| Level I |
No response/total assistance |
No response to external stimuli |
| Level II |
Generalized response/total assistance |
Respond inconsistently and non-purposefully to external stimuli. Responses are often the same regardless of the stimulus applied. |
| Level III |
Localized response/total assistance |
Respond inconsistently and specifically to external stimuli. Responses are directly related to the stimulus. Tend to be more responsive to familiar people (friends and family) than to strangers |
| Level IV |
Confused and agitated/maxassist |
In a hyperactive state with bizarre and non-purposeful behavior. Demonstrate agitated behavior that originates more from internal confusion than the external environment |
| Level V |
Confused, inappropriate non agitated/max assist |
Show an increase in consistency with following and responding to simple commands, their responses are non-purposeful and random to more complex commands. Behavior and verbalization are often inappropriate, and the patient can appear confused and often confabulates. Can perform an action or task if it is first modeled or demonstrated for them, they do not yet initiate tasks on their own. Memory is severely impaired and learning new information is difficult. Can show agitation to unpleasant external stimuli |
| Level VI |
Confused, appropriate/mod assist |
Able to follow simple commands consistently. Able to retain learning for familiar tasks they performed pre-injury (brushing teeth, washing face) but are unable to retain learning for new tasks. Demonstrate an increased awareness of self, situation, and their environment but are unaware of any specific impairments and safety concerns. Responses may be incorrect secondary to memory impairments but appropriate to the situation |
| Level VII |
Automatic, appropriate/min assist for ADLs |
Oriented in familiar settings. Able to perform a daily routine automatically with absent to minimal confusion Demonstrate carry over for new tasks and learning in addition to familiar tasks. Can be superficially aware of diagnosis but unaware of specific impairments. Continue to demonstrate a lack of insight, decreased judgment and safety awareness. Beginning to show interest in social and recreational activities in structured settings. Require at least minimal supervision for learning and safety purposes |
| Level VIII |
Purposeful, appropriate/stand by assist |
Consistently oriented to person, place, and time. Can independently carry out familiar tasks in a non-distracting environment. Beginning to show awareness of their specific impairments and how they interfere with tasks, but they still require stand by assistance with compensatory skills. Able to use assistive memory devices to recall a daily schedule. Acknowledge other people's emotional states and require only minimal assistance to respond appropriately. Demonstrate improvement of memory and ability to consolidate past and future event. Often depressed, irritable, and demonstrate a low threshold to rustration |
| Level IX |
Purposeful, appropriate/stand by assist on request |
Able to shift between different tasks and complete them independently. Aware of and acknowledge their impairments when they interfere with tasks. Able to use compensatory strategies to cope. Able to independently anticipate obstacles that may arise secondary to any lingering impairments. Able to consider the consequences of actions and decisions with assistance. Continue to demonstrate depression and low frustration thresholds |
| Level X |
Purposeful, appropriate/modified independent |
Able to multitask in many different environments with extra time for task completion or devices to assist. Able to create their own methods and tools for memory retention. Can independently anticipate obstacles that may occur as a result of their impairments and take corrective actions. Able to independently make decisions and act appropriately but may require more time or compensatory strategies. May still demonstrate intermittent periods of depression and a lowered threshold for frustration when under stress. Able to appropriately interact with others in social situations |
