Purpose
Assess basic cognitive and visual perception skills
Link to Instrument
Acronym
LOTCA
Area of Assessment
CognitionSensation & Pain
Mental Functions
Primary Image
Loewenstein Occupational Therapy Cognitive Assessment
Discover Careers at Shirley Ryan AbilityLab
We're hiring! Browse jobs and apply today.
Sensation & Pain
Mental Functions
Populations
Key Descriptions
- Used to measure basic cognitive skills to perform ADLs/IADLs, including orientation, visual perceptual/psychomotor abilities, problem solving skills and thinking operations (Stroke Engine).
- Scoring:
1= patient does not perform task
2= patient performs part of task
3= patient performs most of task
4= patient performs task well - Higher score indicates less cognitive impairment
Number of Items
20
Time to Administer
45 minutes
30-45 minutes
Required Training
Reading an Article/ManualAge Ranges
Original
0 - 69
yearsLOTCA-G
70 - 91
yearsInstrument Reviewers
Reviewed by Heidi Jasper-Petrozzino and Kimberly Okechukwu in December 2016.
Considerations
Can be administered over multiple sessions.
Normative Data
Intellectual Disabilities: (Jang et al, 2009; n=111 with intellectual disabilities, n=19 with no disabilities)
LOTCA Normative Data |
|
|
|
|
|
Category | Subscale | No Disability | Mild Disability | Moderate Disability | Severe Disability |
Orientation |
| 16 (0.2) | 13.4 (2.3) | 10.2 (3.8) | 7.6 (4.8) |
| Orientation place | 8 (0.2) | 7.1 (1) | 5.5 (2) | 4.4 (2.5) |
| Orientation time | 8 (0.0) | 6.4 (1.7) | 4.8 (2.2) | 33 (2.6) |
Visual perception |
| 16 (0.0) | 15.4 (1.2) | 14.6 (2) | 13.8 (2.1) |
| Objects identification | 1 (0.0) | 4 (0.0) | 3.9 (0.3) | 3.8 (0.4) |
| Shapes identification | 4.0 (0.0) | 3.8 (0.6) | 3.6 (0.8) | 3.5 (0.9) |
| Overlapping figures | 4.0 (0.0) | 3.8 (0.5) | 3.5 (0.8) | 3.1 (0.7) |
| Object consistency | 4.0 (0.0) | 3.9 (0.4) | 3.6 (0.7) | 3.3 (0.7) |
Spacial perception |
| 12.0 (0.0) | 9.3 (2.4) | 7.6 (2.9) | 6.4 (2.9) |
| Directions on client's body | 4.0 (0.0) | 3.3 (1.1) | 2.7 (1.2) | 2.0 (1.2) |
| Spacial relations | 4.0 (0.0) | 3.3 (1.0) | 2.5 (1.2) | 2.2 (1.1) |
| Spacial relations on picture | 4.0 (0.0) | 2.8 (1.1) | 2.4 (1.2) | 2.2 (1.1) |
Motor praxis |
| 11.9 (0.3) | 10.4 (1.3) | 9.4 (1.9) | 8.8 (1.8) |
| motor imitation | 4.0 (0.0) | 3.6 (0.6) | 3.4 (0.9) | 3.0 (1.1) |
| Use of objects | 4.0 (0.0) | 3.9 (0.3) | 3.8 (0.6) | 3.7 (0.5) |
| Symbolic actions | 3.9 (0.3) | 2.9 (1.0) | 2.2 (1.1) | 2.1 (1.1) |
Visuomotor organization |
| 27.7 (0.5) | 20.6 (5.3) | 16.5 (5.2) | 14.6 (5.2) |
| Copying geometric forms | 4.0 (0.2) | 3.1 (0.6) | 2.4 (0.7) | 2.1 (0.8) |
| Two-dimensional model | 4.0 (0.0) | 3.3 (0.8) | 2.8 (1.1) | 2.6 (1.1) |
| Pegboard construction | 40 (0.2) | 2.9 (1.2) | 2.1 (1.1) | 2.5 (1.3) |
| Colored block design | 4.0 (0.0) | 3.1 (1.1) | 2.6 (1.2) | 2.2 (1.2) |
| Plain block design | 4.0 (0.2) | 2.5 (1.2) | 1.7 (1.1) | 1.7 (0.9) |
| Reproduction of a puzzle | 4.0 (0.0) | 2.5 (1.2) | 2.2 (1.1) | 2.1 (1.1) |
| Drawing a clock | 3.9 (0.3) | 3.1 (1.1) | 2.6 (1.2) | 1.4 (0.8) |
Thinking operations |
| 29.5 (1.2) | 19.2 (4.3) | 14.3 (4.8) | 13.3 (5.5) |
| Categorization | 4.8 (0.7) | 2.9 (1.5) | 1.9 (1.0) | 1.8 (1.2) |
| ROC unstructured | 4.2 (0.5) | 3.5 (0.8) | 2.9 (1.3) | 3.0 (1.3) |
| ROC structured | 4.7 (0.5) | 3.1 (0.8) | 2.7 (1.2) | 2.3 (1.1) |
| Pictoral sequence A | 4.0 (0.0) | 3.3 (0.9) | 2.2 (1.3) | 1.9 (1.2) |
| Pictoral sequence B | 4.0 (0.2) | 2.3 (1.3) | 1.5 (1.0) | 1.4 (0.9) |
| Geometric sequence | 3.9 (0.5) | 2.4 (1.1) | 1.8 (1.0) | 1.8 (1.1) |
| Logic questions | 4.0 (0.2) | 1.6 (0.9) | 1.1 (0.4) | 1.2 (0.6) |
Time for visuomotor subscale completion |
| 2.7 (0.4) | 9.6 (6.0) | 12.4 (8.4) | 12.5 (6.0) |
Time for LOTCA completion |
| 17.7 (5.9) | 53.4 (19.7) | 57.4 (22.4) | 52.3 (19.1) |
Criterion Validity (Predictive/Concurrent)
Concurrent Validity
Intellectual Disabilities: (Jang et al, 2009; n=111 with intellectual disabilities, n=19 with no disabilities)
- Poor to Excellent correlations between LOTCA subscales and the Pictorial IQ Test (r = 0.26 to 0.63)
- Adequate correlation between Orientation and Pictorial IQ Test (r = 0.45)
- Poor correlation between Visual Perception and Pictorial IQ Test (r = 0.26)
- Adequate correlation between Spacial Perception and Pictorial IQ Test (r = 0.46)
- Adequate correlation between Motor Praxis and Pictorial IQ Test (r = 0.42)
- Excellent correlation between Visuomotor Organization and Pictorial IQ Test (r = 0.63)
- Excellent correlation between Thinking Operations and Pictorial IQ Test (r = 0.61)
Mixed Conditions
back to PopulationsInterrater/Intrarater Reliability
Stroke and Brain Injury: (Katz et al., 1989; n=20 traumatic head injury patients, n=28 cerebrovascular accident patients)
- Excellent inter-rater reliability (ICC=0.82 to 0.97)
Internal Consistency
Stroke and Brain Injury: (Katz et al., 1989; n=20 traumatic head injury patients, n=28 cerebrovascular accident patients)
- Excellent internal consistency among all subtests administered
- Excellent internal consistency for perception (Cronbach's alpha = 0.87)
- Excellent internal consistency for visuomotor organization (Cronbach's alpha = 0.95)
- Excellent internal consistency for thinking operations (Cronbach's alpha = 0.85)
Content Validity
Stroke and Brain Injury: (Katz et al., 1989)
- Subtests correlation coefficients range from 0.40 to 0.80, suggesting that assessment should be given in full, not individually.
Stroke
back to PopulationsConstruct Validity
Stroke: (Zwecker et al., 2002; n=66 with stroke)
- Adequate correlation (r= 0.471, p<0.001) between the LOTCA and the FIM cognitive subset
- Excellent correlation (r=0.666, p<0.001) between the FIM cognitive subtest and the Mini Mental State Examination (MMSE)