Measurement Tools

Several measures of function have been used to assess outcomes after TBI. They are variable and can involve neuropsychological assessment as well as motor testing.

The Coma/Near-Coma Scale is useful in evaluat­ing small changes in patients who are at a low level of consciousness.

The Functional Independence Measure (FIM) and the Functional Independence Measure for Children (WeeFIM) can be used to asses global functioning (232). The FIM is useful for children who are more than 7 years of age and the WeeFIM between 6 months and 7 years of age. This tool assesses transfers, locomo­tion, self-care, sphincter control, communication, com­prehension, and social cognition (233). The WeeFIM is often used to demonstrate gains in children with TBI during their inpatient rehabilitation stays.

The Glasgow Outcome Scale is a scale for classi­fying patients with traumatic brain injuries into five categories: death, persistent vegetative state, severe disability, moderate disability, and good recovery (234). This scale has been modified to differentiate outcomes as they apply to children (Table 10.3). It is divided into a cognitive component and a motor component.

The Pediatric Evaluation of Disability Inventory (PEDI) is another clinical assessment tool. It describes performance in the domains of self-care, mobility, and social function. The PEDI has questions about 197 functional skills, 20 caregiver assistance questions, and 20 equipment modification questions. This scale is used in children 6 months of age to 7 years of age, and correlates well with the WeeFIM, demonstrating good validity within both of the measures (232).