Rancho Los Amigos - Revised

Rancho Los Amigos - Revised

The Rancho Los Amigos Levels of Cognitive Functioning Scale is a renowned clinical tool used to rate how people with brain injury are recovering. The ten levels of recovery noted in the scale also help to decide when a patient is ready for rehabilitation. As patients "wake up" after a head injury, they go through different levels of recovery on the Rancho Scale. Each level describes a general pattern of recovery, with a focus on cognition and behavior.


Levels of Cognitive Functioning

 

Level I - No Response: Total Assistance

 

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


Level II - Generalized Response: Total Assistance


Level III - Localized Response: Total Assistance


Level IV - Confused/Agitated: Maximal Assistance


Level V - Confused, Inappropriate Non-Agitated: Maximal Assistance


Level VI - Confused, Appropriate: Moderate Assistance


Level VII - Automatic, Appropriate: Minimal Assistance for Daily Living Skills


Level VIII - Purposeful, Appropriate: Stand-By Assistance


Level IX - Purposeful, Appropriate: Stand-By Assistance on Request


Level X - Purposeful, Appropriate: Modified Independent

 

Original Scale co-authored by Chris Hagen, Ph.D., Danese Malkmus, M.A., Patricia Durham, M.A. Communication Disorders Service, Rancho Los Amigos Hospital, 1972. Revised 11/15/74 by Danese Malkmus, M.A., and Kathryn Stenderup, O.T.R. Revised scale 1997 by Chris Hagen.