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Effectiveness of CO-OP Approach for Children With Neurodevelopmental Disorders: A Systematic Review
Emmanuel Madieu1,2, Sandrine Gagné-Trudel1, Pierre Yves Therriault1
1Department of Occupational Therapy, University of Quebec at Trois-Rivières, Trois-Rivières, Canada.
Insights
The Cognitive Orientation to Daily Occupational Performance (CO-OP) approach significantly improves daily activities and participation for children with neurodevelopmental disorders (NDDs). Group therapy shows promise for enhancing self-esteem and functional outcomes.
Area of Science:
- Occupational Therapy
- Pediatrics
- Developmental Psychology
Background:
- Neurodevelopmental disorders (NDDs) present significant challenges to children's daily functioning.
- The Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is a client-centered, goal-directed intervention.
- Evidence on the effectiveness of the CO-OP approach for children with NDDs requires systematic evaluation.
Purpose of the Study:
- To systematically review the scientific evidence on the effectiveness of the CO-OP approach for children diagnosed with NDDs.
- To synthesize findings related to the impact of CO-OP on occupational performance, activity, and participation.
- To identify gaps in the current research and suggest future directions.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (CINAHL, MEDLINE, PsycINFO, Scopus, etc.) for studies published between 2001 and 2022.
- Eligibility criteria focused on studies assessing CO-OP's effectiveness in children aged 0-18 with NDDs, excluding non-English/French and unpublished works.
- Study quality was appraised using the PEDro-P scale or RoBiNT, with data synthesized following PRISMA guidelines.
Main Results:
- Twenty studies were included in the review, with varying levels of evidence (III, IV, and V).
- Significant improvements were consistently observed in the activity and participation domains for children receiving the CO-OP approach.
- Group therapy sessions demonstrated promising outcomes for enhancing activities, participation, and psychosocial aspects like self-esteem.
Conclusions:
- The CO-OP approach demonstrates a positive impact on the functional abilities of children with NDDs, particularly in activities and participation.
- Group therapy models using CO-OP show potential for broader application and benefit.
- Further high-quality experimental research is needed to determine effect sizes and refine therapeutic protocols.
Objective:
To examine the scientific evidence regarding the effectiveness of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach for children with neurodevelopmental disorders (NDDs).
Data Sources:
Selected articles published between January 2001 and September 2020 and listed in CINAHL, MEDLINE, and PsycINFO on the EBSCO platform, or found searching with Scopus, Google Scholar, OTseekern Central Register of Controlled Trials in the Cochrane Library, WHO International Clinical Trials Registry Platform, Turning Research into Practice, and ProQuest Dissertations and Theses. An update was performed in March 2022.
Study Selection:
Eligibility criteria included studies that assessed the effectiveness of the CO-OP approach on children (0-18 years) with NDDs. Unpublished results were excluded, as well as research published in a language other than English or French.
Data Selection:
The first 2 authors independently reviewed the titles, abstracts, and full texts. Discrepancies were discussed and resolved by consensus. Included studies were quality appraised using the PEDro-P scale or using the risk of bias scale in N-of-1 trials (RoBiNT) according to experimental design.
Data Synthesis:
Results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eighteen studies were initially included, with 2 additional studies added in the update. Three reached evidence level III (15%), 10 reached level IV (70%), and 5 reached level V (15%). All data collected on the activity-participation domain showed a significant improvement. Group therapy sessions show promising results for the improvement of activities or participation, as well as psychosocial dimensions such as self-esteem.
Conclusions:
The scientific evidence analyzed shows that the CO-OP approach has a positive effect on children with NDDs, particularly in regard to their activities and participation. Future experimental studies should be designed in ways that allow determining effect sizes. Group therapy sessions appear relevant but require further research.
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