2 Written Questions
2 Multiple Choice Questions
- Compensates for some deficiencies of the Glasgow Coma Scale by assessing a broader range of responses. Both of these help clinicians measure responsiveness immediately post injury....BUT
What about eventual level of recovery? In the 1970's and 1980's, several procedures were designed to measure TBI patient's eventual level of recovery. Glasgow Outcome Scale, Glasgow Assessment Schedule, Galveston Orientation and Amnesia Test, Rancho Los Amigos Scale of Cognitive Levels
- Severely impaired: sensory stimulation (touch,sound,vision), environmental control (create highly predictable daily life environment to minimize confusion), behavior modification....
Moderately impaired: training of attention, visual processing, memory (often compensatory approaches), language and communication (often a symptom of these underlying cognitive impairments), reasoning, and problem solving may be appropriate. Direct language targets are often social and interpersonal (pragmatic) aspects of communication. Trying to increase the appropriateness, relevance, and efficiency of participation in conversational interactions, to follow shifts in topic, and to appreciate non-literal aspects of communication.
Mildly impaired: compensatory training (for example tape-recording lectures if cannot keep up with notes) and environmental compensation (restructure daily life to minimize the effects. May mean physical modifications to home, or family education to promote constructive attitudes and to minimize unrealistic expectations.)
2 True/False Questions
The Glasgow Coma Scale → Stage 1: Comatose/Semi-comatose (determine level of conscousness, get sense of nature and severity of injuries, etc.)
Stage 2: Responsive and Agitated. Profound disorientation, confusion, and agitation (baseline measures of orientation and memory—briefly assessed)
Stage 3 (Restless and Distractible) and 4 (Oriented, purposeful): Direct testing begins. Focused on cognitive and communication impairments. Alertness, attention, visual perceptual, memory, language and communication , reasoning, and problem solving assessed.
Stages 5 (Dependent) and 6 (Semi-Independent). More challenging tests tolerated.
Plays an important role, especially at stages 4, 5, and 6 → This tool provides a standard set of categories that help clinicians describe a patient's cognitive and behavioral recovery post TBI.
Clinicians often assume that individual patients recovery will follow the RLAS levels—and many do, but the length of time at each interval can differ.
There is some evidence that the longer the patient spends at levels 1-4, the poorer the recovery prognosis. Errors in prediction can occur, however.
The three highest levels are more sensitive to language impairments