Moderate to Severe TBI  /  Diagnosis  /  Rancho Los Amigos Levels of Cognitive Functioning

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Rancho Los Amigos Levels of Cognitive Functioning

The Rancho Los Amigos Levels of Cognitive Functioning is a system of evaluation used to follow the recovery of the TBI patient and to design an appropriate rehabilitation program. The scale is divided into ten levels, from coma to appropriate behavior and cognitive functioning. It’s important to note that every injury and its effects are unique, so every patient will progress at his or her own pace. Some patients may show a variety of behaviors from different levels at once, and others may not progress to each level during recovery.

The levels of cognitive functioning include:

Level Function
Level I No response to stimulation; requires total assistance
Level II Generalized response to stimulation; requires total assistance
Level III Localized response to stimulation; requires total assistance
Level IV Confused, agitated behavior; requires maximal assistance
Level V Confused, inappropriate, non-agitated behavior; requires maximal assistance
Level VI Confused, appropriate behavior; requires moderate assistance
Level VII Automatic, appropriate behavior; requires minimal assistance for daily living skills
Level VIII Purposeful, appropriate behavior; requires stand-by assistance
Level IX Purposeful, appropriate behavior; requires stand-by assistance on request
Level X Purposeful, appropriate behavior; modified independent