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the Child Occupational Self Assessment (COSA) is a client directed assessment tool and an outcome measure designed to capture children's and youth's perceptions regarding their own sense of occupational competence and the importance of everyday activities. Using the instrument in therapy provides a young client with an opportunity to identify and address their participation in important and meaningful occupations. The COSA consists of a series of statements pertaining to everyday occupational participation, and includes tasks related to school, home, and in the community. Its self-rating design allows the client to document his/her understanding of occupational competence and values using familiar visual symbols and simple language.