3. What do I do if my clients cannot answer the questions themselves, i.e. a young child or a client with a cognitive impairment?

Answer: It is important to hear the points of view of all clients, so we suggest that you try the COPM with the client first. The COPM has been used successfully with children as young as eight years old. If it is not possible to use the measure with a client, then look to alternatives. In these situations, it is important to determine the following: Who is the client? Who will be working with you on intervention? Is it the identified client or perhaps the caregiver, parent, spouse, teacher, nurse, etc.? You may need to broaden your thinking with respect to the client. The COPM can be used with caregivers, but remember that you will be gaining their perspective and issues, not those of the referred client. The respondents should be instructed to consider the needs of the client while describing their issues and expectations.