Cognitive Orientation to daily Occupational Performance (CO-OP) for handwriting in children with Developmental Coordination Disorder (DCD).

Abstract

This paper explores the evidence for using a top down approach: cognitive orientation to daily occupational performance (CO-OP), on handwriting difficulties in children with developmental coordination disorder (DCD). Difficulties in handwriting is one of the top reasons for referral to occupational therapy among school-aged children. If left untreated, it could affect the child's self-esteem, emotional wellbeing and academic performance. Children with DCD are especially predisposed to having handwriting issues as they present with marked impairments in motor performance. Though there may be a number of reasons contributing to handwriting difficulties, this paper looks at handwriting difficulties that are a result of DCD, which affects motor abilities. Traditionally, bottom up approaches have been the main mode of intervention for this population. They are still predominantly being used today despite lack of sufficient evidence to support its efficacy. In recent years, there has been a shift towards top-down approaches such as cognitive strategies. One such example is the CO-OP. Preliminary evidence has found CO-OP to be successful when used on children with DCD. However, more research needs to be done to strengthen the evidence base for such top down approaches. The aim of this study is to investigate the effectiveness of using CO-OP to improve motor performance in children with DCD, using handwriting performance as an indicator for improvement. The findings of this study will better inform our knowledge on the efficacy of CO-OP as a top down approach with regards to the specific outcome of handwriting, and therefore strengthen the evidence base for CO-OP as a treatment protocol for children with DCD.