Assessment of Postacute Recovery

Several measures have been developed to assess postacute recovery from pediatric TBI. The Ranchos Los Amigos Levels of Cognitive Functioning Scale (RLCF; Hagen et al. 1972) is a scale commonly used by rehabilitation professionals to assess postacute functioning. The RLCF was developed for the monitoring of adults with TBI but is commonly used in pediatric rehabilitation units. The scale includes eight levels that are thought to parallel the pattern of cognitive recovery following TBI (see Table 27-3). Although the RLCF has been found to predict outcomes after TBI in adult populations, such as return to work (Cifu et al. 1997), little empirical support exists for its use in pediatric TBI. Many rehabilitation units also use measures of functional recovery. The Functional Independence Measure for Children (Msall et al. 1994) is a standardized assessment of self-care, motor, and cognitive skills often used in pe-diatric rehabilitation settings from infancy through 18 years of age. It has received empirical support in general pediatric trauma (Willis et al. 2006) as well as in pediatric TBI (Di Scala et al. 1992; Rice et al. 2005).

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