The Children's Orientation and Amnesia Test: Educational status is a moderator variable in tracking recovery from TBI

Abstract

The Children's Orientation and Amnesia Test (COAT) is an objective, standardized means of assessing cognitive functioning in children and adolescents who are in the early stages of recovery from traumatic brain injury. The COAT is composed of 16 items that assess general orientation, temporal orientation, and memory. This study was designed to determine if children who are receiving special education services perform more poorly on the COAT than children who are in the regular classroom. It was found that children receiving special services performed significantly more poorly, and 13% of them were classified in the impaired range, as compared to 3% of the students in the regular classroom. The results provide important reference data for interpreting COAT scores of children with traumatic brain injuries who have either premorbid learning disabilities or other special service needs.

Regression-predicted age norms for the Children's Orientation and Amnesia Test

“…As reported previously by Iverson et al (1994), the mean total score for children receiving special education services was significantly lower than a sample matched for age values represent the expected percentile for a given age group, and the corresponding T score. Most percentiles and all T scores were rounded to a whole integer.…”

“…c The mean reported in this table differs substantially from that reported in Iverson et al (1994) due to a printing error in the latter publication. ** P < .01.…”

“…In an effort to fill out the 8-and 13-year-old age groups, follow-up testing was conducted with children in second and eighth grades. Previous research demonstrated that children in special education perform more poorly on the COAT than children who are not receiving special services (Iverson, Iverson, & Barton, 1994). Therefore, those children known to be receiving special education services were excluded from the norms (n = 38).…”

“…As a check of this correction method, a sample of children receiving regular education were age-, education-, and gender-matched to the group receiving special education (described in more detail by Iverson et al, 1994). In Table 5, it is demonstrated that preexisting differences between the matched groups are mitigated by the adjustment method.…”

“…For clinical purposes, the adjustment values can be rounded to 2, 2, and 4 for temporal orientation, memory, and COAT total score, respectively. In other words, if a child is involved in special education, their temporal orientation, memory, and total scores should be adjusted upward by 2, 2, and 4 points before Iverson et al (1994), due to the exclusion of an extreme score in the group receiving special education, and the corresponding age-, education-, and gender-matched counterpart in the regular education group. This child scored only 15 on temporal orientation, which altered the slope of the regression lines such that larger clinical corrections would have resulted.…”