Abstract
The Gaylord Occupational Therapy Cognitive (GOT-Cog®) screen was developed with a focus on sequencing and functional cognition. GOT-Cog was shown to be valid and reliable in the long-term acute care hospital setting, and it can be used to assist treatment and discharge planning.
Primary Author and Speaker: Emily Meise
Additional Authors and Speakers: Amanda Meyer
Contributing Authors: Henry C. Hrdlicka, John Corbett, Pete Grevelding
Occupational therapists (OT) evaluate patients’ functional cognition–the interaction of cognitive, self-care, and community living skills. No single cognitive screen captures all cognitive domains important for inpatient OT treatment planning. Our team developed the Gaylord Occupational Therapy Cognitive (GOT-Cog®) screen based on nine domains typically affected following acquired brain injury and extended hospitalization, including functional problem-solving and sequencing. Participants were recruited from inpatients receiving OT services at Gaylord Hospital, an LTACH setting. Construct validity was first tested using the St. Louis University Mental Status (SLUMS) exam as the comparator. Interrater and intrarater reliability and GOT-Cog responsiveness were then tested. Rater reliability was assessed using interclass correlation (ICC) and responsiveness using effect size. For construct validity, GOT-Cog and SLUMS scores positively correlated (r = 0.75, p<.0001, n = 98). All shared domains significantly correlated (r-value range = 0.24-0.69, p ≤.0155), and all unique domains showed significant correlation to participants’ GOT-Cog and SLUMS total scores (r-value range = 0.24-0.65, p ≤.0194). No ordering (p ≥.8081), education (p ≥.4469), or program (p ≥.1738) effects were observed. GOT-Cog then demonstrated moderate-to-good interrater reliability [ICC(95% CI) = 0.74(0.63-0.83)], r = 0.82, n = 83), and good-to-excellent intrarater reliability [ICC(95% CI) = 0.85(0.79-0.90)], r = 0.82, n = 83). When used in a mixed medically complex patient population, GOT-Cog showed a small effect size (d = 0.40, n = 144) from admission to discharge. By combining all cognitive domains desired by OTs into a single assessment, GOT-Cog will allow OTs to better identify patients with functional cognitive deficits that may affect their recovery and treatment regimen. This will result in targeted treatment planning, further OT testing of domains of concern, and referrals to other services for further assessment.
Emily Meise, John Corbett, Amanda Meyer, Pete Grevelding, & Henry C. Hrdlicka. (2024). Construct Validity, Criterion Validity, and Internal Consistency of GOT-Cog®, a Novel Occupational Therapy Cognitive Screen. https://doi.org/10.21203/rs.3.rs-4171298/v1
Hrdlicka, H. C., Meise, E., Corbett, J., Meyer, A., & Grevelding, P. (2024). Content Validity Testing of a Novel Cognitive Screen, the Gaylord Occupational Therapy Cognitive (GOT–Cog), to Improve Inpatient Occupational Therapy Treatment Planning. The American Journal of Occupational Therapy, 78(1), 7801345020. https://doi.org/10.5014/ajot.2024.050306
Role of occupational therapy in assessing functional cognition | AOTA. (2021, November 24). https://www.aota.org/practice/practice-essentials/payment-policy/medicare1/medicare-role-of-ot-in-assessing-functional-cognition
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