Quickly probes cognitive, linguistic and communicative abilities of patients with severe head trauma.
Nancy Helm-Estabrooks and Gillian Hotz

• Time: 25-30 minutes

The BTHI provides useful diagnostic information for immediate treatment, and a baseline for charting recovery. It is an ideal first assessment post-coma because it is brief and efficient to administer and score. It can be administered in more than one short session, if necessary.

Its sensitivity to small performance changes makes it useful for tracking recovery patterns during the period of spontaneous recovery. Results can be used to advise other team members of the best approaches for communicating with a patient, and structuring individualized treatment.

Item clusters include:

• Orientation and Attention
• Following Commands
• Linguistic Organization
• Reading Comprehension
• Naming
• Memory
• Visual-Spatial Skills

Experienced clinicians can identify problem areas to investigate more thoroughly, using modality-specific standardized tests or informal measures.

The BTHI yields cluster raw and standard scores and a total. The total Raw Score can be converted to a percentile rank, standard scores of a normative Severity Score (Severe, Moderate, Mold, Borderline Normal). Internal consistency coefficients were generally high: .65 to .86 to item clusters and .95 for the BTHI Total Score. Test-retest (average 17 days interim) yielded significantly higher retest means. Correlation with the Glasgow Coma Scale at admission (.29) and at time of BTHI testing (.35) were low. Correlations with the Rancho Los Amigos Scale at time of BTHI testing were moderately high (.75).

The BTHI Kit includes a Manual, Stimulus Cards, Manipulatives and 25 Record Forms.