Fair Presenters: Miraclyn, Tuan,

testing Ananya
Guided by: Dr. Sridhar. D

practices
 DEFINITION

 The responsibility of the test user to take whatever measures are possible to
minimize bias in testing for particular groups.
 It must be seriously considered whether an assessment is fair for the clients and
what extraneous variables might influence their scores.
 Sources of bias should be identified and eliminated, where feasible, so that they
do not alter the meaning of scores obtained by our clients.
 Three specific instances of fair testing practices are considered:
Culture
Seniors and,
People with disabilities.
 LOEWENSTEIN OCCUPATIONAL THERAPY
COGNITIVE ASSESSMENT (LOTCA)
 The Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) was
developed in 1974 at the Loewenstein Rehabilitation Hospital, Israel.

 Cognitive battery that measures basic cognitive skills required for everyday
function including orientation, visual perceptual and psychomotor abilities,
problem solving skills and thinking operations.

 Typically used in the initial phase of patient assessment but can also be used to
establish therapeutic goals and to review cognitive status over time
 LOTCA…
 The LOTCA battery is divided into four areas: orientation; perception; visuomotor organization; and
thinking operation.

 It contains 20 subtests including the Risk Object Classification which was added to enhance the
evaluation of the categorization operation.

 The different versions of the instrument include LOTCA, LOTCA II, and LOTCA-G.

 LOTCA-G is specifically designed to assess cognitive functions of the elderly population.

 The LOTCA-G differs with the original LOTCA as it has 23 subtests in six cognitive areas: orientation,
perception, praxis, visuo-motor organization, thinking operation, and memoy.
 CULTURALLY FAIR EVALUATION

 Occupational therapists may be required to assess an individual whose first

language is not the official language of the country.

 There are two main issues here: --The influence of a native language other
than English on interpretation of and response to test items and,
--The influence of cultural expectations, behaviors,
and values on test performance.
 CULTURALLY FAIR EVALUATION

 Language can significantly confound the results that are obtained on an

assessment.

 When the assessment requires a verbal response or when the test items contain
a substantial verbal component, the test may measure language ability more
than the underlying construct.

 The intelligibility of the test items and instructions for individuals whose first
language is not English must be determined
 FAIR TESTING OF LOTCA-G IN MALAY

 When the consent was received by the principal author, the original version of
LOTCA-G was then translated by a Malay language expert and an experienced
occupational therapist.

 The translation process was based on the stipulations in U.S. Census Bureau
Guidelines: two forward and backward translations were carried out by an
experienced occupational therapist and a language expert.

 Two bilingual experts from the Academy of Language Studies and the
Occupational Therapy Department of a local university were appointed to carry
out the forward translation.
 FAIR TESTING OF LOTCA-G IN MALAY

 The translation was approved after a period of discussion among the author and
both experts.

 The backward translation was done by another bilingual expert from the Faculty
of Information Management, Malaysia and a senior occupational therapist.

 The backward translation was then sent to Dr. Noomi Katz in Israel for her
verification as requested by her.
EVALUATION OF THE RELEVANCE AND
TEST CONTENT OF M-LOTCA-G
 Three occupational therapists with 7 to 20 years of experience working with
geriatric cases volunteered to participate as members of the expert review
panel.

 The members rated the 23 items by using a five-point Likert scale with 1
representing strongly disagree and 5 representing strongly agree.

 The expert panels reviewed 23 items considering the fluency, clearness, and
the semantic meaning of words and sentences.
EVALUATION OF THE RELEVANCE AND
TEST CONTENT OF M-LOTCA-G

 The expert panel concluded that the four seasons in the original version could
be changed to two seasons, as there is either the dry season or the rainy
season in Malaysia.

 Otherwise, the contents of the subtests did not require further modifications.

 Minor inconsistencies in the direct, literal translations of the instructions were

resolved by discussion between the translators and panel.
Critiquing Assessments for Older Adults
The issues related to assessment of older adults

 Changes in physical function

 Vision

 Cognitive

 The issue of social consequences

 The outcome of a driving assessment

 Competency assessment
Psychometric Properties of the Malay Version of the Loewenstein Occupational Therapy
Cognitive Assessment for Geriatrics (M-LOTCA-G) Among the Malaysian Elderly Population
Ahmad , Rajendran, Husna, Ghazali, and Chandra. (2015).
• Malaysia, by the year 2035 or even earlier, will be labeled an ageing country

• Prevalence of cognitive impairment among residents of an elderly care

home in the north of Malaysia was 12.3%

• Prevalence of cognitive impairment among residents of an elderly care

home in the north of Malaysia was 12.3%
LOTCA-G

• Specifically designed to assess cognitive functions of the elderly population

• Evaluating comprehensive cognitive ability of perceptual and motor skills, which

involves both motor-free and constructional functions

• Indicate the client’s remaining cognitive abilities and disabilities in the areas of
orientation, perception, visuomotor organization, and thinking operations.
LOTCA G Evaluation of Person with
disability
• Perceive LOTCA G instructions/ material
Items are enlarged

Details are reduced

Subtests are shortened

Total time is reduced to max 45 minutes

Memory subtests were added

Provides clear step by step directions

LOTCA G Evaluation of Person with
disability
• Indicate response verbally or motor means (Have tips to administer
with the aphasic clients)

• Mental health status to participate in LOTCA G (minimal verbal

requirement except for orientation)

• Possibility of test modification (Can be administered over multiple

sessions)
LOTCA G Evaluation of Person with
disability
• Meaningful interpretation of the clients’ performance to the
underlying constructs
LOTCA and LOTCA-G have been effective instruments for screening patients'
cognitive abilities, planning intervention, and predicting functional outcomes

• Influence by Education directly proportional to the scores obtained

Evidence for use of LOTCA G

• Individuals following:
Stroke (Bar-Haim Erez & Katz, 2003)

Dementia (Bar-Haim Erez & Katz, 2003)

Traumatic brain injury (Annes et al., 1996)

CNS dysfunction (Annes et al., 1996)

Mental illness (Jang et al., 2009; Josman & Katz, 2006)

Aphasia (Jang et al., 2009)

Reference
• https://www.ot-innovations.com/clinical-practice/cognition-2/lowenstein-occupa
tional-therapy-cognitive assessment/#:~:text=The%20LOTCA%20battery%20is%2
0used,visuomotor%20organization%20and%20thinking%20operations
.
• https://www.hospeq.com/Dynamic-LOTCA-G-Loewenstein-Geriatric-p/mad71826
2050.htm
• Willard & Spackman’s 11th edition. Page 530- 534
• https://strokengine.ca/en/assessments/loewenstein-occupational-therapy-cogniti
ve-assessment-lotca/
 https://strokengine.ca/en/assessments/loewenstein-occupational-therapy-cog
nitive-assessment-lotca/

 Psychometric Properties of the Malay Version of the Loewenstein

Occupational Therapy Cognitive Assessment for Geriatrics (M-LOTCA-G)
Among the Malaysian Elderly Population
Ahmad , Rajendran, Husna, Ghazali, and Chandra. (2015).
 Mohd Natar, A. K., Nagappan, R., Ainuddin, H. A., Masuri, G., & Thanapalan, C.
K. K. (2015). Psychometric Properties of the Malay Version of the Loewenstein
Occupational Therapy Cognitive Assessment for Geriatrics (M-LOTCA-G)
Among the Malaysian Elderly Population. Educational Gerontology, 41(1), 27–
40. https://doi.org/10.1080/03601277.2014.896542
Thank you