BRAIN-INJURED PERSONS IN AN ALTERED STATE OF CONSCIOUSNESS - MEASURESAND INTERVENTION STRATEGIES

We evaluated the states of consciousness of seven persons who had sust ained a severe head injury, and describe the behavioural manifestation s associated with four treatment strategies. The subjects were between the ages of 19 and 55 and were recruited from both acute and long-ter m care facilities; all were in an altered state of consciousness. The severity of the injury was measured by time in coma, the scores on the Glasgow Coma Scale [1] and the Coma Near Coma Scale [2]. Structured i nterventions consisted of visual, auditory, olfactory, gustatory and t actile stimulation; behaviour was measured using the Disability Rating Scale [3, 4] and a portion of the Levels of Cognitive Functioning Sca le [5]. Sensory-motor indications were recorded using a questionnaire developed by Freeman [6] and a quality-of-life instrument, developed f or use with individuals having multiple disabilities [7], was adapted for the purpose of this study. Our results suggest that the use of str uctured interventions in the first 24 months following severe head inj ury is associated with a trend towards improved auditory and visual sk ills performance, manual performance, swallowing and language. Whereas initially no subject had any form of verbalization, by the final eval uation five subjects had some form of communication, either verbal or non-verbal.