The Rancho Los Amigos Scale (RLAS), a.k.a. the Rancho Los Amigos Levels of Cognitive Functioning Scale (LOCF) or Rancho Scale, is a medical scale used to assess individuals after a closed head injury, including

traumatic brain injury A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity ranging from mild traumatic brain injury (mTBI/concussion) to severe traumati ...

, based on cognitive and behavioural presentations as they emerge from

coma A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to Nociception, respond normally to Pain, painful stimuli, light, or sound, lacks a normal Circadian rhythm, sleep-wake cycle and does not initiate ...

.Rancho Los Amigos National Rehabilitation Center. (1 March 2011). ''The Rancho Levels of Cognitive Functioning''. Retrieved May 15, 2011, from https://web.archive.org/web/20110514024558/http://rancho.org/Research_RanchoLevels.aspx It is named after the

Rancho Los Amigos National Rehabilitation Center Rancho Los Amigos National Rehabilitation Center is a rehabilitation hospital located in Downey, California, United States. Its name in Spanish means "Friends' Ranch". History Overview Rancho Los Amigos National Rehabilitation Center, or Ran ...

, located in

Downey, California Downey is a city located in Southeast Los Angeles County, California, United States, southeast of Downtown Los Angeles. It is considered part of the Gateway Cities. The city is the birthplace of the Apollo space program and Taco Bell. It is ...

, United States in

Los Angeles County Los Angeles County, officially the County of Los Angeles and sometimes abbreviated as LA County, is the most populous county in the United States, with 9,663,345 residents estimated in 2023. Its population is greater than that of 40 individua ...

. After being assessed based on the LOCF, individuals with brain injury receive a score from one to eight. A score of one represents non-responsive cognitive functioning, whereas a score of eight represents purposeful and appropriate functioning.Fulk, G. D. (2007). Traumatic Brain Injury. In S. B. O’Sullivan & T. J. Schmitz (Eds.), ''Physical Rehabilitation'' (5th ed., pp. 895-935). Philadelphia, PA: F. A. Davis Company. Each of the eight levels represents the typical sequential progression of recovery from brain damage. However, individuals progress at different rates and may plateau at any stage of recovery. These patients are scored based on combinations of the following criteria: * responsiveness to stimuli * ability to follow commands * presence of non-purposeful behavior *

cooperation Cooperation (written as co-operation in British English and, with a varied usage along time, coöperation) takes place when a group of organisms works or acts together for a collective benefit to the group as opposed to working in competition ...

confusion In psychology, confusion is the quality or emotional state of being bewildered or unclear. The term "acute mental confusion"

attention Attention or focus, is the concentration of awareness on some phenomenon to the exclusion of other stimuli. It is the selective concentration on discrete information, either subjectively or objectively. William James (1890) wrote that "Atte ...

to environment * focus * coherence of verbalization * appropriateness of verbalizations and actions * memory recall *

orientation Orientation may refer to: Positioning in physical space * Map orientation, the relationship between directions on a map and compass directions * Orientation (housing), the position of a building with respect to the sun, a concept in building des ...

judgement Judgement (or judgment) is the evaluation of given circumstances to make a decision. Judgement is also the ability to make considered decisions. In an informal context, a judgement is opinion expressed as fact. In the context of a legal tria ...

and

reasoning Reason is the capacity of consciously applying logic by drawing valid conclusions from new or existing information, with the aim of seeking the truth. It is associated with such characteristically human activities as philosophy, religion, scien ...

LOCF scores are used by health care professionals for standardized communication about patient status and can be used by physiatrists,

physical therapists Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease prevention ...

occupational therapists Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's abil ...

, recreational therapists, and speech language pathologists as the basis for treatment planning. This eight-level scale was found to possess test-retest and interrater reliability as well as concurrent and predictive validity.Gouvier, W. D., Blanton, P. D., LaPorte, K. K., & Nepomuceno, C. (1987). Reliability and validity of the Disability Rating Scale and the Levels of Cognitive Functioning Scale in monitoring recovery from severe head injury. ''Archives of Physical Medicine and Rehabilitation'', 68(2), 94-97. It is widely used clinically and is often paired with the Glasgow Coma Scale in health care facilities.

References

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External links

Family Guide To The Rancho Levels of Cognitive Functioning
- description of the scale at the Rancho Los Amigos National Rehabilitation Center Neurology Medical scales Coma Medical assessment and evaluation instruments