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The Neurobehavioral Cognitive Status Examination and the Glasgow Coma Scale: A validation study
Abstracts
149
plinary treatment and assessment of TBI. Qualifiable cognitive, behavioral, physical, and social changes are identified which serve to define the specific functional level at which a patient may be functioning at any given point in treatment. For each functional level a general approach to treatment is outlined. Aside from providing a means of assessing change over the course of treatment, the LTBIS has proven especially useful in helping to enhance the family’s understanding of head injury and the recovery process. The current scale assesses the following “functions”: cognition, communication, mobility, oral motor abilities, activities of daily living, and psychosocial adjustment. In addition to these scales a number of specific scales have been developed that broaden the use of the LTBIS to more domain specific situations. Each functional area within the LTBIS is assessed along an ordinal scale ranging from coma (Level 1) to independence (Level 8). A profile analysis of the patient’s functioning is possible for each of the functional areas assessed by the LTBIS. The “cognition” section of the LTBIS is provided in detail to illustrate the assessment and treatment components of the LTBIS.
Hammill, C., &Walker, N. W. Mediplex Rehab, Camden. The Neurobebavioral Cognitive Status Examination and The Glasgow Coma Scale: A validation study. Intro: Brief, bedside screening evaluations are increasingly being used as a means of evaluating cognitive functioning prior to more in-depth and time consuming neuropsychological tests. It is often the clinician’s first attempt to identify, albeit grossly, areas of deficit resulting from brain dysfunction. The Neurobehavioral Cognitive Screening Examination (NCSE) (Kiernan et al., 1987) is one of the newest screening exams. Its authors claim superiority over other screening evaluations in that the NCSE does not rely on a single composite score to detect the presence or absence of brain damage; a concept rooted in the erroneous assumption of “organicity” as a unitary disorder. Instead, a profile is determined based on performance in various aspects of cognitive functioning. This enables the individual to determine the degree of disability of cognitive impairment. Normative data have been collected on the NCSE on 60 normal subjects and 30 neurosurgical subjects with documented brain lesions (Kiernan et al., 1987). Superiority of the NCSE over other screening batteries has been established (Schwann et al., 1987). Method: The present study is a validation study of the NCSE in relation to severity of injury. Severity of injury will be determined by using the Glasgow Coma Scale scores (GCS). Thirty patients admitted to a hospital trauma unit will be administered the NCSE within 72 hours after emergence from coma. The patients will be separated into three groups based on the average GCS over the first 72 hours after admission to the trauma unit. Data will be analyzed on the basis of comparison between the NCSE and GCS. Results: In theory the results should support the ability of the NCSE to discriminate TBI survivors on the basis of severity of injury.
149
plinary treatment and assessment of TBI. Qualifiable cognitive, behavioral, physical, and social changes are identified which serve to define the specific functional level at which a patient may be functioning at any given point in treatment. For each functional level a general approach to treatment is outlined. Aside from providing a means of assessing change over the course of treatment, the LTBIS has proven especially useful in helping to enhance the family’s understanding of head injury and the recovery process. The current scale assesses the following “functions”: cognition, communication, mobility, oral motor abilities, activities of daily living, and psychosocial adjustment. In addition to these scales a number of specific scales have been developed that broaden the use of the LTBIS to more domain specific situations. Each functional area within the LTBIS is assessed along an ordinal scale ranging from coma (Level 1) to independence (Level 8). A profile analysis of the patient’s functioning is possible for each of the functional areas assessed by the LTBIS. The “cognition” section of the LTBIS is provided in detail to illustrate the assessment and treatment components of the LTBIS.
Hammill, C., &Walker, N. W. Mediplex Rehab, Camden. The Neurobebavioral Cognitive Status Examination and The Glasgow Coma Scale: A validation study. Intro: Brief, bedside screening evaluations are increasingly being used as a means of evaluating cognitive functioning prior to more in-depth and time consuming neuropsychological tests. It is often the clinician’s first attempt to identify, albeit grossly, areas of deficit resulting from brain dysfunction. The Neurobehavioral Cognitive Screening Examination (NCSE) (Kiernan et al., 1987) is one of the newest screening exams. Its authors claim superiority over other screening evaluations in that the NCSE does not rely on a single composite score to detect the presence or absence of brain damage; a concept rooted in the erroneous assumption of “organicity” as a unitary disorder. Instead, a profile is determined based on performance in various aspects of cognitive functioning. This enables the individual to determine the degree of disability of cognitive impairment. Normative data have been collected on the NCSE on 60 normal subjects and 30 neurosurgical subjects with documented brain lesions (Kiernan et al., 1987). Superiority of the NCSE over other screening batteries has been established (Schwann et al., 1987). Method: The present study is a validation study of the NCSE in relation to severity of injury. Severity of injury will be determined by using the Glasgow Coma Scale scores (GCS). Thirty patients admitted to a hospital trauma unit will be administered the NCSE within 72 hours after emergence from coma. The patients will be separated into three groups based on the average GCS over the first 72 hours after admission to the trauma unit. Data will be analyzed on the basis of comparison between the NCSE and GCS. Results: In theory the results should support the ability of the NCSE to discriminate TBI survivors on the basis of severity of injury.