The Galveston Orientation and Amnesia Test

The Galveston Orientation and Amnesia Test

Harvey S. Levin, Ph.D., Vincent M. O'Donnell, M.A., & Robert G. Grossman, M.D.

Instructions: Can be administered Daily. Score of 78 or more on three consecutive occasions is considered to indicate that patient is out of post-traumatic amnesia (PTA).

Question
What is your name?
When were you born? Where do you live? Where are you now: (a) City (b) Building When were you admitted to this hospital? How did you get here? What is the first event you can remember after the injury? Can you give some detail? Can you describe the last event you can recall before the accident? What time is it now? What day of the week is it? What day of the month is it? (i.e. the date) What is the month? What is the year? Total Error: Total Actual Score = (100 - total error) = 100 _____ = 76-100 = Normal / 66-75 = Borderline / <66 = Impaired Developed by Harvey Levin, Ph.D., Vincent M. O'Donnell, M.A., & Robert G. Grossman, M.D.

Error Score

Notes

-2 _____ Must give both first name and surname. -4 _____ Must give day, month, and year. -4 _____ Town is sufficient.

-5 _____ Must give actual town. -5 _____ Usually in hospital or rehab center. Actual name necessary. -5 _____ Date. -5 _____ Mode of transport. -5 _____ Any plausible event is sufficient (record answer) -5 _____ Must give relevant detail. -5 _____ Any plausible event is sufficient (record answer) -5 _____ -1 for each half-hour error. -3 _____ -1 for each day error. -5 _____ -1 for each day error. -15 _____ -30 _____ -5 for each month error. -10 for each year error.

Can be a negative number.

Tracking Chart 100

90

80

70

http://www.utmb.edu/psychology/Adultrehab/GOAT.htm[5/10/2012 4:39:29 PM]

The Galveston Orientation and Amnesia Test

60 50 40 30 20 10 0

Date ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____

http://www.utmb.edu/psychology/Adultrehab/GOAT.htm[5/10/2012 4:39:29 PM]