Definition
The Rancho Los Amigos Scale (RLAS), aka the Rancho Los Amigos Levels of Cognitive Functioning Scale (LOCF), and often referred to simply as the “Rancho Scale,” is an ordinal scale of recovery of function following traumatic brain injury. It consists of eight levels: (1) no response (coma); (2) generalized response (vegetative state); (3) localized response; (4) confused-agitated; (5) confused, inappropriate, non-agitated; (6) confused-appropriate; (7) automatic-appropriate; and (8) purposeful-appropriate. Each level has a prose description of its characteristic features, which, particularly for the higher levels, is quite lengthy. Although the scale has demonstrated acceptable inter-rater and test-retest reliability, it has been criticized because of the lack of operational definitions for each level of the scale and the fact that, particularly in higher functioning individuals, it is common to show features characteristic of more than one scale level. In addition, it has...
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References and Readings
Dowling, G. A. (1985). Levels of cognitive functioning: Evaluation of interrater reliability. Journal of Neurosurgical Nursing, 17(2), 129–134.
Gouvier, W., Blanton, P., LaPorte, 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, 94–97.
Hagen, C., Malkmus, D., & Durham, P. (1972). Levels of cognitive functioning. Downey: Rancho Los Amigos Hospital.
The Center for Outcome Measurement in Brain Injury. Introduction to the Level of Cognitive Functioning Scale. http://www.tbims.org/combi/lcfs/index.html. Accessed 29 June 2016
Van Baalen, B., van Woensel, M. P. C., van Kessel, M. A., Roebroeck, M. E., & Stam, H. J. (2006). Reliability and sensitivity to change of measurement instruments used in a traumatic brain injury population. Clinical Rehabilitation, 20, 686–700.
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Whyte, J., Kunz, R. (2016). Rancho Los Amigos Scale. In: Kreutzer, J., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_67-3
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DOI: https://doi.org/10.1007/978-3-319-56782-2_67-3
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