Implementing the Cognitive Orientation to Daily Occupational Performance (CO-OP) Approach with Children with Fetal Alcohol Spectrum Disorder: A Feasibility Study

Abstract

Background/objectives: This study examined the feasibility of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for improving occupational performance, satisfaction and participation in children with Fetal Alcohol Spectrum Disorder (FASD). Methods: A mixed-methods descriptive case series explored nine feasibility domains (acceptability, practicality, implementation, expansion, limited efficacy testing, demand, recruitment rate, participation rate, and data collection). Children identified three occupational performance goals to practice across 10 weekly 30–60 min sessions. Data was collected for three children. Pre- and post-intervention scores on the Canadian Occupational Performance Measure (COPM), Perceived Quality Rating Scale- Generic version (PQRS-G) and the Participation and Environment Measure for Children and Youth (PEM-CY), along with caregiver and child interviews, were analysed. Reflexive thematic analysis examined acceptability and practicality from participants’ perspectives. Results: Five children were screened, four enrolled and three female children (n = 3), aged 11–12 years completed post-CO-OP measures, and their results were analysed. Caregivers and children reported some improvements in goal performance and satisfaction on the COPM. CO-OP was perceived as acceptable by caregivers and children. Caregivers valued child-chosen goals, recognised the importance of practice for progress and retention, and noted that additional support to use CO-OP strategies at home would be beneficial. Conclusions: Findings provide preliminary support for CO-OP in enhancing occupational performance and participation for children with FASD. Evaluation with a larger sample is needed to further test feasibility and determine the approach’s efficacy.

The authors' abstract, as published at the source. Children, 2026 · DOI ↗