CO055
L'approche Cognitive Orientation to daily Occupational Performance (CO-OP) avec des enfants cérébro-lésés présentant des troubles des fonctions exécutives : analyse qualitative de l'engagement des proches-aidants
Eleonore
Dietrich
(Saint-Maurice, France),
Mathilde
Chevignard
(Saint-Maurice, France),
Hélène
Lebrault
(Saint-Maurice, France),
Rose
Martini
(Ottawa, Canada)
Objective :
Acquired brain injury (ABI) is the leading cause of death and acquired disability in children. Cognitive and behavioral sequelae are common, including executive functions (EF) deficits, for which metacognitive interventions have been shown to be effective. The Cognitive Orientation to daily Occupational Performance (COOP) approach integrates metacognitive strategies in problem solving around daily activities. The child’s caregivers’ involvement is a key feature of COOP that can enhance rehabilitation outcomes.
Objective: To analyse caregivers’ experience following a COOP intervention with children and adolescents presenting EF deficits resulting from severe ABI.
Objective: To analyse caregivers’ experience following a COOP intervention with children and adolescents presenting EF deficits resulting from severe ABI.
Material / Patients and Methods :
Following a COOP intervention using a single case experimental design, with twelve children/adolescents following severe ABI, we performed descriptive thematic qualitative analysis of caregivers’ semi-structured interviews, at three time-points (immediately and 3- and 6-months post-intervention).
Results :
The analysis of the interviews highlighted three themes: i- the child is an actor in his/her therapy; ii- the caregiver is the cornerstone that can amplify the effects of COOP; iii- COOP is mastered over time.
Discussion - Conclusion :
These themes highlight the progressive nature of proficiency in the COOP approach for both caregivers and children. This is evident in the children's improvement in task performance, but also in their ability to problem solve. For caregivers, their role in supporting the COOP approach also changes over time as their confidence in their child's problem-solving abilities increases, as well as in their own ability to adequately provide guidance. Engagement seems to be central in facilitating this progression for both children and caregivers.
Keywords :
Cognitive Orientation to daily Occupationnal Performance; rehabilitation; executive functions; acquired brain injury; caregivers; child; occupational therapy.