What are the seven (7) key features of co-op?
- Client chosen goals
- Dynamic performance analysis
- Cognitive strategy use
- Guided discovery
- Enabling principles
- Parent significant other involvement
- Intervention format
What prerequisites does the child require for them to participate in co-op as an intervention? Why
are these required?
● Sufficient language fluency
● Responsiveness
● Ability to attend
● Motivation
What pre-requisites does the therapist require to work with the child using co-op and why are these
important?
● Behavioural management ● Learning principles ● Client-centered philosophy ● Understanding of disability ● Dynamic performance analysis (dpa) ● Guided discovery/mediational techniques
What is a dpa and why is it important? How does a dpa differ from an activity analysis or the
occupational analysis undertaken in 4qm?
● Dynamic performance analysis: motivation, task knowledge, performance competence
● Objectives: - to identify performance problems (with child environment and task); to identify potential
strategies to enable performance
● Co-ops version of occupational analysis in the 4qm
How and when do you use a dpa?
● You do it constantly throughout intervention, identifies where the task breaks down, questions if they
need to change strategies etc
● Look at task break-down and relate strategies to improve those tasks. Not looking at underlying
problem.
● Use with dpa clinical decision tree
What are the different types of strategies used in co-op
● Cognitive strategy use
● Global problem-solving strategy
● Domain specific strategies
● Good strategy use
How do you use Global problem-solving strategy
Have a goal > plan the goal > do the plan > check if it worked. Continue this process until
objective is met.
How do you use Domain specific strategies
BATSF 2Vs
- Body position – verbalisation of attention to or shift of the body, whole or part relative to the
task - Attention to task – verbalisation to cue attending to the doing of the task (e.G. ‘Where are you
looking when you are throwing the ball’) - Task specification/modification – discussion regarding the specifics or modification of the task
or parts of the task that facilitate motor performance (e.G. ‘Let’s put tape on the floor so you
know where to stand’) - Supplementation task knowledge – any verbalization of task specific information or how to get
task specific information (e.G. ‘We always start writing at the left; you make a capital a like this’) - Feeling the movement – verbalization of attention to the feeling of a particular movement as it
is being carried out (e.G. ‘Feel how tight you need to pull your hair – tight but not too tight; feel
the brush going straight through’) - Verbal motor mnemonic – involves the child attaching a name to the task or a component of
the task or body position, that evokes a mental image to guide motor performance (e.G. ‘What
does this letter remind you of? S is like a snake) - Verbal rote script – the child identifies a rote pattern of words to guide a motor sequence (e.G. ‘
7: Across and down; 8: starts like an s and keeps going; 5: across and down and a big fat belly)
note: there are other domain specific strategies for asd, cerebral palsy and traumatic brain
injury
How do you use Good strategy
○ Broad repertoire of strategies (global, specific)
○ Effort & strategy use effect performance (learns to attribute success to effort & application of
strategy)
○ Sufficient task knowledge is necessary for effective performance & strategy use
What do you guide discovery of? Why is it important to guide discovery?
● Guide discovery to individual’s personal strategies
● Important because it will help them to remember their own strategies in their next occupational
performance challenge
Provide at least one example of each of the domain specific strategies and an aspect of task
breakdown they would be useful in supporting?
● Ask don’t tell: what is going wrong; how did you do that; what do you need to do first; did this strategy
work better than that one…
● One thing at a time: one focus – activity or strategy; learn reinforce strategy before identifying others
● Coach, don’t adjust: experiment; compare/contrast
● Make it obvious: frame it in gdpc; problem solving needs to be modeled; remains the center of therapy
What techniques can you use to enable the child’s performance in co-op?
- Make it fun: laugh at self; state the ridiculous; play games; rhymes, silly words
- Promote learning
- Work towards independence
- Promote generalisation and transfer
What is the process you would follow to implement co-op with a child?
- Pre intervention: Set client goals, Dynamic performance analysis
- Intervention: Cognitive strategy use GPDC, homework, domain specific strategies, homework
- Post-intervention: Re-evaluate
**Throughout entire process ● Guide discovery ● Enabling principles ● Parent involvement ● Use materials to supplement performance
identify a similarity and a difference between co-op and 4QM?
○ In CO-OP, the child needs to be intrinsically motivated which facilitates their cooperation in
developing intervention, while in 4QM, the child needs the necessary performance components
to participate in occupations
○ Both CO-OP and 4QM is about moving towards autonomy in occupations and improve
occupational performance
○ CO-OP uses higher order questioning so that the child can figure how task breakdown and why
a certain action produces a certain consequence (guided discovery) – taking ownership of
problem and 4QM uses lower order questioning
How would you decide whether to use co-op or 4qm with a child who has having difficulty mastering
a self-care skill?
○ Relate it to the prerequisites needed in both CO-OP and 4QM and how that impacts on the
decision making for the appropriate tool to use
○ E.g. does the child have the necessary performance components
○ E.g. can the child communicate with the therapist or does he/she require physical patterning
What is the role of the therapist when using co-op?
- Use cognitive strategies (global specific and domain strategies) to enable successful
occupational engagement in individuals with performance problems - Enable skill acquisition through a process of strategy use and guided discovery
- Skills need to be appropriate to contextual and temporal features of occupation
- Promoting generalisation and transfer of skills
What is the role of the therapist when using 4QM
- Providing appropriate scaffolding in response to child’s changing needs à whether
scaffolding is initiated by facilitator or child and if the strategy is direct or indirect (child
comes up with strategies themselves) - Consider child and therapist characteristic and impact on teaching/learning process
(ALERT factors) - Develop autonomy in skills that lead to enhanced occupational performance in context
What is the role of the therapist when using OPC
- Guided discovery for the parent – for them to discover where the task breakdown is –
based on what the information the parent is giving the OT - Interview based with the parent – talking intervention
- Thinking and seeing what the parents see as the major issues that want to be ‘fixed’
- Providing the parent relevant information on how to help the child
- What questions need to be asked
- Careful about the language and how OT will structure it
How to set goals with clients using CO-OP
- Conversation with parents
- Framing/delimiting occupational goals
- Daily log
- PACS (Paediatric Activity Card Sort)
- PEGS
- COPM
- Establishing baseline performance-PQRS (Performance Quality Rating Scale)
What are cognitive startegies?
- cognitive tools put into place to help learn, memorize and problem solve
- goal directed, cognitive operations used to facilitate learning and problem solving
- a skill under consideration
Types of cognitive strategies
- Global Strategy
2. Domain Specific Strategy (DSS)
Therapist questioning in Body Position section of Domain Specific strategies
Childs strategy
How close is your body to the table?
How should you position your bottom on the chair?
“Glue my back to the chair”
“Stack my blocks”
“Line up my bellybutton”
Therapist questioning in Attention to Doing section of Domain Specific strategies
Childs strategy
“Where are you looking when you are throwing the ball”
“Let’s notice the difference”
“I need to focus”
“Eyes on the ball”
“Look at what I’m doing”
Therapist questioning in Task Specification Modification section of Domain Specific strategies
“Lets put tape on the floor so you know where to stand”
“start at the top of page to write t, l, h, f, b”
-
Week 128
-
Week 2 - 4QM23
-
Week 331
-
Week 6 - Learning Disabilities33
-
Week 5 - Performance Coaching30
-
Week 4 - Sensory Processing36
-
Week 813
-
Week 4 - ASD16
-
Week 2 - Developmental Delay14
-
Week 5 - ADHD6
-
Week 6 - Managing Handwriting Challenges14
-
Week 6 - Working in Educational Contexts3
-
Week 7 - Frame of Reference for Social Participation10
