Exploring the Use of the CO-OP With Children With EF Functions Deficits Following ABI
Condition: Acquired Brain Injury
MeSH terms: Brain Injuries
Study type: Interventional

Summary: 
      Purpose:

      Acquired brain injury (ABI) in childhood are the cause of disabling motor, cognitive and
      behavioural disorders, with severe consequences on the later development of autonomy and
      learning, with long-term repercussions on independence for activities of daily living, and
      social and professional integration. Among cognitive disorders, executive function (EF)
      deficits are among the most frequent and disabling, with major consequences on the
      development of autonomy and the course of schooling and learning. The Cognitive Orientation
      to daily Occupational Performance (CO-OP) could be an interesting approach for the
      rehabilitation of these consequences. CO-OP is a performance-based treatment approach for
      children and adults who experience difficulties performing the skills they want to, need to
      or are expected to perform. CO-OP is a specifically tailored, active client-centered approach
      that engages the individual at the meta-cognitive level to solve performance problems.
      Focused on enabling success, the CO-OP approach employs collaborative goal setting, dynamic
      performance analysis, cognitive strategy use, guided discovery, and enabling principles. It
      has been shown to be effective in a variety of populations, but has been little explored in
      children with ABI.

      Objectives To assess whether the use of CO-OP could be of interest in children with executive
      functions deficits following ABI, to improve their occupational performance, their executive
      functioning in everyday life and their cognitive processes constituting EF.
    

Detailed description: 
      Method

        -  Single case experimental study with multiple baselines across individuals and behaviors

        -  14 individual sessions of CO-OP intervention.

        -  Two goals trained, one control goal.

        -  Different assessments used : Canadian Occupational Performance Measure (COPM), the Goal
           Attainment Scales (GAS), the Children's Cooking Task (CCT) and parent- and
           teacher-ratings of the Behavior Rating Inventory of Executive Functions (BRIEF)
           questionnaire.
    

Intervention name(s): CO-OP rehabilitation
Intervention type(s): Other
Intervention description(s): The intervention was included within the child's conventional rehabilitation program.
In the CO-OP original protocol, the child sets 3 goals. Here, we concentrated on two rather than three goals, as addressing three occupations per session seemed too ambitious given the children's cognitive profile (the third goal served as control goal).
We chose to increase the number of sessions to 14 (two sessions per week for seven weeks, vs ten in the original protocol).
The global strategy was taught to the child at the first session. The following sessions consisted of an iterative process of implementation of the global strategy in the context of guided discovery to identify domain specific strategies to overcome performance ''breakdowns" the children were experiencing when performing the self-selected tasks. In addition, "homework" was assigned to encourage the application and practice. Parents were invited to attend the sessions if it was possible for them.
Intervention model: Single Group Assignment
Intervention model description: single case experimental study design (SCED) with multiple baselines across individuals and behaviors
Masking: None (Open Label)
Primary purpose: Other
Keywords: Cognitive Orientation to daily Occupational Performance; Rehabilitation; Executive functions; child acquired brain injury; occupational performance