“CO-OP is a client-centred, performance-based, problem solving approach that enables skill acquisition through a process of strategy use and guided discovery”
Motor learning has 3 distinct phases
- Cognitive phase: marked by disjointed movements. It is necessary to pause and think about each movement before attempting it.
- Associative phase: Less thought is required to carry out individual steps, however the overall task it is not yet fluid.
- Autonomic phase: no longer need to think about the movement and it gets more and more refined with practice.
Key features of CO-OP
- Client directed motivating goal
- Dynamic Performance Analysis
- Cognitive Strategy Use
- Guided Discovery
Dynamic Performance Analysis
- Identifying performance problems or break downs in the task
- Identify potential strategies to enable performance
- This can relate to the person, the environment or the task
Task: To put on a pair of shorts
- Person: both legs going into one side, right hand letting go of the pants, not bending body forward to hold pants open etc.
- Task: entire sequence for lower body dressing very complex
- Environment: difficult to balance and complete in standing position
- Person: prompt to hold onto pants with both hands, touch cue to facilitate bending
- Task: Start at point of being handed the pants in correct orientation. Use elastic loose shorts which are easier
- Environment: Complete sitting down
Skill Acquisition through strategy use:
A cognitive strategy is a tool put in place to help learn, memorize and problem solve.
Global problem solving strategy in CO-OP is Goal, Plan, Do, Check:
- Goal: What do I want to do?
- Plan: How am I going to do it?
- Do: Do it (carry out the plan)
- Check: How well did the plan work?
If the person can’t come up with a specific goal or plan:
- Supplementing task knowledge
- Verbal motor mnemonic to assist in remembering the plan
- Specify the exact task to be completed
- Demonstrate the task
If the person has trouble executing the movement:
- Feeling the movement
- Body Position
- Attention to task
- Task modification
If the person can do the movement but needs verbal guidance:
- Verbal guidance
- Verbal self-guidance
- Verbal rote script
- Complete the routine exactly the same way each time
- Everyone learns best if given the opportunity to problem solve situations and come up with solutions themselves.
- Ask lots of questions, comment on performance and give feedback
- That step seems hard?
- It seems that ________ is happening when we get to that part?
- Why do you think it isn’t working?
- Demonstrate what is happening to highlight breakdown and encourage problem solving.
- Which way do you think works better?
- I wonder what we could do differently?
- I wonder if this would work?