classification system for TBI preL

Question 1

No response RLA level 1

Answer 1

Deep sleep
Unresponsive to stimuli

Question 2

Generalized Response RLA level 2

Answer 2

Patient reactions to stimuli
The same for different stimuli
Non-specific and significantly delayed
Limited eye movements
Non-Purposeful motor responses

Question 3

Localized Response RLA level 3

Answer 3

Reacts specifically but inconsistently
Responses are related to the type of stimuli, such as tracking
May follow simple commands such as closing eyes, or squeezing hands, better from others

Question 4

RLA levels IV. Confused-agitated

Answer 4

Heightened state of activity
Behavior is bizarre and non-purposeful
Aggressive or flighty behavior
Performs activities without purpose

Question 5

RLA level V. Confused-Inappropriate

Answer 5

Responds to simple command
Gross attention to the environment
Responses are inappropriate to situation
Verbalization is often inappropriate
Memory is severely impaired
No carry over

Question 6

RLA level VI. Confused-Appropriate

Answer 6

Patient shows goal-directed behavior but is dependent on external environment
Follows simple directions/commands
Shows carry over
Responses may be incorrect but appropriate to the situation

Question 7

RLA level VII. Automatic-Appropriate

Answer 7

Patient mostly appropriate and oriented within hospital and home settings
Daily routines are automatic
Minimal to no confusion
Carryover for new learning but at a decreased rate

Question 8

RLA VIII. Purposive-Appropriate: Stand-By Assist

Answer 8

Recalls and integrates events
Maintains carryover for new learning
Is aware and responsive to the environment, but needs assist to acknowledge others’ feelings

May show
Decreased tolerance to stress
Decreased understanding of abstract concepts
Decreased ability in judgment for emergencies

Question 9

RLA level IX. Purposive-Appropriate: Stand-By Assist on Request

Answer 9

Uses memory devices (“to-do” lists)
Initiates and carries out familiar tasks independently
Requests assistance for unfamiliar tasks
Acknowledges impairments in the moment
Needing stand-by assist to anticipate/avoid problems
Acknowledges needs and feelings of others with stand-by assist

May show
Increased tolerance for 2hrs of activity time
Easily irritable with low frustration tolerance
Depression may continue

Question 10

RLA level X. Purposive-Appropriate: Modified Independent

Answer 10

Able to handle multiple tasks simultaneously
Able to create and maintain own memory devices
Independently caries out familiar and unfamiliar tasks- requires more time or compensatory strategies

May show
Irritability or frustration with sick, fatigued, under emotional stress
Periodic times of depression