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Children's Orientation
and Amnesia Test (COAT)
| General Orientation |
|
| 1. What is your name?
first (2) last (3) |
(5)_____ |
2. How old are you?
(3) When is your birthday?
month (1) day (1) |
(5)_____ |
| 3. Where do you live?
city (3) state (2) |
(5)_____ |
4. What is your father's
name? (5)
What is your mother's name? (5) |
(5)_____ |
5. What school do
you go to? (3)
What grade are you in? (2) |
(5)_____ |
6. Where are you now?
(5) (May rephrase
question: Are you at home now? Are you in
hospital? If rephrased, child must correctly
answer both questions to receive credit.) |
(5)_____ |
| 7. Is it daytime or
night-time? (5) |
(5)_____ |
General Orientation Total |
_____
|
| Temporal Orientation:
(administer if age 8-15) |
|
8. What time is it
now? (5) (correct = 5;
< hr. off = 4; 1 hr. off = 3; > 1 hr. off = 2;
2 hrs. off = 1) |
(5)_____ |
9. What day of the
week is it? (5) (correct = 5;
1 off = 4; 2 off = 3; 3 off = 2; 4 off = 1) |
(5)_____ |
10. What day of the
month is it? (5) (correct = 5;
1 off = 4; 2 off = 3; 3 off = 2; 4 off = 1) |
(5)_____ |
11. What month is
it? (10) (correct = 10;
1 off = 7; 2 off = 4; 3 off = 1) |
(5)_____ |
12. What is the year?
(15) (correct = 15;
1 off = 10; 2 off = 5; 3 off = 1) |
(5)_____ |
Temporal Orientation
Total |
_______
|
| Memory |
|
13. Say these numbers
after me in the same order. (Discontinue when the child fails both
series of digits at any length. Score 2 points if both digital series
are correctly repeated; score 1 point if only 1 is correct.)
3
5
35296 81493
58
42
539418 724856
643
926
8129365 4739128
7216 3279 |
(14)_____ |
14. How many fingers
am I holding up? Two
fingers (2) three fingers (3) 10 fingers (5) |
(10)_____ |
15. Who is on Sesame
Street? (10)
(can substitute other major television show) |
(10)_____ |
| 16. What is my name?
(10) |
(10)_____ |
Memory Total |
_______
|
| Overall Total |
_______
|
Ewing-Cobbs, L., Levin, H.S., Fletcher,
J.M., Miner, M.E., & Eisenberg, H.M. (1990). The children's orientation
and amnesia test: Relationship to severity of acute head injury and
to recovery of memory. Neurosurgery, 27(5), 683-691. |
