The COPM as a Framework

In Practice

When the COPM is completed by both parent and teacher, it can serve as a means of opening communication between them and identifying mutually agreed-upon goals.

In my work with younger, school-aged children, I use the COPM during the initial interview. It helps me get to know the concerns of a parent or teacher, and guides me in setting priorities for intervention. It is also an excellent medium to explain occupational therapy and the services that I can offer. At critical points in the service delivery process, I will use the COPM to stop and reflect with a parent and/or teacher about a child’s occupational performance. Many parents say that the COPM helps them to focus on what is really important. When the COPM is completed by both parent and teacher, it can serve as a means of opening communication between them and identifying mutually agreed-upon goals.

I view the COPM as both an outcome measure and as a framework for my interviews. It allows me the freedom to write the concerns of parents and teachers in words that we all understand. My intervention outcomes are occupation-based and meaningful to the child and family.

In the following case, I used the COPM to identify a mother’s perceptions of her son’s occupational performance at a critical point in the intervention process.

Chad

Chad is a nine-year-old boy who lives with his parents and one older sibling. His diagnosis is spina bifida (lumbosacral myelomeningolcele) and hydrocephalus. He walks independently when bilateral ankle foot orthoses are worn.

Chad has been receiving occupational therapy services from an outpatient children’s treatment centre since his family moved to the area one year ago. Services are now provided primarily in the school environment. Chad is currently in grade three, fully integrated in a class of 19 students with a teacher and part-time teaching assistant. During the occupational therapist’s most recent visit, some concerns were expressed by the teacher and teaching assistant about Chad’s behaviour and problems with the self-catheterization routine at school. The occupational therapist contacted Chad’s mother and decided to use the COPM to identify her perceptions.

The interview was held at home as this was considered to be the most comfortable environment for Mrs. T. to openly discuss her concerns. She identified three main problems:

  1. Chad needed to be more careful about keeping clean during self-catheterization;
  2. Chad was having difficulty attending to school tasks on his own, as he didn’t listen to the teacher’s instructions;
  3. Chad did not always play safely in the schoolyard, especially during the winter months.

The occupational therapist reviewed the results with Mrs. T., discussed the concerns of the school staff and together they established a plan of action. The results of this COPM were then discussed with school staff and it was agreed to focus efforts on these three areas.

Once these issues were addressed, new problem areas in Chad’s occupational performance were then identified by Mrs. T. using the COPM.

This table illustrates the change in Performance and Satisfaction for each of the prioritized occupational performance problems. (you may need to scroll horizontally to view all the data)

Occupational Performance Problem Time 1 Time 2
Performance Satisfaction Performance Satisfaction
Cleanliness during self-catheterization 6 3 8 10
Attending to school tasks 3 2 5 8
Playing safely outdoors at school 8 6 4 4
Total Scores: 17 11 18 22
Average Scores (Total Scores / number of problems): 5.7 3.7 5.7 7.3
Change Scores
(Time 2 – Time 1):
Performance Satisfaction
0 + 3.6

Leave a Reply

Your email address will not be published. Required fields are marked *