Patient responds to internal cues only. A change in the level of arousal is a specific response to an external stimulus that produces pain or has an instinctive survival value.

Complete dependence

Motor actions are Automatic/Reflexive. 

Patient’s awareness is limited to own postural actions (proprioceptive cues) to move body in space or overcome effects of gravity. There is a lack of awareness of the effects that actions have on objects or other people.

Complete dependence

Patient performs spontaneous manual actions in response to tactile cues. Repetitive actions demonstrate an awareness of material objects but lack of awareness of cause and effect, end product, or goal.

Modified dependence

3.0     Grasp objects – purposeful grasp and release

3.2     Distinguishes between objects

3.4     Sustains actions on objects (may look perseverative)

3.6     Cause and effect – notices effects have on objects, by manipulating them e.g. able to sort objects, uses mirrors during ADLs

3.8     Uses all objects and knows when an activity is completed

Patient is aware of tangible cues (what can be seen and touched) and understands visible cause-and-effect relationships. Goal-directed actions demonstrate an
awareness of a familiar end-product but fail to solve new problems, anticipate, or correct mistakes. There is no independent new learning and they cannot invent new motor actions.
They do not recognize errors unless clearly visible, and may request help when mistakes are
noticed.

Modified dependence

Attention span is usually good for up to one hour.

The Patient is able to learn new ways of doing things through trial-and-error problem solving. The Patient detects the best effect by exploring distinctive properties of objects and trying different actions. They exercise poor judgment with no symbolic thought to plan actions or anticipate potential mistakes. They may make hasty or impulsive decisions or make abrupt changes in their course of action. The determination of what is best may be made according to personal preferences or social standards. The Patient can imitate a series of new directions; new learning is recognized and repeated during the process of doing an activity.

Modified independence

Absence of dysfunction, task performance is planned and premeditated, anticipates errors, and able to use abstract and symbolic reasoning. Considers several hypothetical plans of actions and establishes abstract criteria for selecting the best plan. Able to make plans for the future, taking into account possible risks to health and well-being for one’s self and others.

Level 2.4 – gross body movements, aimless walking.

Level 2.8 –  may use grab bars and furniture to stabilize their balance.

Level 4.6 – May live alone with daily assistance to monitor personal safety. May require reminders to do household chores

Level 4.8 – May live alone with daily assistance to monitor safety and check problem- solving methods.

Level 4.2 – May spend a daily allowance, walk to familiar locations in the neighborhood, or follow a simple, familiar bus route.

Level 4.4 – May manage a daily allowance and go to familiar places in the neighborhood.

Level 4.6 – May require reminders to attend familiar community events, or to do anything in addition to daily household routine.

Level 4.8 – May get self to a regularly scheduled community activity

Level 5.2 – May live alone with weekly checks to monitor safety and examine potentially dangerous effects of impulsive behavior.

Level 5.4 –  May live alone

Level 5.4 – May work in a job with a wide margin of error.  May not be safe in jobs with a high potential for industrial accidents.

Level 5.6  –  May work in a suitable job and be relied upon to consistently follow safety precautions.