We use our own unique systematic assessment program called PERPOS, or Pate Environmentally Relevant Program Outcome System, as the basis for much of our treatment and research.

PERPOS is a measurement tool that focuses on the complex interactions of the environment and ability. It is comprised of:

  1. amount of structure needed
  2. distraction tolerated
  3. overall functioning/deficit

During the first week of treatment, we will evaluate:

  • speech
  • self-care
  • physical/motor and cognitive abilities
  • daily life skills.

Lower PERPOS scores represent a greater degree of impairment, while higher scores represent a lesser degree of impairment. These scores are determined during bi-weekly treatment team meetings, which include neuropsychologists, physical therapists, occupational therapists, speech language pathologists, case managers and other members of the clinical team. This approach accurately and precisely measures an individual’s distraction and structure tolerance and culminates in a plan that helps patients prepare for the next step in their lives.


High-level Structure, Low-level Distraction – Therapist directed activity provides patient with limited choices in a quiet environment with only the therapist and patient.
Mid-level Structure, Mid-level Distraction – Therapist aided activity in an environment with more people around and more to see.
Low-level Structure, High-level Distraction – Replication of real life situations such as grocery shopping that provides a highly distracted environment in which the patient may be structuring him/herself with little to no input from the therapist.



The treatment model at Pate Rehabilitation attempts to improve functional abilities in a way that maximizes transfer of gains made at the treatment facility to the patient’s home or work environments.  Maximum transfer of functional improvement to their environments occurs by treating patients’ functional impairments in various settings that closely resemble the environment in which they plan to use their skills.

The level of distraction and amount of structure present in each patient’s environment are the core elements of our treatment approach.  The PERPOS measures these elements, and this information informs therapists how well patients perform functional activities within different environments. Our treatment teams monitor patients’ abilities, distraction tolerance, and need for structure on a biweekly basis and they frequently adjust treatment goals accordingly to better assist patients’ ability to return to their home and work environments.

How We Use PERPOS Information

  • Forecasting effective length of stay
  • Therapists’ treatment planning
  • Justification of progress to payor
  • Patient insight development
  • Progress monitoring (data bi-weekly)