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Controlled Oral Word Association Test (COWAT) subtest of the Multilingual Aphasia Examination (MAE)
Please visit this website for more information about the instrument: Controlled Oral Word Association Test
Supplemental – Highly Recommended: Epilepsy and Sport-Related Concussion (SRC)
Supplemental: Multiple Sclerosis (MS) and Traumatic Brain Injury (TBI)
Short Description of Instrument
The Controlled Oral Word Association Test (COWAT) is a measure of verbal fluency and is a subtest of the Multilingual Aphasia Examination (Benton, Hamsher, & Sivan, 1994).
The COWAT uses the three letter set of C, F, and L to assess phonemic fluency. Individuals are given 1 min to name as many words as possible beginning with one of the letters. The procedure is then repeated for the remaining two letters (see Strauss, et al., 2006 and Benton, et al., 1994 for specific administration instructions).
Advantages: The COWAT has a rich history of use in mild TBI and sports concussion, particularly older adolescents and adults.   Quick to administer. Appears sensitive to TBI and predicts severity.  Strong psychometric properties.    
Limitations: Less use with children with mild TBI, none with sports concussion. Low specificity. The abilities underlying performance on the test are varied (attention, working memory, processing speed, episodic memory), thus it is difficult to attribute impairment to a particular cognitive function. Highly influenced by premorbid verbal IQ.
Benton AL, Hamsher K deS, Sivan AB. (1994). Multilingual Aphasia Examination, 3rd Edition (MAE). Accessed: 8 May 2017. Available at:
Benton, A., & Hamsher, K (1989). Multilingual Aphasia Examination. Iowa City: AJA Associates.
Miceli G, Caltagirone C, Gainotti G, Masullo C, Silveri MC. Neuropsychological correlates of localized cerebral lesions in non-aphasic brain-damaged patients. J Clin Neuropsychol. 1981;3(1):53–63.
Ross TP. The reliability of cluster and switch scores for the Controlled Oral Word Association Test. Arch Clin Neuropsychol. 2003;18(2):153–164.
Strauss E, Sherman EMS, Spreen O. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary, 3rd ed. New York: Oxford University Press; 2006, pp. 501–526.
Troyer AK, Moscovitch M, Winocur G, Leach L, Freedman M. Clustering and switching on verbal fluency tests in Alzheimer's and Parkinson's disease. J Int Neuropsychol Soc. 1998;4(2):137–143.