Canadian Occupational Performance Measure (COPM): A client- centered interview in parents and children with movement disorders

Therapeutic goal setting in children with movement disorders usually has its focus on improvement of body function. Often an intensive training program for children and their parents is mandatory. Rarely an evaluation of the effect for the everyday life is performed. We present our experience with the use of a standardized and client-centered interview, the Canadian Occupational Performance Measure (COPM), for goal setting on the participation level.

Methods: We performed the COPM in two children aged 10 and 12 Years (f/m) with bilateral and unilateral spastic cerebral palsy GMFCS-Level 3 and 1and in 6 mothers with children aged 2 to 12 years with cerebral palsy or developmental movement disorder. The COPM evaluates the client's self-perception of occupational performance. All problems, needs and wishes in the fields of self-supply (body, mobility) productivity (learning, playing, kindergarten, school), and leisure time are regarded. The client is asked how good he think he could perform a task, how satisfied he is with this and how import it is for him. By this the goals are specified and quantified and the COPM can be used as an outcome measure. The therapeutic goals of our patients on the level of body function were: regulation of tone, improvement of fine and groß motor coordination and joint mobility.

Results: With the use of the COPM

1) parents easily defined their goals on participation level, they felt comfortable, competent and engaged. However, on function level they felt incompetent and disengaged

2) goals of parents, children and therapists could be matched and the meaning of the physical activity for everyday life became visible

3) parents and children were better motivated for therapy

4) the children experienced themselves as persons with skills and weakenings, the deficit and diagnosis aspect played a minor role

5) goals were better specified and quantified and linked to precise interventions on the different ICF levels (function, participation and environment).

Therapeutic goals after COPM were: to be able to conduct a spoon to the mouth, to clean one's self on the toilette, to put the jacket on by one's self.

Conclusion: To our experience with a small group of children with movement disorders the COPM is a helpful tool for goal setting on the participation level in the children's everyday life. The participation of children and parents by identifying beneficial and obstructive factors improves their motivation for therapy.