ChildDevelopmentRehab.Learning the Skills of Childhood

Last modified by Support on 2012/03/01 11:09


Research Recap
Learning the Skills of Childhood: Studies of the Cognitive Orientation to daily Occupational Performance Approach for Children with Motor Challenges

Summary prepared by: H. Polatajko and A. Mandich

Why did we do these studies?
Some children have trouble learning the physical skills that other children pick-up quite easily. Children with Developmental Coordination Disorder may be described as awkward or having motor coordination problems. Occupational performance refers to how well children can do the everyday activities they need to do on their own.

Taking part in everyday activities (e.g. throw a ball and use a computer) and being able to do self-care skills (e.g. comb hair and cut food) are key to the healthy development of children. One important predictor of success in school is how well children can perform motor-based activities (actions that involve the movement of muscles in the body). Children who are unable to participate in physical activities find it more difficult to join social groups and to make friends. When children fail to master the basic skills of
childhood — tying shoes, doing up snaps, riding a bike and learning to write their name — their lives are profoundly impacted.

Since there were no proven ways to help these children, we decided to develop a new approach to treating these children. We designed a treatment strategy based on behaviour and motor learning theory. The approach has the following characteristics:
        ∞ Quick (requires no more than 10 sessions)
        ∞ Portable (does not require specialized, large equipment)
        ∞ Effective at helping children learn motor skills.

The approach is based on Donald Meichenbaum’s four step problem solving strategy:
        1. Goal - What do I want to do?
        2. Plan – How am I going to do it?
        3. Do it
        4. Check – How well did my plan work?

Known as “Cognitive Orientation to daily Occupational Performance”, the approach builds on the children’s thinking skills. It encourages them to figure out how to do a skill by thinking about the smaller parts of the larger skill. For example, if the goal is to write your name, the necessary plans could include putting your fingers on the pencil, positioning the paper, holding the paper still, not pressing too hard, etc. We carried out a series of studies to test this new approach.

Who participated in the studies?
Children with a primary diagnosis of Developmental Coordination Disorder (DCD), 7-12 years old, participated in the initial studies. Some of the children also had a second diagnosis such as Attention Deficit Disorder (ADD).

How did we do the studies?
In our studies the children decided what they wanted to learn to do. The children then learned to use the four problem solving steps to get better at their chosen skills. In the first study we used a single-case experimental design with nine direct replications. In the second study, we used a systematic replication of the first using a different therapist and four new children. The third study was a detailed analysis of the videotaped treatment sessions from the first and second studies.

What did we find?
The first and second studies showed that the children could improve their performance of a variety of skills when they used cognitive strategies. The results indicated that this approach is promising and provides a solid foundation to further explore cognitive-based treatments for children with motor-based performance problems.

The videotape analysis revealed that in addition to the broad four-step problem solving strategy, the therapists provided child specific strategies related to the children’s chosen skills and their unique performance problems.

What do these findings mean?
The approach that helped children improve their performance was more than simply using the four-step problem solving strategy. The therapists also carefully analyzed the specific problems each child experienced and offered tailor-made strategies. Our findings demonstrated that a problem solving approach could help these children experience success and could possibly do it better than any other approaches.

What’s next?
We have since conducted and published a number of other studies evaluating other aspects of Cognitive Orientation to Occupational Performance (CO-OP).

For more information contact:
Dr. Helene Polatajko, Department of Occupational Therapy, University of Toronto

NOTES: FUNDING was provided for these studies by the Cloverleaf Foundation.

Created by CRRN CRRN on 2010/03/08 19:16