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Background and Aim: Although motor difficulties are not considered as a diagnostic criterion in Diagnostic and Statistical Manual of Mental Disorders: However its association with Attention Deficit Hyperactivity Disorder (ADHD) is commonly reported. CO-OP is a problem-solving approach developed to help children with Developmental Coordination Disorder and addresses their motor-based problems.  In this approach, therapist supports the children to use their cognitive strategies in a process of guided discovery to solve occupational performance problems. The objectives of CO-OP are to improve the motor performance of children with ADHD by helping them to discover various procedures to remove barriers and enhance supports by facilitating activities and participation. This study was designed to examine the influence of CO-OP on motor-based occupational performance of children with ADHD. 

Materials and Methods: A single case experimental design (multiple baseline) was used to examine the influence of a 12 weeks intervention of CO-OP (twice a week) on Six children with ADHD. Each child selected three different goals to practice during intervention. Outcome measures included the Canadian Occupational Performance Measure (COPM), and the Bruininks-Oseretsky Test of Motor Proficiency and Performance (BOTMP). At first and prior to the intervention, the COPM was administered to the children and parents separately to obtain a rating of performance and satisfaction of the child in selective goals. The CO-OP intervention protocol was based on Polatajko and colleagues' work in 2001. During intervention, children were taught the global problem solving strategies helping them to discover and perform domain-specific strategies. Therapist and family also supported children to achieve the performance of selected goals.

Results: The results of this study demonstrated improvements in both goals and motor performance in the participants due to the intervention. These results support the use of the CO-OP with children with ADHD.

Conclusion: Further research into the application of CO-OP with children with ADHD is warranted based on preliminary positive findings regarding the efficacy of this intervention to address motor-based performance difficulties.