Intervention for Children with Disabilities

An occupational therapist working in the community children's center has been using the COPM to measure change after intervention for the children that she sees for therapy services. She is interested in looking at research that uses the COPM to evaluate the effectiveness of new and emerging occupational therapy interventions. Her caseload is broad and includes children with physical disabilities such as cerebral palsy and children with autism.

There have been many studies that have used the COPM as a primary outcome measure in evaluations of interventions for children with disabilities. We cite only a few of these here. For example, Sakzewski and colleagues (2011) measured the relative impact of constraint induced movement therapy and bimanual training with children with hemiplegia. Intervention was provided through a 10 day camp approach. In another study with young children with cerebral palsy, Darrah and Law et al (2011) used the COPM as the initial step in a context focused therapy intervention. They found no difference between the two therapy approaches and both groups showed significant changes on the COPM (average of 2.8 – 2.9 points in performance scores). In a recent study by Dunn and colleagues (2012), the COPM was used to measure the effect of an occupational therapy contextual intervention for children with autism spectrum disorders. Three components of intervention – authentic activity settings, families daily routines, and the child’s sensory processing patterns – were focused on through coaching strategies with parents of 20 children. Results indicated significant changes in performance participation on the COPM. The occupational therapist also provides some programs for the children she sees and their families. Thus, she was very interested to find the study by Novak and colleagues (2009) who, using the COPM, found statistically significant changes in the participation and daily functioning of children with cerebral palsy after occupational therapy home programs.

Darrah, J., Law, M. C., Pollock, N., Wilson, B., Russell, D. J., Walter, S. D., … & Galuppi, B. (2011). Context therapy: a new intervention approach for children with cerebral palsy. Developmental Medicine & Child Neurology, 53(7), 615-620.

Dunn, W., Cox, J., Foster, L., Mische-Lawson, L., & Tanquary, J. (2012). Impact of a Contextual Intervention on Child Participation and Parent Competence Among Children With Autism Spectrum Disorders: A Pretest–Posttest Repeated-Measures Design. The American Journal of Occupational Therapy, 66(5), 520-528.

Novak, I., Cusick, A., & Lannin, N. (2009). Occupational therapy home programs for cerebral palsy: double-blind, randomized, controlled trial. Pediatrics, 124(4), e606-e614.

Sakzewski, L., Ziviani, J., Abbott, D. F., Macdonell, R. A., Jackson, G. D., & Boyd, R. N. (2011). Participation outcomes in a randomized trial of 2 models of upper-limb rehabilitation for children with congenital hemiplegia. Archives of physical medicine and rehabilitation, 92(4), 531-539.

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