Brain Injury Assessment and Evaluation

The first step in becoming a Pate patient is meeting with a clinical expert for a brain injury assessment and evaluation.

He or she reviews records to understand the complexities of the case and talks directly with the patient, family, and any other appropriate professionals involved in the patient’s care. The purpose is to understand the patient’s needs, goals and expectations.

By getting to know the patient personally, we can better assess what treatment team at Pate would be the best fit, and design a realistic treatment plan to help the patient prepare for the next step in their lives.



Evaluation During Treatment

In the first week of treatment, our clinical team assesses and evaluates each patient in depth to determine his or her individual needs.

Some areas evaluated are speech, self-care, physical/motor and cognitive abilities, as well as a functional assessment of daily life skills.

On an ongoing basis, our treatment teams monitor patients’ abilities, distraction tolerance, and need for structure. With biweekly meetings to assess progress, they frequently adjust treatment goals to better assist patients.

We also use a scale we designed. PERPOS is a measurement tool that focuses on the complex interactions of the environment and ability. We discovered that the level of distraction and structure in patient’s environments is very important in recovery.  So this tool measures:

  1. Amount of structure needed
  2. Distraction tolerated
  3. Overall functioning/deficit


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.

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.


Importance of Environment

Pate Rehabilitation attempts to improve functional abilities in a way that maximizes the gains made at the treatment facility and transfers them to the patient’s home or work environments.

Maximum transfer of functional improvement to their environments occurs by treating patients’ functional impairments in 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.


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)

Our clinical 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.


Improving Outcomes

Our on-staff behavioral and rehabilitation psychologists and neuropsychologists are integral members of our interdisciplinary clinical teams, and are fundamental to the assessment and personalized plan development for each patient.

They understand how the structure and function of the brain relates to specific psychological processes, like memory, critical thinking and judgment, and how those processes may affect behavior.

They guide the assessment of progress, making sure each team member keeps the whole person in mind – including his or her interests, profession or work history, and hobbies—and adjusts the treatment plan for individual needs so that the person can thrive in the real world.

We’ve provided some examples to showcase the importance of having these highly trained and experienced professionals on staff as an integral part of the patient’s therapy program.