RANCHO LOS AMIGOS COGNITIVE LEVELS

(The following scale describes the phases of recovery for Traumatic Brain Injury.)

Level I No response to stimuli. Appears in deep sleep.

Level II Generalized response. First reaction may be to deep pain. Has delayed, inconsistent responses.

Level III Localized Response. Inconsistent responses, but reacts in a more specific manner to stimulus. Might follow simple command "Squeeze my hand."

Level IV Confused - Agitated. Reacts to own inner confusion, fear disorientation. Excitable behavior, may be physically or verbally abusive.

Level V Non-agitated-Confused-Inappropriate. Usually disoriented. Follows tasks for 2-3 minutes, but easily distracted by environment, frustrated.

Level VI Confused - Appropriate. Follows simple directions consistently. Memory and attention increasing. Self-care tasks performed without help.

Level VII Automatic-Appropriate. If physically able, can carry out routine activities. Appears normal. Needs supervision for safety.

Level VIII Purposeful, Alert, Oriented. May have decreased abilities relative to premorbid state.

Level IX Purposeful and Appropriate. May need stand-by assistance on request. Needs supervision to anticipate a problem before it occurs and take action to avoid it. May be easily irritable.

Level X Purposeful and Appropriate. Able to independently create and maintain own assistive memory devices. Able to independently think about consequences of decisions or actions. May require more than usual amount of time to select the appropriate decision or action.