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Monitoring behavior during coma and post-traumatic amnesia.
Wilson, B.A., Shiel, A., Watson, M., Horn, S. & McLellan, L.
In A-L. Christensen and B. Uzzell (Eds.), Brain Injury and Neuropsychological Rehabilitation (pp. 85-98). Hillsdale, N.J.: Lawrence Erlbaum Associates.
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This chapter is concerned with the assessment of severely head injured people in the earliest days after insult. A set of scales for monitoring the recovery of functional skills in these people has recently been developed (the Wessex Head Injury Matrix - WHIM). The matrix comprises 11 sub-scales for measuring progress in four main areas: cognition, self-care, motor functioning and social behaviour; and one scale for assessing post-traumatic amnesia. From the scales it is possible to (a) detect small improvements that might otherwise be missed, (b) see whether a patient is showing the typical order of recovery, and (c) pinpoint specific deficits in functioning. Observations are described in behavioural terms that enable therapists to determine steps to focus on in rehabilitation. As this functional approach concentrates on skills required for everyday life it has considerable implications for the care and rehabilitation of people recovering from severe head injury.