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Cognitive Assessment of Minnesota

Theoretical Assumptions of CAM

CNS is organized in a hierarchical structure.

"Attention, language, and memory are the basic processes which serves as building blocks for the development of hierarhical intellectual abilities.....These higher level skills can be attained only when the basic processes are intact"

Shraddha B. & Savannah F.

Population

Reliability, Validity & Sensitivty

8. Object Identification

Reliability

  • Test-Retest: Good-High
  • Interrater: Good-High

Validity:

  • Shown to be comparable with Mini-Mental Status and Porteus Maze Test Quotient

Sensitivity:

  • Insensitive to mild impairment

Age: 18+ years

Diagnoses:

  • cerebrovascular accidents
  • traumatic brain injury
  • acquired brain injury

Not appropriate for individuals with:

  • severe visual-perceptual-motor deficits
  • visual acuity deficits
  • aphasia

2. Memory & Orientation

  • Purpose: assess ability to recognize common objects from the environment
  • Preparation: paperclips, toothbrush, pen, key, nickel, comb, and rubber band
  • Task: client points out object asked for by therapist
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Decreased Visual Acuity
  • Impulsivity
  • Perseveration
  • Aphasia
  • Purpose: To test remote and recent memory
  • Preparation: Gather biographical data on client
  • Task: Pt. answers questions
  • Areas to Rule Out:
  • Decreased Attention,
  • Apashia
  • Hearing Deficits

4. Following Directions

Description of CAM

Administrator Qualifications

  • A quick cognitive screen to that utilizes both functional and nonfunctional tasks to identify deficits following injury to the brain.

Test Information

17 Subtests

Qualification Level B:

“A master's degree in psychology, education, occupational therapy, social work, or in a field closely related to the intended use of the assessment, and formal training in the ethical administration, scoring, and interpretation of clinical assessments”

11. Auditory Memory and Sequencing

Developed by:

Ruth A. Rustad, OTR, Terry L. DeGroot, OTR, Margaret L. Jingkunz, OTR, Karen S. Freeberg, OTR, Laureen G. Borowick, OTR, & Ann M. Wanttie, OTR

  • Year: 1993
  • Publisher: Pearson

  • Purpose: assess ability to register and process information and appropriately respond
  • Preparation: Written Directions Index Cards
  • Task: Appropriate Yes/No, One Step Verbal Directions, Imitation
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Aphasia
  • Apraxia
  • Hearing Deficits
  • Perseveration

  • attention span
  • memory/orientation
  • visual neglect
  • following directions
  • immediate memory
  • temporal awareness
  • matching
  • object identification
  • visual memory and sequencing
  • recall/recognition
  • auditory memory and sequencing
  • simple money skills
  • simple math
  • foresight and planning
  • safety and judgment
  • concrete problem solving
  • abstract reasoning
  • Purpose: assess ability to assimilate, process, and duplicate verbal information in graded manner
  • Task: Pt asked to repeat letter sequences, graded by length. Pt asked to repeat letter sequences in reverse order of presentation, graded by length.
  • Areas to Rule Out:
  • Decreased Attention
  • Aphasia
  • Hearing Deficits
  • Fatigue

Scoring

7. Matching

3= mild to no impairment

2=moderate impairment

1= severe impairment

OR

2= intact

1= impaired

Some subtests scores need to transferred from raw scores. All scores are then placed on a scoring profile to help identify deficits

17. Abstract REasoning

Attention Span

  • Purpose: assess ability to transcend the immediate environment to appreciate different aspects of a situation/problem; think symbolically
  • Task: Pt asked to explain proverbs;
  • Areas to Rule Out:
  • Decreased Attention
  • Aphasia
  • Fatigue

13. Simple MAth Skills

  • Purpose: assess ability to identify similar objects from a group of objects
  • Preparation: Duplicates of paperclips, toothbrush, pen, key, nickel, comb, and rubber band
  • Task: One set is placed in front of client, client must identify the match from this set with the object presented by the therapist
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Decreased Visual Acuity
  • Impulsivity
  • Perseveration

Therapist observation throughout test of sustained and selective attention

  • Purpose: assess ability to solve simple math problems
  • Preparation: paper, pencil, eight 5x7" cards, photocopy of math problems
  • Task: Pt asked to solve single digit math problems then asked to solve multiple digit math problems
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Aphasia
  • Decreased Visual Acuity
  • Fatigue

REferences

Occupational and Physical Therapy: Cognitive Assessment of Minnesota (n.d.). In Pearson. Retrieved February 20, 2015, from http://www.pearsonclinical.com/therapy/products/100000577/cognitive-assessment-of-minnesota-the.html

Rustad, R. A., DeGroot, T. L., Jungkunz, M. L., Freeberg, K. S., Borowick, L. G., Wanttie, A. M., & Toglia, J. P. (1993). The Cognitive Assessment of Minnesota. San Antonio, TX: Pearson.

12. Simple Money Skills

5. Immediate Memory

Thank You!

  • Purpose: assess ability to identify coins and their values, count coins, and make simple change
  • Preparation: 10 pennies, 1 nickel, 1 dime, 1 quarter, 1 half dollar
  • Task: Pt asked to name coins; Pt asked to count and make change
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Aphasia
  • Hearing Deficits
  • Decreased Visual Acuity
  • Fatigue

16. Concrete Problem Solving

10. Recall/recognition

14. Foresight and Planning

15. SAfety and Judgment

  • Purpose: assess ability to recall/recognize information after 5-10 minutes
  • Task: Asked to recall the 3 words and movements showed to them previously. Prompts given if pt. cannot recall.
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Apraxia
  • Decreased Proprioception
  • Fatigue
  • Purpose: ability to analyze a problem and the formulate and execute a plan
  • Preparation: A screen to occlude pt.'s view, eight 1" cubes, clock/watch
  • Task: Pt. asked to build cube designs in a graded manner; problem solve a scenario
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Aphasia
  • Apraxia
  • Hearing Deficits
  • Incoordination
  • Fatigue
  • Purpose: Assess ability to recall information after 1 minute
  • Task:
  • Remember and repeat 3 words
  • Remember and repeat 3 movements
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Aphasia
  • Apraxia
  • Hearing Deficits
  • Perseveration
  • Decreased proprioception

6. Temporal Awareness

  • Purpose: assess ability to recall, problem solve, process, sequence, organize, plan and reason
  • Task: Pt. presented with scenarios and asked to provide appropriate response
  • Areas to Rule Out:
  • Decreased Attention
  • Aphasia
  • Hearing Deficits
  • Fatigue
  • Purpose: assess ability to plan ahead. Observe rate and strategy of performance of client during task.
  • Preparation: clock/watch, photocopy of maze, pencil/pen
  • Task: Pt. asked complete maze from start to finish without going over the black line
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-Perceptual-Motor Deficits
  • Apraxia
  • Incoordination
  • Decreased Visual Acuity
  • Impulsivity
  • Fatigue
  • Purpose: assess perception of hours, minutes, and seconds
  • Preparation: clock or watch in client's visual field
  • Task: Ask pt. "How have long have you been working with me this afternoon?"
  • Areas to Rule:
  • Decreased Attention
  • Aphasia

Clinical Utility

9. Visual Memory and Sequencing

Strengths

  • Easy to Score
  • Evaluates a diverse amount of cognitive skills in relatively brief period of time
  • Subtests are founded on functional skills
  • Materials are easily obtained and low-cost
  • Clear instructions and familiar tasks

Weaknesses:

  • May take too long to administer
  • Normed on a small population
  • Not appropriate for individuals with severe visual-motor-perceptual deficits, visual acuity deficits, or aphasia

Time

  • Purpose: assess ability to assimilate, process, and duplicate visual information in a graded manner
  • Preparation: paperclip, toothbrush, pen, key, nickel, comb, and rubber band
  • Task: Repeat visual sequence "Simon Says"
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-perceptual-motor deficits
  • Decreased Visual Acuity
  • Impulsivity
  • Perseveration
  • Aphasia

3. Visual Neglect

40 minutes

or

two 20 minute sessions

  • Purpose: To obtain information on client's visual field
  • Preparation: photocopy of neglect worksheet, pen/pencil, tape
  • Task: Visual Neglect Worksheet
  • Areas to Rule Out:
  • Decreased Attention
  • Visual-perceptual-motor deficits
  • Apraxia
  • Decreased Visual Acuity
  • Perseveration

ECG

bpm

62

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