conducted in the cerebral palsy population suggesting CO-OP improves function at a low dose and low cost with large effect sizes (yellow light, weak positive) [73][74][75][76]. The conduct of a definitive trial is warranted.…”

“With CO-OP I’m the boss” – experiences of the cognitive orientation to daily occupational performance approach as reported by young adults with cerebral palsy or spina bifida

“…The participants in this study are the same individuals who participated in the feasibility study [23]. They were recruited through habilitation services in two different parts of Sweden.…”

“…To the best of our knowledge, this approach has not been used in those groups. Hence it was decided to conduct a pilot study [23]. The result from this study showed that COOP is a promising approach for enabling young people with cerebral palsy or spina bifida to achieve their personal goals and to enhance their occupational performance and executive functioning through strategy use [23].…”

“…Hence it was decided to conduct a pilot study [23]. The result from this study showed that COOP is a promising approach for enabling young people with cerebral palsy or spina bifida to achieve their personal goals and to enhance their occupational performance and executive functioning through strategy use [23]. CO-OP is a clientcentred/person-centred approach [19] and as such the person's own experiences are of paramount importance.…”