- Recently, researchers in occupational therapy have investigated the use of a cognitive or "top down" approach to improving the occupational performance of children with developmental coordination disorder. A cognitive approach is multifaceted in nature and one essential component of such an approach is the use of cognitive strategies. Although strategy use has a long history within the education and psychology literature, little discussion within the pediatric therapy literature has occurred. This paper reports the results of an in-depth videotape analysis of therapists using cognitive strategies during occupational therapy intervention. Eight domain specific strategies were identified and elucidated. This research will be beneficial to therapists who wish to incorporate a cognitive approach into their clinical practice.