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Cognitive Functioning with TBI – Rancho Level of Cognitive Functioning

The Law Office of David Dwork

When a personal injury comes in the form of a Traumatic Brain Injury (TBI) the effects can be physical, cognitive, emotional or behavioral. While most of us are familiar with the terms physical, emotional and behavioral, cognitive may need clarification.

Cognition: the scientific term for the “process of thought”.

  • In psychology it usually refers to an information processing view of an individual’s psychological functions;
  • or, the development of concepts

Cognitive skills that we take for granted include: paying attention, awareness of our surroundings, organizing, planning, follow through on decisions, problem solving, judgment, reasoning and awareness of problems. Memory skills include the ability to remember things from both before and after a traumatic brain injury.

While each traumatic brain injury is unique unto the individual there are levels of cognitive functioning that doctors and rehabilitation teams use to assess the patient. The Rancho Level of Cognitive Functioning Scale (LCFS) is one of the earliest developed scales used to access cognitive functioning in TBI patients.

LCFS is used in the planning of treatment, tracking of recovery and classifying of outcome levels in post-comma patients. The scale is comprised of eight levels:

  1. No response
  2. Generalized
  3. Localized
  4. Confused-agitated
  5. Confused, inappropriate, non-agitated
  6. Confused-appropriate
  7. Automatic-appropriate
  8. Purposeful-appropriate

There is a range of abilities within each level and some TBI patients will pass through the levels quickly, while others may plateau at a certain level. Each TBI case is different as is each individual.

This pdf, written by Rancho Los Amigos National Rehabilitation Center in CA is a resource for the families and friends of someone with a traumatic brain injury. In it you will find details describing each level of cognitive functioning in the LCFS scale and can be done at that level to provide the support that a TBI patient requires.

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