The CO-OP Approach

Cognitive Orientation to daily Occupational Performance (CO-OP; CO-OP Approach) is a performance-based treatment approach for children and adults who experience difficulties performing the skills they want to, need, to or are expected to perform. CO-OP is a specifically tailored, active client-centered approach that engages the individual at the meta-cognitive level to solve performance problems. Focused on enabling success, the CO-OP Approach employs collaborative goal setting, dynamic performance analysis, cognitive strategy use, guided discovery, and enabling principles. These elements, all considered essential to the CO-OP Approach, are situated within a structured intervention format, and may involve the parent/significant other as appropriate.

Internationally acclaimed by therapists and researchers, CO-OP is a therapy that guides individuals to independently discover and develop cognitive strategies to perform the necessary tasks of everyday living such as dressing, grooming, writing, bicycling, swimming, typing, and other daily living skills.

Evidence-based practice (EBP) is the term used in healthcare to indicate that practitioners are using the best available evidence to ensure that the interventions they provide have undergone a rigorous scientific review process. Health care practitioners are expected to use interventions that have high level evidence supporting their use. 

CO-OP is an evidence-based approach in three ways:

  1. Its theoretical foundations are based on evidence,
  2. The CO-OP Approach itself has been carefully researched, with a number of populations making it one of the most researched approaches in rehabilitation (see the breadth of peer-reviewed publications on the approach).
  3. Therapists who use CO-OP with individual clients do assessments and collect evidence throughout the intervention to ensure that the client is learning cognitive strategies and acquiring their chosen skills.

CO-OP has a solid theoretical foundation and research repeatedly demonstrates its success.

The success of the CO-OP Approach is highlighted by Helene Polatajko in the Ted Talk video below:



The CO-OP Approach was developed to provide therapists with an evidence-based approach to enabling performance success in an effective and efficient way. CO-OP is not only supported by a broad research base but is also embedded in an evidence framework. Originally designed for children with Developmental Co-ordination Disorder, that is children with motor-based performance problems, it has demonstrated efficacy in helping children and adults with a variety of diagnoses acquire skills and experience success in performing everyday activities that are important to them.

The goal of the CO-OP Approach is to enable individuals with performance difficulties, be they physical, cognitive, or other, to succeed in performing the everyday tasks and activities that are important to them. CO-OP uses a process of guided discovery to enable the identification of the specific strategies that will support performance success. In CO-OP individuals learn how to talk themselves through performance problems.

CO-OP Objectives

  • Skill acquisition
  • Development of cognitive strategies
  • Generalization of skills and strategies to everyday life
  • Transfer of learning to new skills and contexts.


The CO-OP Approach benefits both children and adults. Research has been conducted with the following populations:

  • Developmental coordination disorder (DCD)
  • Acquired brain injury (ABI)
  • Autism spectrum disorder (ASD)
  • Pervasive developmental disorder (PDD)
  • Asperger’s syndrome
  • Attention deficit hyperactivity disorder (ADHD)
  • Cerebral palsy
  • Developmental disabilities
  • Dyslexia
  • Childhood-onset hyperkinetic movement disorders including dystonia
  • Older healthy adults with cognitive complaints
  • Stroke
  • Traumatic brain injury (TBI)


CO-OP was developed in the early 1990s by Dr. Polatajko working with research students and colleagues to meet the needs of children experiencing motor-based performance problems for whom existing approaches were proving ineffective. Embedded in a learning paradigm, it adopted a unique perspective on the performance problems experienced by children with developmental coordination disorder. To ensure the children experienced success, the CO-OP Approach was designed to be a task-oriented, problem-solving approach that enabled children to be actively engaged in solving their performance problems and experiencing success. Since its original introduction, research has demonstrated CO-OP’s efficacy for a wide variety of children and adult populations. In 2011, in Toronto, an international meeting of CO-OP scholars was held, leading to the formation of the International CO-OP Academy. In 2019, a not-for-profit corporation called the International Cognitive Approaches Network (ICAN) was formed to build on and further the work of the Academy.

More information about CO-OP is available in a free, online, introductory course available here.