Purpose
Assess basic cognitive and visual perception skills
Link to Instrument
Acronym
LOTCA
Area of Assessment
CognitionVision & Perception
Primary Image
Loewenstein Occupational Therapy Cognitive Assessment
Vision & Perception
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.
Intellectual Disability
back to PopulationsNormative Data
Intellectual Disabilities: (Jang et al, 2009; n=111 with intellectual disabilities, n=19 with no disabilities)
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LOTCA Normative Data |
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Category |
Subscale |
No Disability |
Mild Disability |
Moderate Disability |
Severe Disability |
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Orientation |
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16 (0.2) |
13.4 (2.3) |
10.2 (3.8) |
7.6 (4.8) |
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Orientation place |
8 (0.2) |
7.1 (1) |
5.5 (2) |
4.4 (2.5) |
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Orientation time |
8 (0.0) |
6.4 (1.7) |
4.8 (2.2) |
33 (2.6) |
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Visual perception |
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16 (0.0) |
15.4 (1.2) |
14.6 (2) |
13.8 (2.1) |
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Objects identification |
1 (0.0) |
4 (0.0) |
3.9 (0.3) |
3.8 (0.4) |
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Shapes identification |
4.0 (0.0) |
3.8 (0.6) |
3.6 (0.8) |
3.5 (0.9) |
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Overlapping figures |
4.0 (0.0) |
3.8 (0.5) |
3.5 (0.8) |
3.1 (0.7) |
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Object consistency |
4.0 (0.0) |
3.9 (0.4) |
3.6 (0.7) |
3.3 (0.7) |
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Spacial perception |
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12.0 (0.0) |
9.3 (2.4) |
7.6 (2.9) |
6.4 (2.9) |
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Directions on client's body |
4.0 (0.0) |
3.3 (1.1) |
2.7 (1.2) |
2.0 (1.2) |
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Spacial relations |
4.0 (0.0) |
3.3 (1.0) |
2.5 (1.2) |
2.2 (1.1) |
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Spacial relations on picture |
4.0 (0.0) |
2.8 (1.1) |
2.4 (1.2) |
2.2 (1.1) |
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Motor praxis |
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11.9 (0.3) |
10.4 (1.3) |
9.4 (1.9) |
8.8 (1.8) |
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motor imitation |
4.0 (0.0) |
3.6 (0.6) |
3.4 (0.9) |
3.0 (1.1) |
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Use of objects |
4.0 (0.0) |
3.9 (0.3) |
3.8 (0.6) |
3.7 (0.5) |
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Symbolic actions |
3.9 (0.3) |
2.9 (1.0) |
2.2 (1.1) |
2.1 (1.1) |
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Visuomotor organization |
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27.7 (0.5) |
20.6 (5.3) |
16.5 (5.2) |
14.6 (5.2) |
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Copying geometric forms |
4.0 (0.2) |
3.1 (0.6) |
2.4 (0.7) |
2.1 (0.8) |
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Two-dimensional model |
4.0 (0.0) |
3.3 (0.8) |
2.8 (1.1) |
2.6 (1.1) |
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Pegboard construction |
40 (0.2) |
2.9 (1.2) |
2.1 (1.1) |
2.5 (1.3) |
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Colored block design |
4.0 (0.0) |
3.1 (1.1) |
2.6 (1.2) |
2.2 (1.2) |
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Plain block design |
4.0 (0.2) |
2.5 (1.2) |
1.7 (1.1) |
1.7 (0.9) |
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Reproduction of a puzzle |
4.0 (0.0) |
2.5 (1.2) |
2.2 (1.1) |
2.1 (1.1) |
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Drawing a clock |
3.9 (0.3) |
3.1 (1.1) |
2.6 (1.2) |
1.4 (0.8) |
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Thinking operations |
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29.5 (1.2) |
19.2 (4.3) |
14.3 (4.8) |
13.3 (5.5) |
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Categorization |
4.8 (0.7) |
2.9 (1.5) |
1.9 (1.0) |
1.8 (1.2) |
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ROC unstructured |
4.2 (0.5) |
3.5 (0.8) |
2.9 (1.3) |
3.0 (1.3) |
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ROC structured |
4.7 (0.5) |
3.1 (0.8) |
2.7 (1.2) |
2.3 (1.1) |
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Pictoral sequence A |
4.0 (0.0) |
3.3 (0.9) |
2.2 (1.3) |
1.9 (1.2) |
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Pictoral sequence B |
4.0 (0.2) |
2.3 (1.3) |
1.5 (1.0) |
1.4 (0.9) |
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Geometric sequence |
3.9 (0.5) |
2.4 (1.1) |
1.8 (1.0) |
1.8 (1.1) |
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Logic questions |
4.0 (0.2) |
1.6 (0.9) |
1.1 (0.4) |
1.2 (0.6) |
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Time for visuomotor subscale completion |
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2.7 (0.4) |
9.6 (6.0) |
12.4 (8.4) |
12.5 (6.0) |
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Time for LOTCA completion |
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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)
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Poor to Excellent correlations between LOTCA subscales and the Pictorial IQ Test (r = 0.26 to 0.63)
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Adequate correlation between Orientation and Pictorial IQ Test (r = 0.45)
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Poor correlation between Visual Perception and Pictorial IQ Test (r = 0.26)
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Adequate correlation between Spacial Perception and Pictorial IQ Test (r = 0.46)
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Adequate correlation between Motor Praxis and Pictorial IQ Test (r = 0.42)
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Excellent correlation between Visuomotor Organization and Pictorial IQ Test (r = 0.63)
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Excellent correlation between Thinking Operations and Pictorial IQ Test (r = 0.61)
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Mixed Populations
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)
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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)