Efficacy of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach with and without parental coaching on activity and participation for children with developmental coordination disorder: A randomized clinical trial.

Araujo et al. (2021) split the kids with developmental coordination disorder into two groups. One group got the standard CO-OP therapy. The other got CO-OP plus six extra parent-coaching sessions.

Therapists saw each child for ten one-hour sessions. Parents in the coaching group met for six group talks. The team tracked motor skills, daily activity success, and how often the kids joined in at home and school.

Both groups improved the same amount on motor tasks and daily living skills. The extra parent classes added no bonus.

Surprisingly, neither group raised their participation scores. Kids still joined recess, chores, and games at the same low rate as before.

Boets et al. (2011) showed that even preschoolers with DCD already take part less and enjoy activities less than peers. Soares now shows that CO-OP can fix the skill part but still leaves the participation gap untouched.

Coetzee et al. (2013) found that a short, school-based visual-therapy block gave big, lasting eye-movement gains for 7- to young learners. CO-OP gives similar quick motor gains, but both studies hint that one isolated skill program is not enough to raise real-world joining in.

Fusar-Poli et al. (2017) report high hyperactivity and emotional problems in the same age range. Taken together, the three papers suggest you need to pair motor training with behavior or participation strategies if you want kids to actually use the new skills at recess or at home.

You can stop asking parents to sit through extra coaching nights—time is better spent rehearsing skills in natural settings. Target participation directly: embed practice in recess games, PE warm-ups, or classroom jobs. Add self-monitoring or peer buddies to turn new skills into real-world use.