Every occupational therapist needs to have assessment tools that can provide valid, reliable and predictable information that will help determine a patient's social or cognitive level, and that will help the therapist to chart a course of treatment and track changes over time. The Lowenstein Occupational Therapy Cognitive Assessment (LOTCA™ ) battery is used to assess adults with neurological deficits and mental health. The Dynamic Lowenstein Occupational Therapy Cognitive Assessment (DLOTCA™ ) builds off the research used to develop the original LOTCA™ series, and integrates a dynamic component that provides the ability to measure learning potential and recognize thinking strategies through the use of mediation. Additionally, it enables the therapist to identify the level of awareness the client has regarding her own condition and cognitive disability.
The DLOTCA™ is specifically intended for use with clients aged 18 to 69 years old, and is a series of cognitive tests that enables the OT to obtain a detailed cognitive profile and evaluation of clients with neurological deficits, which helps in intervention planning, management and maintenance. It consists of 28 sub-tests in 7 cognitive areas: Orientation, Awareness, Visual Perception, Spatial Perception, Praxis, Visuomotor Construction and Thinking Operations. Like the original LOTCA™ battery of tests, scoring is on an ordinal scale of 1-4 (1 being severe deficit, and 4 being average performance), except for orientation scores which range from 1-8, and categorization where the range is 1-5. Reliability, validity and standards of performance for the DLOTCA™ are available not only for brain injured patients, patients following stroke and schizophrenic patients, but are also for healthy adults and children as well.
The DLOTCA-G™ is designed to be used specifically with patients aged 70 and over, and addresses the physical and mental factors that can accompany aging. This battery of tests offers larger components, multiple choice questions, reduced pictorial detail, memory sub-tests and a shorter administration time. This geriatric version consists of 24 sub-tests in 8 cognitive areas: Orientation, Awareness, Visual Perception, Spatial Perception, Praxis, Visuomotor Construction, Thinking Operations and Memory. And like the original LOTCA™, scoring is on an ordinal scale of 1-4, except for orientation which is scored from 1-8. The Memory sub-test includes delayed recall and recognition, while the overall time for the administration of the whole battery is only 30 to 45 minutes. Construct validity was determined for the DLOTCA-G™ by comparing healthy elderly adults and patients following stroke, as well as patients with dementia, showing significant differences between the groups. Age-related decline in cognitive function was taken into account and this battery was found to differentiate between healthy elderly adults and those following stroke.
Both versions were designed to provide standardized testing procedures and established norms for systematic data collection in cognitive assessment, and published studies are available upon request. The esteemed authors of the Dynamic Lowenstein Occupational Therapy Cognitive Assessment Manual (DLOTCA™ and DLOCTA-G™) are Noomi Katz, PhD, OTR; Liat Livni, MSc, OT; Asnat Bar-Haim Erez, PhD, OT; and Sarah Averbuch, MSc, OT.
Carol Koenigsknecht,
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Hulet Smith, OT
