Cognitive Orientation to Daily Occupational Performance CO-OP wk.8

CO-Op Approach

1. Client-chosen goals

2. Dynamic performance analysis

3. Cognitive strategy use

4. Guided discovery

5. Enabling principles

6. Parent or caregiver involvement

7. Session structure and format

(Polatajko & Mandich, 2004)

History

developed in the 1990s for children with developmental coordination disorder (DCD)

now focus on the importance of cognition in skill acquisition

CO-OP Approach Goals 

enables various populations with a variety of occupational performance issues, including motor-based performance issues, to use cognitive

strategies to attain their occupational performance goals

• skills acquired can be generalized to real-worlk situations and transferred to novel tasks 

5 Components 

1. Client-centered
2. Performance-based
3. Problem solving
4. Strategy use
5. Guided discovery

Client Centered

collaborative partnership with client starting at goal setting and continuing through all aspects of the interaction

General Communication Strategies for Goal Setting

Be direct

ask for clarification… like “tell me more about___ “

open ended questions

address one topic at a time

don’t make assumptions

don’t think about the next topic while the client is still talking about topic at hand

Performance Base

when used to describe an intervention, indicates that the intervention is focused on goal-oriented performance; rather than on underlying processes

top down approach —> shifts from deficit driven models to learning models

Perspective is Performance Based

intervention is explicit, task-specific, and goal driven

CO-OP initiated w the identification by the client of 3 occupational performance goals using the COPM

uses the Performance Quality Rating Scale (PQRS) as a tool specifically designed for the CO-Op approach that rates performance on a scale of 1-10 scale

Dynamic Performance Analysis (DPA)

begin w performance based assessment

involves direct observation or reported observations in all aspects of the performance

• a dynamic process that cannot be done in isolation of the actual performance

Focuses on the idiosyncrasies of the performance by a specific person in a specific context

Careful attention is paid to the various aspects of the performance, such as

movements performed relative to the skills required and the fit with occupational and environmental demands

Problem Solving

Problem solving is the ability to combine previously learned knowledge in a new way to solve a new problem.

◦ From a learning perspective, performance issues are viewed as a problem to be solved.

◦ Problem solving is a higher-order cognitive process. It is considered the most complex of all cognitive functions.

◦ Generally held that all people can become more effective problem solvers through the use of problem-solving strategies

Strategy Use

Strategies are tools or plans of action used for accomplishing a task or achieving a purpose; they are always goal directed (Toglia, Rodgers, & Polatajko, 2012).

Cognitive Strategy USe

GOAL-PLAN-DO-CHECK is a cognitive strategy!

involved in all activities that require thinking, planning, and decision making

throughout the Cognitive Orientation to daily Occupational Performance intervention, therapist and client are engaged in iterative exchange about goal, plan, implementation of plan, and checking

Global Cognitive Strategy

Include the GOAL-PLAN-DO-CHECK strategy

◦ Higher order strategies used to control or coordinate other strategies

Domain-specific (DSS)

Specific to a person, situation, task, or part of a task.

◦ Introduced to solve specific performance issues as they arise and are often used only for a short time.

◦ Not taught like global strategies, but discovered during the dynamic performance analysis DPA) process.

some DSS include task specification, verbal, mnemonic, body positioning, verbal self guidance, etc.

◦ Guided discovery ensures that the client is actively engaged in problem solving and identification of domain-specific strategies, becomes skilled at

the process, and feels ownership of the solutions and that the developed strategies are relevant to the client in his or her real-world context.

Guided Discovery 

◦ A method of instruction designed to facilitate active learning
◦ Elicits the learner’s active involvement in the discovery of new learning
◦ Between direct ‘teaching’ and pure discovery learning
◦ More effective than discovery learning in supporting skill acquisition and transfer
◦ Using guided discovery ensures that the learner identifies the solutions that make sense, fit with existing knowledge, and have relevance to real-world context

Guided Discovery 4 Catchphrases

1. One thing at a time

2. ask, don’t tell

3. coach, don’t adjust

4. make it obvious

CO-OP Perspective of Human Occupational Performance

The unique perspective on occupational performance that is inherent in Cognitive Orientation to daily Occupational Performance is that the person’s individual cognitive process has primacy in occupational performance

It all starts with the person !

understand role cognition!