Transcription of Brief Cognitive Assessment Tool Short Form - BCAT
1 Name: _____DOB: _____Gender: Female / MaleEducation: _____Examiner: _____ORIENTATION Year Month Day/Week State City SituationIMMEDIATE VERBAL RECALL Banana Justice Sara BridgeBrief Cognitive Assessment tool Short FormToday s Date: _____ Total Score: _____ / 21 IMMEDIATE STORY RECALL(Instructions: X > 8 = 2 points, X = 4-7 = 1 point, X < 3 = 0 points) Carol / borrowed / $10 / from her brother / Jack / last week. / She couldn't pay him back / because she bought / a delicious / ice cream cone / at the circus Shifting: (Instructions: X > 8 = 2 points, X = 6-7 = 1 point, X < 5 = 0 points) 1A - 2B - 3C - 4D - 5E - 6F - 7G - 8H - 9I - 10 JAll Rights Reserved | William Mansbach, | / 6_____ / 4_____ / 2-SFDELAYED STORY RECALL(Instructions: X > 8 = 2 points, X = 4-7 = 1 point, X < 3 = 0 points) Carol / borrowed / $10 / from her brother / Jack / last week.
2 / She couldn't pay him back / because she bought / a delicious / ice cream cone / at the circus instead. STORY RECOGNITIONWhat was the name of the woman who borrowed money?How much money did she borrow?What was the name of the woman s brother?What did the woman buy?Where did the woman go? Carol$15 RobertIce CreamMall Mary$10To mSandwichCircus Sue$16 JackSodaGrocery_____ / 2_____ / 11_____ / 2_____ / 11_____ / 5 The BCAT-SF is a Cognitive screening measure. It is an abbreviated version of the original BCAT. As such, de nitive diagnoses should not be made based on this test alone. These results are based on the inputting of BCAT-SF item scores.
3 The conclusions reported are the result of statistical analyses from data collected from psychometric research. All results are based on statistical probabilities, not certainties. Mansbach Health Tools, LLC is not responsible for formal diagnoses or treatments.
