Effectiveness of Cognitive Orientation to daily Occupational Performance for autistic children with developmental coordination disorder.

The study planned a randomised trial but analysed combined pretest-posttest data due to a smaller than anticipated sample, reducing statistical power from over eighty percent to seventy percent. The sample was restricted to autistic children without intellectual disability who could communicate verbally, so results do not apply to non-speaking children or those with intellectual disability. Sixty-two percent of the sample had co-occurring attention deficit hyperactivity disorder, which may have influenced the ability to transfer gains to broader motor proficiency. Some children received other therapies for social and communication skills during the study, and although motor-based interventions were paused, these additional supports could have influenced outcomes. The waitlist group completed baseline assessments three months after randomisation rather than simultaneously, making it difficult to fully isolate intervention effects from natural change over time. The waitlist group scored significantly higher on movement quality at pretest, and although improvement ranges were similar, this baseline imbalance complicates interpretation.

The authors declared no conflicts of interest. Funding was provided by the Waterloo Foundation, Canada Research Chairs, the University of British Columbia, the Faculty of Medicine at the University of British Columbia, and the Azrieli Foundation.

Do not interpret the significant statistical improvement in motor proficiency scores as evidence that the intervention generalises to broader motor ability. The authors state this change was not clinically meaningful, and follow-up analysis showed no significant change in motor proficiency over time.