Loewenstein Occupational Therapy Cognitive Assessment (LOTCA)

 

Loewenstein Occupational Therapy Cognitive Assessment Evaluation Summary

  What does the tool measure? Basic cognitive skills required for everyday function including orientation, visual perceptual and psychomotor abilities, problem-solving skills and thinking operations.
  What types of clients can the tool be used for? The LOTCA was designed for individuals aged up to 70 years with neurological deficit.
  Is this a screening or assessment tool? Assessment tool
Time to administer The LOTCA and LOTCA-II take approximately 45 minutes to administer. The LOTCA-G takes approximately 30-45 minutes to administer.
  Versions LOTCA-II
LOTCA – G (for individuals aged 70-91)
Other Languages Spanish, Hebrew, Chinese (Mandarin), Taiwanese and Iranian.
Measurement Properties
  Reliability

Internal consistency:
One study reported excellent internal consistency of the original LOTCA.

Test-retest:
No studies have reported on test-retest reliability of the LOTCA with patients with stroke.

Intra-rater:
No studies have reported on the intra-rater reliability of the LOTCA.

Inter-rater:
One study reported excellent intra-rater reliability of the LOTCA.
One study reported excellent inter-rater agreement for the LOTCA-G.

  Validity

Content:
One study has reported on the content validity of the original LOTCA using factor analysis.

Criterion:
Concurrent:
One study reported adequate correlations between areas of the LOTCA-G and the MMSE, using Spearman correlation analysis.
One study reported poor to excellent correlations between the LOTCA-II and the OT-APST in patients with stroke, using Somers’s d concordance correlations.
– One study reported poor to adequate correlations between the LOTCA and functional motor outcomes (as measured by FIM motor and MRFS scores) in patients with stroke, using Pearson correlations.

Predictive:
No studies have reported on the predictive validity of the LOTCA.

Construct:
Two studies report suitable construct validity of LOTCA subtests.

Convergent/Discriminant.
One study reported a statistically significant difference in the time taken to complete the LOTCA and the LOTCA-G in a group of healthy adults.
Four studies have reported poor to excellent correlations between the original LOTCA and MMSE, FIM, Rivermead Perceptual Assessment Battery (RPAB), Motor-Free Visual Perception Test (MVPT), Rabideau Kitchen Evaluation – Revised or Phone Use tests.

One study reported adequate to excellent convergent validity of the LOTCA-II and the OT-APST, using Spearman’s rho correlations.

Known Groups:
Two studies have reported that the LOTCA-G is able to differentiate healthy adults, adults with dementia and adults with stroke.
Six studies have reported that LOTCA is able to differentiate healthy young adults, healthy elderly adults, individuals with schizophrenia, patients with dementia, patients with intracerebral hemorrhage, ischemia or stroke, patients with unilateral spatial neglect, and patients with traumatic brain injury.
One study reported that different versions of the puzzle reproduction task are able to differentiate younger and older adults.
While 1 study reported that the LOTCA could differentiate between left vs. right stroke, another study found no differences with regard to side of lesion.
One study reported differences between American and Israeli patients with CVA on several subtests of the LOTCA.

  Floor/Ceiling Effects – One study reported ceiling effects from 23% to 96.9%, and negligible floor effects for most items of the LOTCA
– One study examined the floor/ceiling effects of the LOTCA-II in a group of individuals with schizophrenia and reported no ceiling effects.
  Sensitivity/ Specificity No studies have examined the sensitivity or the specificity of the LOTCA.
  Does the tool detect change in patients? No studies have reported on the responsiveness of the LOTCA.
  Acceptability The LOTCA has been described as time-consuming, although it can be completed over several sessions.
The LOTCA has adaptations for use with individuals with communication difficulties.
Feasibility The LOTCA can be time-consuming to administer.

The LOTCA permits use of domain-specific scores rather than just a global score, allowing for assessment of many aspects of the client’s cognitive and perceptual abilities.

How to obtain the tool? The LOTCA can be purchased from http://store.grovergear.com/, http://www.ot-innovations.com, or http://therapro.com.