Noomi Katz, Asnat Bar-Haim Erez, Liat Livni, Sarah Averbuch; Dynamic Lowenstein Occupational Therapy Cognitive Assessment: Evaluation of Potential to Change in Cognitive Performance. Am J Occup Ther 2012;66(2):207-214. doi: 10.5014/ajot.2012.002469.
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© 2017 American Occupational Therapy Association
OBJECTIVE. We studied the psychometric properties of the dynamic version of the Lowenstein Occupational Therapy Cognitive Assessment (DLOTCA) and examined the most frequent level of mediation used for planning for intervention.
METHOD. Participants included 83 clients hospitalized after first stroke (mean age = 57.7, standard deviation = 8.33) and 45 healthy control participants. All were assessed with the DLOTCA after providing informed consent.
RESULTS. Interrater reliability showed high correlations between all pairs of raters. Internal consistency reliability showed moderate to high αs (.602–.813) for all domains except Visual Perception. We found significant differences between the groups of participants before mediation; both benefited from mediation, showing moderate to high effect sizes. Stroke clients needed higher levels of mediation.
CONCLUSION. The DLOTCA is effective in providing insight into whether participants need mediation and the level and type of assistance they require. The DLOTCA provides guidance for planning intervention for people with cognitive disabilities.
Identify the cognitive abilities and disabilities of the individual in the different domains
Measure learning potential and change
Recognize thinking strategies through the use of dynamic assessment
Identify the person’s level of awareness of his or her condition and cognitive disabilities.
Level 1: General intervention—“Pay attention, don’t hurry….”
Level 2: General feedback—“Is that exactly the same?” “How many parts do you see?” “Where is the . . . ?”
Level 3: Specific feedback—The examiner points to the error: “You made a mistake here. . . . Try and correct it.”
Level 4: Structured category—The examiner gives cues through the use of key points.
Level 5: Copying or subtracting amount—The examiner performs the task and then asks the client to perform it, or the examiner reduces the number of stimuli (e.g., the number of cards in the categorization task) and then asks the client to complete the task. (Katz, Livni, et al., 2011, p. 16)
Pretest/static scores provide information on domains of abilities and difficulties as well as the level of difficulties
Mediation scores describe what level of mediation was most frequently used in which domain. This level should be used in the initial intervention process.
Posttest or after-mediation scores describe learning potential and the amount of improvement in each domain. They provide therapists with information on the learning potential of the person assessed. Learning potential is based on the discrepancy between pretest and posttest scores.
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