Complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular, or painful stimuli

Demonstrates generalized reflex response to painful stimuli

Responds to repeated auditory stimuli with increased or decreased activity

Responds to external stimuli with physiological changes generalized, gross body movement, and/or not purposeful vocalization

Responses noted above may be same regardless of type and location of stimulation

Responses may be significantly delayed

Demonstrates withdrawal or vocalization to painful stimuli

Turns toward or away from auditory stimuli

Blinks when strong light crosses visual field

Follows moving object passed within visual field

Responds to discomfort by pulling tubes or restraints

Responds inconsistently to simple commands

Responses directly related to type of stimulus

May respond to some persons (especially family and friends) but not to others

Alert and in heightened state of activity

Purposeful attempts to remove restraints or tubes or crawl out of bed

May perform motor activities such as sitting, reaching, and walking but without any apparent purpose or upon another's request

Very brief and usually nonpurposeful moments of sustained alternatives and divided attention

Absent short-term memory

May cry out or scream out of proportion to stimulus even after its removal

May exhibit aggressive or flight behavior

Mood may swing from euphoric to hostile with no apparent relationship to environmental events

Unable to cooperate with treatment efforts

Verbalizations are frequently incoherent and/or inappropriate to activity or environment

Alert, not agitated but may wander randomly or with a vague intention of going home

May become agitated in response to external stimulation and/or lack of environmental structure

Not oriented to person, place, or time

Frequent brief periods, nonpurposeful sustained attention

Severely impaired recent memory, with confusion of past and present in reaction to ongoing activity

Absent goal-directed, problem-solving, self-monitoring behavior

Often demonstrates inappropriate use of objects without external direction

May be able to perform previously learned tasks when structure and cues provided

Unable to learn new information

Able to respond appropriately to simple commands fairly consistently with external structures and cues

Responses to simple commands without external structure are random and nonpurposeful in relation to command

Able to converse on a social automatic level for brief periods of time when provided external structure and cues

Verbalizations about present events become inappropriate and confabulatory when external structure and cues are not provided

Inconsistently oriented to person, time, and place

Able to attend to highly familiar tasks in nondistracting environment for 30 minutes with moderate redirection

Remote memory has more depth and detail than recent memory

Vague recognition of some staff

Able to use assistive memory aid with maximum assistance

Emerging awareness of appropriate response to self, family, and basic needs

Moderate assist to problem solve barriers to task completion

Supervised for old learning (eg, self care)

Shows carry over for relearned familiar tasks (eg, self care)

Maximum assistance for new learning with little or no carry over

Unaware of impairments, disabilities, and safety risks

Consistently follows simple directions

Verbal expressions are appropriate in highly familiar and structured situations

Consistently oriented to person and place within highly familiar environments; moderate assistance for orientation to time

Able to attend to highly familiar tasks in a nondistraction environment for at least 30 minutes with minimal assist to complete tasks

Minimal supervision for new learning

Demonstrates carry over of new learning

Initiates and carries out steps to complete familiar personal and household routine but has shallow recall of what he/she has been doing

Able to monitor accuracy and completeness of each step in routine personal and household activities of daily living (ADLs) and modify plan with minimal assistance

Superficial awareness of his/her condition but unaware of specific impairments and disabilities and the limits they place on his/her ability to safely, accurately, and completely carry out his/her household, community, work, and leisure ADLs

Minimal supervision for safety in routine home and community activities

Unrealistic planning for the future

Unable to think about consequences of a decision or action

Overestimates abilities

Unaware of others' needs and feelings

Oppositional/uncooperative

Unable to recognize inappropriate social interaction behavior

Consistently oriented to person, place, and time

Independently attends to and completes familiar tasks for 1 hour in distracting environments

Able to recall and integrate past and recent events

Uses assistive memory devices to recall daily schedule, to-do lists, and record critical information for later use with standby assistance

Initiates and carries out steps to complete familiar personal, household, community, work, and leisure routines with standby assistance and can modify the plan when needed with minimal assistance

Requires no assistance once new tasks/activities are learned

Aware of and acknowledges impairments and disabilities when they interfere with task completion but requires standby assistance to take appropriate corrective action

Thinks about consequences of a decision or action with minimal assistance

Overestimates or underestimates abilities

Acknowledges others' needs and feelings and responds appropriately with minimal assistance

Depressed

Irritable

Low frustration tolerance/easily angered

Argumentative

Self-centered

Uncharacteristically dependent/independent

Able to recognize and acknowledge inappropriate social interaction behavior while it is occurring and takes corrective action with minimal assistance

Independently shifts back and forth between tasks and completes them accurately for at least 2 consecutive hours

Uses assistive memory devices to recall daily schedule, "to do" lists, and record critical information for later use with assistance when requested

Initiates and carries out steps to complete familiar personal, household, work, and leisure tasks independently and unfamiliar personal, household, work, and leisure tasks with assistance when requested

Aware of and acknowledges impairments and disabilities when they interfere with task completion and takes appropriate corrective action but requires stand-by assistance to anticipate a problem before it occurs and take action to avoid it

Able to think about consequences of decisions or actions with assistance when requested

Accurately estimates abilities but requires stand-by assistance to adjust to task demands

Acknowledges others' needs and feelings and responds appropriately with standby assistance

Depression may continue

May be easily irritable

May have low frustration tolerance

Able to self monitor appropriateness of social interaction with stand-by assistance

Able to handle multiple tasks simultaneously in all environments but may require periodic breaks

Able to independently procure, create, and maintain own assistive memory devices

Independently initiates and carries out steps to complete familiar and unfamiliar personal, household, community, work, and leisure tasks but may require more than usual amount of time and/or compensatory strategies to complete them

Anticipates impact of impairments and disabilities on ability to complete daily living tasks and takes action to avoid problems before they occur but may require more than usual amount of time and/or compensatory strategies

Able to independently think about consequences of decisions or actions but may require more than usual amount of time and/or compensatory strategies to select the appropriate decision or action

Accurately estimates abilities and independently adjusts to task demands

Able to recognize the needs and feelings of others and automatically respond in appropriate manner

Periodic periods of depression may occur

Irritability and low frustration tolerance when sick, fatigued, and/or under emotional stress

Social interaction behavior is consistently appropriate