Cognitive strategy use by children with Asperger's syndrome during intervention for motor-based goals

Background:  Cognitive Orientation for (daily) Occupational Performance (CO-OP) is a cognitive approach utilised by occupational therapists to help guide children in the discovery of appropriate strategies for effective task performance through a structured problem-solving process. There has been limited research into its utility for children with Asperger's syndrome (AS). These children often present with motor difficulties, although these are not required for diagnosis of the syndrome. A recent study found that children with AS were able to use the CO-OP framework to enhance their performance of motor-based goals.
Methods:  This paper presents two case studies demonstrating the use of CO-OP with children with AS, and explores the global and domain-specific strategies and types of guidance utilised to improve their task performance. Two children with AS, aged 9 and 11, with above average intellectual ability, engaged in 10 sessions of CO-OP. All sessions were videotaped. One hundred minutes of randomly selected footage were coded per child using the Observer Software Package version 5.0.
Results:  The mean interrater agreement for the two children was 94.06% and 89.30%. Both children (i) utilised the global strategies 'do', followed by 'plan' and 'check', (ii) used at least three domain-specific strategies in each session with 'task specification/modification' and 'body position' utilised most, and (iii) used limited verbal self-guidance.
Conclusion:  These two children with AS were able to utilise cognitive strategies to effectively solve their motor performance problems. Children with AS and those with DCD used similar strategies to achieve motor goals. CO-OP appears to have potential as an effective intervention for children with AS. Study limitations, clinical implications and directions for future research are discussed.