BI Asessment Tools
Orientation Log (O-Log)
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Mental confusion can be a significant barrier to independent living and to participation in rehabilitation. Measuring orientation is one way to evaluate confusion and has been helpful in documenting change over time. Orientation assessment is a component of all measures of mental status largely because it is quick to ascertain, can be scored objectively, and is generally agreed to be within the cognitive capacity of normal individuals. The Orientation Log (O-Log) was developed to measure orientation to time, place, and circumstance in a rehabilitation population. The O-Log can be used for serial assessment of orientation to document changes over time. This can be very helpful in documenting progress that could help justify continuing treatment. The instrument can be used with anyone who is potentially disoriented; the questions are not specific to any disorder. Thus far the O-Log has been used with people experiencing TBI, CVA, tumor, infectious disease, and degenerative disorders. Each of the 10 questions comprising the O-Log are objectively scored and the scale can be presented in just a few minutes. The ten items of the O-Log are scored 0 to 3 depending on the response provided. A spontaneous correct response is awarded 3 points on any item. No item is weighted more than another. A score of 2 is assigned if the spontaneous response is lacking or incorrect, but a correct response is provided following a logical cue given by the examiner. For instance, if the person misstates the location, the examiner states, "This is a place where doctors and nurses work." If the person states it is January when it is March, the examiner states, "January was two months ago, so what month is it now." The content of the cue will vary depending on the error. A score of 1 is given if spontaneous and cued responses are lacking or incorrect, but a correct response is provided in a recognition format. For instance, the examiner would name three months, three years, three locations, etc. and ask the person to recognize the correct item. Zero points are assigned if the spontaneous, cued, and recognition formats do not generate a correct response. For fully oriented individuals the scale takes as little as three minutes to administer, whereas for those who are confused and require a recognition format for every question 10 to 15 minutes may be required. The scale can be administered at bedside or in any other setting. Scores for each of the 10 items are summed to obtain a total score that ranges from 0 to 30. Specific domain scores can be calculated as follows: Place = City + Kind of Place + Name of Hospital; Time = Month + Date +Year + Day of Week + Clock Time; Situation = Etiology/Event + Pathology/Deficits. For more information, contact Tom Novack, Ph.D. Source material provided by University of Alabama at Birmingham Traumatic Brain Injury Care System. Novack, T. (2000). The Orientation Log. The Center for Outcome Measurement in Brain Injury. Salisbury, D., Baños, J.H., Novack, T.A., & Schneider, J.J. (2005). Significance of decreased orientation performance during rehabilitation. Rehabilitation Psychology, 50: 174-176. Alderson AL, Novack TA. (2002). Measuring recovery of orientation during acute rehabilitation for traumatic brain injury: value and expectations of recovery. Jounal of Head Trauma Rehabilitation, 17, 210-219. Dowler, R.N., Bush, B.A., Novack, T.A., & Jackson, W.T. (2000). Cognitive orientation in rehabilitation and neuropsychological outcome after traumatic brain injury. Brain Injury, 14, 117-23. Israelian, M.A., Novack, T.A., Glen, E.T., & Alderson, A. (2000). Changes in orientation during acute rehabilitation following traumatic brain injury. Rehabilitation Psychology, 45, 284-291. Novack, T.A., Dowler, R.N., Bush, B.A., Glen, E.T., & Schneider, J.J. (2000). Validity of the Orientation Log relative to the Galveston Orientation and Amnesia Test. Journal of Head Trauma Rehabilitation, 15: 957-961. 
Orientation Log (O-Log Form)
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