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
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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.
Intellectual Disability
back to PopulationsNormative 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)
Bibliography
Jang, Y., Chern, J.-S., & Lin, K.-C. (2009). Validity of the Loewenstein Occupational Therapy Cognitive Assessment in people with intellectual disabilities. American Journal of Occupational Therapy, 63, 414–422.
Katz, N., Itzkovich, M., Averbuch, S., & Elazar, B. (1989). Loewentstein Occupational Therapy Cognitive Assessment (LOTCA) Batter for Brain-Injured Patients: Reliability and Validity. The American Journal of Occupational Therapy, 43(3), 184-192.
Zwecker, M., Lewenkorhn, S. et al. (2002). Functional reach test, cognitive FIM instrument and Loewenstein occupational therapy cognitive assessment: Relation to functional outcome of stroke patients”. Archives of Physical Medicine and Rehabilitation, 83, 342-345.