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영어

Objective : This study aimed to investigate the effects of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach on the quality of task performance in school-aged children with cerebral palsy and to examine whether the skills acquired could transfer to other tasks. Methods : The participant was an 8-year-old child diagnosed with cerebral palsy. A single-subject AB design was employed. The baseline phase consisted of three sessions conducted until data stabilization was confirmed. The intervention was delivered twice a week for 30 min per session, for a total of 10 sessions. Two tasks were selected to assess improvements in task performance: one task was directly trained using the CO-OP intervention, while the other to examine transfer effects, was not trained. Changes in task performance quality were measured using a handwriting assessment, and transfer effects were evaluated using a coloring task from the Bruininks-Oseretsky Test of Motor Proficiency (Filling in Shapes – Circle, Star). Results : The handwriting and coloring assessments showed that the average scores for both tasks increased during the intervention period compared to the baseline, indicating improved task performance quality. Notably, performance improvements were observed not only in the task trained using the CO-OP approach but also in the untrained task. During the intervention phase (B), the scores exceeded two standard deviations from the baseline for at least two consecutive sessions, demonstrating a significant change. Conclusion : The CO-OP intervention was effective in improving task performance quality in a school-aged child with cerebral palsy and demonstrated that the skills acquired could transfer to new tasks. The findings indicate the clinical significance of the CO-OP approach, which may apply to school-aged children. Its effectiveness needs to be confirmed in this population.

한국어

목적 : 본 연구는 학령기 뇌성마비 아동에게 인지기반 작업수행중재법(Cognitive Orientation to daily Occupational Performance; CO-OP)을 적용하여 학습과제 수행의 질에 미치는 효과와 훈련된 기술의 다른 과제 전이 가능성을 확인하고자 하였다. 연구방법 : 연구 대상은 뇌성마비 진단을 받은 만 8세의 아동 1명이며, 연구설계는 개별 실험연구(single subject research design) 중 AB설계를 적용하였다. 기초선 단계는 자료가 안정화될 때까지 총 3회 수행하 였으며, 중재는 주 2회, 회당 30분씩 총 10회 진행하였다. 작업수행 향상을 확인하기 위해 두 과제를 선정하 였으며, 하나는 CO-OP 중재를 통해 훈련을 실시하고, 다른 하나는 전이 효과 확인을 위해 훈련하지 않았다. 학습과제 수행의 질 변화는 글씨쓰기 평가로, 전이 과제 수행은 색칠하기 평가(Bruininks-Oseretsky test of Motor Proficiency, Filling in shapes – circle, star)로 측정하였다. 결과 : 글씨쓰기와 색칠하기 모두 기초선에 비하여 중재기간 동안 평균 점수가 증가하여 학습과제 수행의 질 이 향상되었다. 특히 CO-OP 접근법으로 훈련한 과제뿐만 아니라 훈련하지 않은 과제에서도 수행 향상이 나타났으며, 중재기(B)에서 2회 이상 연속으로 2 표준 편차를 초과하는 유의미한 변화가 확인되었다. 결론 : CO-OP 중재는 학령기 뇌성마비 아동의 학습과제 수행의 질 향상에 효과적이며, 습득된 기술이 새 로운 과제로 전이될 수 있음을 확인하였다. 또한 CO-OP 접근법이 학령기 아동에게도 적용 가능하며, 그 효과가 확인되었다는 점에서 임상적 의의가 있다.