Vezinat Clarisse, Lebrault Hélène, Câmara-Costa Hugo, Martini Rose, Chevignard Mathilde
Rehabilitation Department for Children with Acquired Neurological Injury, Paris-Est Val-de-Marne Hospitals, Saint Maurice, France.
Faculty of Medicine, Sorbonne University, Paris, France.
Aust Occup Ther J. 2025 Aug;72(4):e70040. doi: 10.1111/1440-1630.70040.
Children with acquired brain injury (ABI) often have executive function (EF) deficits that affect their ability to carry out activities efficiently. Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive approach to problem-solving. It has demonstrated effectiveness in a variety of populations, most recently with children with EF deficits following ABI. One of the challenges of rehabilitation is transferring skills acquired during sessions into everyday life. The literature suggests that CO-OP enables transfer of skills to untrained tasks, but research on transfer following its use with children with ABI is limited. The aims of this study were (1) to determine whether skills acquired during CO-OP transfer to new untrained activities, (2) to study the possible influence of parental involvement in CO-OP on children's attainment of transfer goals, and (3) to determine if the degree of difference between trained and untrained goals is associated with achievement of transfer.
A quasi-experimental design was used. Eleven children with EF deficits following ABI took part in the study. At the end of CO-OP intervention, children identified three new goals. These 'transfer' goals were assessed at baseline (immediately post-intervention) and at 2-, 4- and 6-month, using the Goal Attainment Scale (GAS) and the self- and parent-rated Canadian Occupational Performance Measure (COPM). Children did not receive any specific intervention during this time.
There was no consumer and community involvement.
At 6 months, GAS indicated that 22 of 32 transfer goals had improved by at least one level. COPM showed a significant increase in (1) child perception of performance and satisfaction for 24/31 and 25/31 goals, respectively, and (2) parent perception of performance and satisfaction for 19/29 of goals.
This study showed that CO-OP facilitates transfer of acquired skills to new, untrained activities, even after the end of the intervention.
获得性脑损伤（ABI）儿童通常存在执行功能（EF）缺陷，这会影响他们高效开展活动的能力。日常职业表现认知取向（CO-OP）是一种解决问题的认知方法。它已在多种人群中证明有效，最近在ABI后存在EF缺陷的儿童中也得到验证。康复的挑战之一是将训练期间获得的技能应用到日常生活中。文献表明，CO-OP能够将技能迁移到未训练的任务中，但针对ABI儿童使用该方法后技能迁移的研究有限。本研究的目的是：（1）确定CO-OP训练期间获得的技能是否能迁移到新的未训练活动中；（2）研究家长参与CO-OP对儿童实现迁移目标的可能影响；（3）确定训练目标与未训练目标之间的差异程度是否与迁移的实现相关。
采用准实验设计。11名ABI后存在EF缺陷的儿童参与了本研究。在CO-OP干预结束时，儿童确定了三个新目标。这些“迁移”目标在基线（干预后即刻）以及2个月、4个月和6个月时，使用目标达成量表（GAS）以及儿童自评和家长评定的加拿大职业表现测量量表（COPM）进行评估。在此期间，儿童未接受任何特定干预。
未涉及消费者与社区参与。
在6个月时，GAS表明32个迁移目标中有22个至少提高了一个水平。COPM显示：（1）儿童对24/31和25/31个目标的表现感知和满意度显著提高；（2）家长对19/29个目标的表现感知和满意度显著提高。
本研究表明，即使在干预结束后，CO-OP仍有助于将获得的技能迁移到新的未训练活动中。
