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OBJECTIVE. We examined the effect of the Cognitive-Functional (Cog-Fun) occupational therapy intervention on executive functions and participation among children with attention deficit hyperactivity disorder (ADHD).
METHOD. We used a randomized, controlled study with a crossover design. One hundred and seven children age 7-10 yr diagnosed with ADHD were allocated to treatment or wait-list control group. The control group received treatment after a 3-mo wait. Outcome measures included the Behavior Rating Inventory of Executive Function (BRIEF) and the Canadian Occupational Performance Measure (COPM).
RESULTS. Significant improvements were found on both the BRIEF and COPM after intervention with large treatment effects. Before crossover, significant Time . Group interactions were found on the BRIEF.
CONCLUSION. This study supports the effectiveness of the Cog-Fun intervention in improving executive functions and participation among children with ADHD.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting 5% of school-age children (American Psychiatric Association, 2013). ADHD is characterized by significant difficulties with executive functions (EFs), defined as self-regulation constructs for effective self-management to attain one's goals. Included among EFs are emotional, cognitive, and behavioral regulation, such as inhibition and working memory (Barkley, 2012; Brown, 2013). Participation in occupations of personal care, household chores, academics, leisure, and social domains is often impeded by executive dysfunction among children with ADHD (Antshel, Hier, & Barkley, 2014; Biederman et al., 2004; de Schipper et al., 2015; Tseng & Gau, 2013).
The impact of neurocognitive deficits on participation among people with a variety of acquired or developmental disorders has been addressed by cognitive rehabilitation models in occupational therapy (Katz, 2011). Evidence has shown that these models have been effective for populations with EF impairment (Dawson et al., 2009; Polatajko, Mandich, & McEwen, 2011; Toglia, Johnston, Goverover, & Dain, 2010); however, they have not been systematically applied to children with ADHD (Cermak & Maeir, 2011). The Cognitive Orientation to daily Occupational Performance (CO-OP; Polatajko et al., 2011) is an important treatment approach that includes a major focus on metacognitive strategies within an occupational context. Although there is ample evidence for the use of the CO-OP approach for children with developmental coordination disorder (Polatajko et al., 2011), aside from a case study of a child with ADHD in which the CO-OP approach was used (Polatajko & Mandich,...