Cognitive Orientation to daily Occupational Performance (CO-OP) Approach
The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach is a therapy intervention that helps children develop motor skills by building problem-solving abilities and learning strategies that work best for them.
CO-OP differs from many traditional therapy approaches in that the therapist does not rely only on direct instruction or hands-on guidance. Instead, the therapist helps the child think through the activity, identify what is difficult, and develop a plan in the child’s own words. This approach helps children build independence, confidence, and problem-solving skills that can carry over to other daily activities.
The CO-OP Approach includes Four Steps:
- Goal: The child and caregiver come up with relevant goals for what the child needs or wants to do.
- Plan: With guidance and support from the therapist, the child develops a plan for how to complete the task.
- Do: The child carries out the plan.
- Check: The child is guided to assess the following:
i)Was the plan used?
ii)Did the plan work?
If the plan did not work, the caregiver then guides the child on how to modify the plan.
What Guided Discovery Looks Like
A key component of CO-OP is guided discovery. This means the therapist helps the child find solutions by asking questions and encouraging problem-solving, rather than immediately providing a solution.
This approach helps the child learn to reflect on their performance, try strategies, and discover what works best for them. The therapist will often help the child change one part of the task at a time, then try it again to see whether performance improves. If a child needs more support, the therapist may offer choices, simplify the question, or model part of the task. The goal is to provide only the level of support needed while keeping the child actively involved in problem-solving and learning.
Why Families May Choose CO-OP
CO-OP can help children become more independent in everyday activities by building skills in a way that is meaningful and personalized. Because children are involved in making their own plans and evaluating what works, they often develop strategies they can carry over to new tasks at home, at school, and in the community.
Who Can Benefit?
CO-OP is commonly used with children who have difficulty learning or performing motor skills needed for everyday activities. These skills may include dressing, handwriting, using playground equipment, riding a bike, and participating in sports or play. Evidence supports using CO-OP in children with but not limited to:
- Developmental coordination disorder
- Cerebral palsy
- Autism
- Spina bifida
- Down syndrome
- Global developmental delay
- Children with executive functioning difficulties
Location of Service
CO-OP services are available through outpatient occupational and physical therapy at Cincinnati Children’s neighborhood locations.
