Comparison of CO-OP and goal-directed training on occupational performance and functional status in children with cerebral palsy: Three-armed randomised trial.

No follow-up assessments were conducted, so it is unknown whether the gains at 12 weeks were maintained. The study was run at a single centre with one therapist delivering all interventions and one evaluator scoring all outcomes. Children with intellectual disability, GMFCS level V, epilepsy, or autism were excluded, so the findings do not extend to those populations. Twenty children per group is a modest sample; the authors note that larger studies may clarify the size of the differences. The CO-OP and goal-directed training groups each received an additional 60 minutes of therapy per session beyond the conventional programme, so the comparison is not between two equal-time interventions.

The authors report no competing interests. No industry funding is mentioned in the text.

Do not read the null PEDI comparison between goal-directed training plus standard therapy and standard therapy alone as evidence that goal-directed training is ineffective. It did produce significantly higher COPM performance and satisfaction scores than standard therapy alone. The two approaches appear to work through different mechanisms, and the study's population excluded children with intellectual disability, GMFCS level V, epilepsy, or autism, so the result does not generalise to those groups.