Me. Hayden et al., Reducing level of handicap in traumatic brain injury: An environmentally based model of treatment, J HEAD TR R, 15(4), 2000, pp. 1000-1021
A treatment model is described that has as its primary focus reducing the l
ever of handicap of individuals with traumatic brain injury (TBI) by addres
sing the interaction between critical environmental variables and areas of
deficit. The model focuses on two primary environmental variables-degree of
distraction tolerated and degree of structure required by each individual
to function optimally. These variables are systematically addressed in trea
tment through environmental simulations within the clinic. hn outcome measu
rement system (Pate Environmentally Relevant Program Outcome System [PERPOS
]) is presented that quantities the level of handicap throughout treatment
and at discharge as a function of the interplay between deficit and environ
ment. Data are provided that validate the PERPOS scores through comparison
with qualitative descriptors of day-to-day functioning in several domains.
Outcome data indicate the participants in this treatment model made signifi
cant gains with regard to reduction of handicap.