PTH 605 Cognition - Perception Test Worksheet

Types of Items Equipmen Scoring Time to What is being Minimum Abilities

t Complete assessed? / Patient
Populations
Glasgow Coma Eye opening, verbal response, -test sheet Low score 3 Level of Patients post TBI
Scale motor response High score 15 consciousness in
Total score of 8 or less = severe acute brain injury
brain injury/coma

0-15 → lower score less severe

Montreal Visuospatial / Executive: Score Total score is out of 30 6- 30 Cognitive Inatact vision,
Cognitive Alternating trail making, sheet, stop Scores …. minutes functions: visuo- arrousable,
Assessment viscuoconstructive skills with watch, spatial and Alzheimer’s
(MoCA) clock pencil and 26 or greater = norm executive Disease, Brain
paper functions, naming, tumor, Dementia,
Naming: Animals memory, attention, Parkinson’s
language, Disease, Stroke
Memory: Introduce word list abstraction,
orientation
and delayed recall

Attention: Forward digit span,

backward digit span, vigilance,
serial 7's)

Language: Sentence repetition

and verbal fluency

Abstraction: Recognize
similarity

Orientation
St Louis tests orientation, memory, Paper copy 30-point, 11 question 6-30 dementia or Mild Community
University attention, and executive of SLUM/ screening, Cut-off scores for minutes Neurocognitive dwelling elders
Mental Status function, with items such as pencil dementia or mild Impairment
(SLUMS) animal naming, digit span, neurocognitive impairment are
Examination figure recognition, clock based on the education level of
drawing and size differentiation. the patient (high school and
above or less than high school)
PTH 605 Cognition - Perception Test Worksheet

Mini-Cog Remember 3 items, clock Pencil/pape Out of 5 points 3 minutes Memory/dementia

drawing test, r

Digit Span Give patient short list of none Compared to “normal” recall: 7 A couple Memory/attention Communication
numbers to repeat forward and numbers forward, 5 numbers minutes abilities/ ability to
backward backward follow commands

Galveston Questions indicating orientation, None Score of 78 or more on three A couple Orientation, In a conscious/ alert
Orientation & memory consecutive occasions is of minutes amnesia, memory state
Amnesia Test considered to indicate that
(GOAT) patient is out of post-traumatic
amnesia
76-100 = Normal / 66-75 =
Borderline /
Trail Making Pt. has to connect dots with Pencil/ Timed--- higher the time--- A couple Sequencing, Frontal lobe
Test numbers in a particular order paper form higher the deficit of minutes vision, attention dysfunction/ stroke,
need to have intact
- Indicates brain damage motor abilities
>90sec
PTH 605 Cognition - Perception Test Worksheet

Types of Items Equipment Scoring Time to Complete What is being Minimum Abilities /
assessed? Patient Populations
Star Pencil/paper Max score is 54 A few minutes Unilateral neglect, Post-CVA
Cancelation Patient must cross worksheet < 44 = unilateral vision
Test out all small stairs special neglect

Line Bisection Paper/pencil measuring the Visual processing, may be influenced by

Test Patients are asked to deviation of the U/L neglect or may be
place a mark with a bisection from the indicative of other
pencil (with their true center of the syndromes besides
preferred or line. A deviation of spatial neglect, such
unaffected hand) more than 6 mm as hemianopia
through the center of from the midpoint
a series of 18 indicates
horizontal lines on an impairment
11x
8.5-inch page

Double No equipment Ability to feel or see Unilateral neglect Arousable, sensation

Simultaneous on B/L sides with
Stimulation tactile stimulation
(extinction)
tests
Kettle Test Ask patient to make Kettle, ingredients Each step scored 0-4, Sequencing and Command following,
2 beverages, one for for beverages, any Total score 0-52, planning attention, arousal,
themselves and for other, higher scores planning, apraxia
for the PT, each with plates/utensils/etc reflecting more
2 different severe problems in
ingredients performance.
Multiple Ask patient go to get Not standardized 3o minutes or more Executive function,
Errands Test certain items motor planning
Executive Observation of Standardized Executive functions
Functions IADLS—hand
Performance washing meal prep,
Test looking up on google