Protocol summary

Study aim
Determining the effect of the "cognitive orientation to daily occupational performance" (CO-OP) approach on occupational and motor performances performances in children with Autism spectrum disorder (ASD).
Design
Clinical trial with control group, parallel groups, double-blind, randomized with SPSS software, on 30 patients.
Settings and conduct
Occupational Therapy Clinic - Autism Special Schools
Participants/Inclusion and exclusion criteria
In this study, the main inclusion criteria include children aged 7 to 12 years with a diagnosis of high-functioning ASD, the ability to communicate verbally in Persian. The main exclusion criteria include children with intellectual disabilities or progressive neurological disorders, children whose parents do not cooperate or withdraw from the study, and children who are unable to complete interventions or assessments for medical reasons.
Intervention groups
This study will be a clinical trial and will include two intervention and control groups: 1. Control group: Children in this group will receive routine occupational therapy treatment at the center, which will be assessed in two sessions (pre-test and post-test) with research tools. Routine treatment in this study refers to a set of common occupational therapy interventions that are typically provided in rehabilitation centers for children with ASD. 2. Intervention group: Children in this group will receive routine treatment along with a CO-OP-based intervention. This intervention is designed based on the standard protocol developed by Polatajko et al. and is structured and based on cognitive learning. The CO-OP-based intervention is designed as a structured 12-session protocol (45-60 minute sessions) in children aged 7 to 12 years. The sessions will be held 2 days a week.
Main outcome variables
Occupational performance; Performance satisfaction; Motor skills

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20260207068781N1
Registration date: 2026-03-15, 1404/12/24
Registration timing: prospective

Last update: 2026-03-15, 1404/12/24
Update count: 0
Registration date
2026-03-15, 1404/12/24
Registrant information
Name
Seifolah Jahantabi Nejad
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 61 3333 7352
Email address
jahantabi-s@ajums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2026-04-09, 1405/01/20
Expected recruitment end date
2026-06-21, 1405/03/31
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
The effect of the "cognitive orientation to daily occupational performance" (CO-OP) approach on occupational and motor performances in 7-12 year old children with Autism spectrum disorder
Public title
The effect of CO-OP approach on occupational and motor performances in children with Autism spectrum disorder
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Children must be between the ages of 7 and 12. Having high-functioning autism spectrum disorder (based on the ASSQ questionnaire) and a diagnosis from a pediatric psychiatrist. Have the ability to communicate verbally in Persian. An IQ greater than or equal to 70 (based on the WISC Children's Test or its equivalent in the medical record). No intellectual disability or progressive neurological disorders. Completion of informed consent by the child or parent.
Exclusion criteria:
Unwillingness of the child or parent to continue participation at any stage prior to randomization.
Age
From 7 years old to 12 months old
Gender
Both
Phase
N/A
Groups that have been masked
  • Investigator
  • Outcome assessor
Sample size
Target sample size: 30
Randomization (investigator's opinion)
Randomized
Randomization description
After meeting the entry requirements, obtaining written informed consent, and completing a pre-test assessment, participants will be randomly assigned to two intervention and control groups with a 1:1 allocation ratio. In this study, a block randomization method with variable block sizes will be used to maintain a balance in the number of samples in the two groups and reduce the predictability of the allocation sequence. The randomization unit will be individual, and the random sequence will be generated using SPSS version 25 software by a member of the research team who has no role in implementing the intervention and evaluating the outcomes. In order to reduce allocation bias, allocation concealment will be performed sequentially through the use of opaque, sealed, numbered, and sealed envelopes, such that after completing the baseline assessment of each participant, the relevant envelope will be opened and his or her group will be determined. The outcome assessor will be blind to the group allocation of the participants and will not interfere in the randomization and intervention allocation process.
Blinding (investigator's opinion)
Double blinded
Blinding description
In this study, pre-test and post-test assessments are conducted by an independent, blinded evaluator who has no knowledge of the children's allocation to the intervention or control group. The principal investigator is also blinded to the children's grouping during data collection. The occupational therapist conducting the intervention sessions is aware of the CO-OP method for operational purposes, but is not responsible for data evaluation. Due to the nature of the CO-OP-based occupational therapy intervention, blinding of participants was not possible. The staff of the treatment centers and schools also have only the necessary information for operational support and are blinded to the group allocation. This design reduces assessment bias and increases the validity of the study results.
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Ahvaz Jundishapur University of Medical Sciences
Street address
Ahvaz - University City - Ahvaz Jundishapur University of Medical Sciences - Vice Chancellor for Research and Technology - First Floor - University Research Ethics Working Group Unit
City
Ahvaz
Province
Khouzestan
Postal code
6135715794
Approval date
2026-01-31, 1404/11/11
Ethics committee reference number
IR.AJUMS.REC.1404.585

Health conditions studied

1

Description of health condition studied
Children with high-functioning Autism Spectrum disorder
ICD-10 code
F84.0
ICD-10 code description
Autistic disorder

Primary outcomes

1

Description
Comparison of occupational performance scores in children with Autism spectrum disorder.
Timepoint
At the beginning of the study (before the intervention) and immediately after the end of the intervention (post-test).
Method of measurement
Canadian Occupational Performance Measure

2

Description
Comparing satisfaction with occupational performance of children with Autism spectrum disorder.
Timepoint
At the beginning of the study (before the intervention) and immediately after the end of the intervention (post-test).
Method of measurement
Canadian Occupational Performance Measure

3

Description
Comparison of motor skills scores of children with Autism spectrum disorder.
Timepoint
At the beginning of the study (before the intervention) and immediately after the end of the intervention (post-test).
Method of measurement
Bruininks-Oseretsky Test Of Motor Proficiency, Second Edition

Secondary outcomes

empty

Intervention groups

1

Description
Intervention group: Intervention group: In addition to receiving routine treatment, children in the intervention group will receive an intervention based on the Cognitive Orientation to daily Occupational Performance (CO-OP) approach. This intervention is designed based on the standard protocol developed by Helen Polatajko et al. and has a specific, staged structure and is based on cognitive learning. The intervention consists of 12 sessions of 45 to 60 minutes, two days a week for six weeks. The sessions are held in a controlled environment of occupational therapy centers or special schools for autism, and each session consists of three stages: review of goals and planning (5 minutes), active practice with the “goal-plan-do-check” cycle (30 minutes), and final feedback (10 minutes). To maintain motivation and prevent fatigue, activities are divided into shorter intervals and 2–3 minute breaks, symbolic games, and a reward system are applied. Parents will also be present at some sessions to observe the intervention process and receive the necessary training to transfer the strategies to the home and school environment. The CO-OP intervention consists of three main phases: 1. Preparation (sessions 1 and 2): Includes an initial assessment with COPM and BOT-2 to identify person-centered goals and training in the general CO-OP strategy and self-talk. 2. Skill acquisition and intervention (sessions 3 to 11): Practicing strategies on the child's chosen goals using guided discovery and dynamic performance analysis, along with training parents to transfer the strategies. 3. Reassessment (session 12): Measuring changes in performance and satisfaction with COPM and changes in motor skills with BOT-2 and providing feedback and guidance to parents to generalize the strategies in the child's daily life.
Category
Treatment - Other

2

Description
Control group: Children in the control group will receive routine occupational therapy at the center. This treatment includes a set of standard and common occupational therapy interventions that are usually provided in rehabilitation centers for children with autism spectrum disorder and aims to improve motor function, participation in daily activities, and increase social and play skills. Routine therapy interventions include sensory-motor activities, gross and fine motor skill practice, activities related to personal care and daily living, and play therapy. In this group, unlike the CO-OP intervention group, explicit training in cognitive strategies and systematic use of the “goal-plan-do-control” cycle will not be provided. Pre-test and post-test assessments will be conducted for all participants in the control group using the COPM and BOT-2 research instruments to measure changes in occupational performance, satisfaction with performance, and motor skills.
Category
Treatment - Other

Recruitment centers

1

Recruitment center
Name of recruitment center
Ahvaz Jundishapur University of Medical Sciences
Full name of responsible person
Saifollah Jahantabi-nejad
Street address
Iran-Ahvaz-Golestan Highway-Ahvaz Jundishapour University
City
Ahvaz
Province
Khouzestan
Postal code
6135715794
Phone
+98 61 3311 0000
Email
eduaum@ajums.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Ahvaz University of Medical Sciences
Full name of responsible person
Dr. Abdollah Rafiei
Street address
Ahvaz, University City - Vice President for Research and Technology, Ahvaz Jundishapur University of Medical Sciences and Health Services - Ground Floor
City
Ahvaz
Province
Khouzestan
Postal code
6135715794
Phone
+98 61 3373 8383
Email
itc@ajums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Ahvaz University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Ahvaz University of Medical Sciences
Full name of responsible person
Seifolah Jahantabi Nejad
Position
Associate Professor
Latest degree
Ph.D.
Other areas of specialty/work
Occupational Therapy
Street address
Golestan Ave
City
Ahvaz
Province
Khouzestan
Postal code
6135715794
Phone
+98 61 3333 7352
Fax
Email
jahantabi-s@ajums.ac.ir

Person responsible for scientific inquiries

Contact
Name of organization / entity
Ahvaz University of Medical Sciences
Full name of responsible person
Seifolah Jahantabi Nejad
Position
Associate Professor
Latest degree
Ph.D.
Other areas of specialty/work
Occupational Therapy
Street address
Golestan Ave
City
Ahvaz
Province
Khouzestan
Postal code
6135715794
Phone
+98 61 3333 7352
Fax
Email
jahantabi-s@ajums.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Ahvaz University of Medical Sciences
Full name of responsible person
Seifolah Jahantabi Nejad
Position
Associate Professor
Latest degree
Ph.D.
Other areas of specialty/work
Occupational Therapy
Street address
Golestan Ave
City
Ahvaz
Province
Khouzestan
Postal code
6135715794
Phone
+98 61 3333 7352
Fax
Email
jahantabi-s@ajums.ac.ir

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Not applicable
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
Title and more details about the data/document
Individual participant data (IPD) and related study documents from the clinical trial on occupational therapy in children with Autism Spectrum Disorder. The dataset includes de-identified participant-level information for all study variables, including primary outcomes (occupational performance, satisfaction with performance, motor skills) and relevant demographic characteristics. All personal identifiers have been removed to ensure confidentiality. The shared documents also include the study protocol, statistical analysis plan, and informed consent forms
When the data will become available and for how long
Individual participant data and study-related documentation will be available for sharing for six months after the publication of the main study results. The access period will be from 1405 AH after the access start date.
To whom data/document is available
Access to the individual participant data and related study documents will be granted only to researchers affiliated with academic or scientific institutions who submit a reasonable request. Researchers from industry may also request access if their proposed analysis aligns with the scientific objectives of the study and is approved by the study steering committee.
Under which criteria data/document could be used
The provided data and documents are intended solely for research and scientific purposes by academic researchers and investigators affiliated with scientific institutions. Any secondary analysis of the data must ensure participant confidentiality, with all identifying information removed. Commercial use or publication of the data without written permission from the research team is prohibited. Requesting researchers must specify the purpose and type of analysis in their application, and access will be granted upon approval by the research team.
From where data/document is obtainable
To receive the study data and documents, applicants can send their request via email to the principal investigator, "Dr. Seifollah Jahantabi-nejad", at the email address "jahantabi-s@ajums.ac.ir". If necessary, it is also possible to send a postal correspondence to the address "Khuzestan-Ahvaz-Golestan-Ahvaz Jundishapur University of Medical Sciences-Faculty of Rehabilitation Sciences". After being reviewed and approved by the research team, the requests will be submitted to the applicant within a specified period of time.
What processes are involved for a request to access data/document
The applicant must first submit a written or emailed request to the principal investigator, including the purpose of data use and research details. The research team will review the request and, if the documentation is complete and ethical and privacy requirements are met, approve it. After approval, de-identified data or documents will be provided to the applicant in electronic or printed format. The review and provision process is usually completed within 2 to 4 weeks after receiving a complete request.
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