The Outreach Program (TOP) in the Kent School District assists young adults in their transition from high school to adulthood. The research team and Dr. Abbott, an occupational therapist at TOP, sought to address whether better outcomes when teaching instrumental activities of daily living (IADLs) to adolescents with intellectual disabilities occur when addressing underlying performance skills and client factors through the Cognitive Orientation to Occupational Performance (CO-OP) approach or when addressing them through traditional occupational therapy practices. There is strong evidence to support CO-OP as an effective strategy to improve performance and moderate evidence indicating that it improves executive functioning and cognitive flexibility for a variety of diagnoses. We recommend CO-OP be integrated into traditional therapy practices and that additional research is conducted to explore group implementation and include more diagnoses.

Student researchers developed and presented an inservice presentation on the use and implementation of CO-OP in the school setting. An opportunity to receive Competency Assessment Units for NBCOT certification renewal through participation in a study group was provided during the inservice presentation to occupational therapists in Kent School District. Outcomes of this presentation were monitored through a survey to gain an understanding of whether the occupational therapists present would consider implementing CO-OP in their everyday practice. The findings suggest that the majority of people who attended the inservice presentation were interested in seeking more information regarding CO-OP without participating in the NBCOT study group. Additional research in the form of a scoping review is recommended in order to investigate what approaches best support developing autonomy and independent problem-solving in adolescents with intellectual disabilities.

Publication Place

Tacoma, Washington


University of Puget Sound

Project Chairperson

Jennifer Pitonyak, PhD, OTR/L, SCFES


Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound