Child Occupational Self Assessment Form – Fill Out and Use This PDF

Child Occupational Self Assessment Form PDF Details

The Child Occupational Self Assessment (COSA) is a self-report instrument developed within the Model of Human Occupation (MOHO), a theory of occupational therapy created by Gary Kielhofner and colleagues. Designed for youth ages 6 to 17, the COSA invites children to rate their competence in everyday activities and the personal importance of those activities. Therapists use this evaluation to set therapy goals and track progress over time.

The assessment contains 25 items spanning four performance areas: Volition (motivation and personal values toward activities), Habituation (daily routines and roles at school and home), Communication and Social Skills (peer interactions and community participation), and Process and Motor Skills (cognitive and physical task performance). For each item, a child selects a competence rating ranging from "I have a lot of trouble doing this" to "I am really good at doing this," plus an importance rating on a three-point scale.

Research by Kramer and Federico provides evidence of strong construct validity for the COSA as an occupational therapy evaluation instrument. The COSA manual provides detailed administration guidelines, and version 2.2 was updated by Ten Velden and Kielhofner. The non-standardized score totals serve to identify where changes are occurring, guiding therapy interventions tailored to each child's needs. Download the Occupational Therapy Referral Checklist for additional therapy intake documentation.