Offering diagnosis and treatment of communication, hearing, and swallowing disorders
Published: Feb. 24, 2011
Updated: Nov. 3, 2011
Speech-language pathologists (SLPs) provide rehabilitative services to patients who have sustained a traumatic brain injury (TBI). The main focus of this rehabilitation is cognitive-communication therapy.
Cognition is a person’s ability to think, process information, remember and recall events, pay attention, solve problems, demonstrate awareness of his surroundings and self, as well as plan and organize.
Therefore, cognitive-communication is the way a person uses these skills, along with language, to communicate.
Following TBI, some or all of these skills may have changed as a result of the person’s injury. The SLP will evaluate the person with TBI to determine their strengths and areas for improvement and develop an individualized cognitive-communicative therapy plan.
One important part of the recovery process involves the use of the Rancho Los Amigo Scale, or Rancho Levels of Cognitive Functioning. This scale is used by SLPs and other rehabilitation specialists to identify, document, and communicate patient progress.
As a person recovers from a TBI, they move through a predictable pattern of recovery. The person demonstrates behaviors and cognitive-communicative abilities that change and improve over time.
The scale detailed below has eight levels. Rancho levels I-III describe behaviors and abilities that are severely affected by the TBI, whereas the highest levels, Level VIII+, describes mild deficits.
A person with TBI usually progresses from a lower level to a higher level as the TBI improves through participation in therapy.
The Rancho scale is a predictable pattern of behaviors and abilities and is a guide -- although the pattern is the same, there can be much variation among individuals. Speech therapy and rehabilitation can help patients move to the next stage when they are ready.
Select a link below to learn how patients react at a certain level of cognition and how friends and family can help support the patient at each stage of recovery.
The scale is adapted from “The Family Guide to the Rancho Levels of Cognitive Functioning” from the Rancho Los Amigos National Rehabilitation Center.