2.4 The Galveston Orientation and Amnesia Test (GOAT)

Describe the Galveston Orientation and Amnesia Test (GOAT).

The GOAT consists of 10 items regarding orientation to:

  1. person: name, address and birth date;
     
  2. place: city/town and building they are in;
     
  3. time: current time, date, month year and date of hospital admission;
  4. memory of events both after and prior to the injury 3.

To view the Galveston Orientation and Amnesia Test (GOAT) click here.

What are the advantages of the GOAT?

  1. The GOAT provides an objective rating of early cognitive recovery eliminating the need for sometimes ambiguous terminology used to describe mental status, such as “confused"4.
     
  2. Due to its design, the scale has been shown to be useful for assessing patients with a wide range of cognitive impairments 5.

What are its limitations of the GOAT?

  1. The standard GOAT response format makes administration difficult with nonverbal patients 6.
     
  2. The requirement for oral or written expression may result in penalizing patients who are experiencing deficits of expression but not in orientation or in the retrieval or consolidation of memory 7.
     
  3. An aphasia-specific version of the GOAT has been created; however it requires further evaluation.
     

Note: While the GOAT does contain items intended to provide an assessment of memory, it is primarily a measure of disorientation. Eight of the 10 GOAT items evaluate orientation while only 2 examine memory 8.

What does a GOAT score of 75 mean?

  1. The GOAT is scored from 0 to 100.
     
  2. Scores that fall above 75fall into the range considered normal within the reference group4;5.
     
  3. In order a patient to be out of PTA, the GOAT score must be above 75 on three consecutive administrations.
  • The GOAT was intended to evaluate orientation to time, place and person and to provide an estimation of the intervals prior to and following the injury for which there is no recall 4.
     
  • The duration of PTA is defined as the period following coma in which the GOATscore is less than 75 4.
     
  • PTA is considered to have ended if a score of 75 or more is achieved on 3 consecutive administrations 6-8.
     
  • Assessment consists of 10 items regarding orientation to person (name, address & birth date), place (city/town and building they are in) and time (current time, date, month, year & date of hospital admission) as well as memory of events both after and prior to the injury 3.
     
  • The GOAT is a brief and simple mental status examination developed for use by health professionals at the bedside or in the Emergency Department4;5.
     

For a more detailed discussion on the GOAT post ABI pleasesee ERABI/Assessment of Outcomes Following Acquired/Traumatic Brain Injury.