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RehabMeasures Instrument

Loewenstein Occupational Therapy Cognitive Assessment

Last Updated

Purpose

Assess basic cognitive and visual perception skills

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Instrument Details

Acronym LOTCA

Area of Assessment

Cognition
Vision & Perception

Cost

Not Free

Actual Cost

$330.00

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/Manual

Age Ranges

Original

0 - 69

years

LOTCA-G

70 - 91

years

Instrument Reviewers

Reviewed by Heidi Jasper-Petrozzino and Kimberly Okechukwu in December 2016.

Considerations

Can be administered over multiple sessions.

Intellectual Disability

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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 Populations

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Interrater/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

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Construct 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)