2.3 Ranchos Los Amigos Scale of Cognitive Functioning

Describe the Rancho Los Amigos Scale of Cognitive Functioning.

  1. Describes 8 stages of cognitive function that brain injury patients typically progress   (see table).
  2. Not an outcome measure but rather a global index used to describe awareness, environmental interaction and behavioural competence.
  3. Used to monitor recovery.


For further details on the RLA-Cognitive Functioning Scale go to: http://www.rancho.org/Research_RanchoLevels.aspx


Rancho Los Amigos Levels of Cognitive Functioning 1


No Response: Total assistance


Generalized response: Total assistance


Localized response: Total assistance


Confused-agitated: Maximal assistance


Confused-inappropriate, non-agitated: Maximal assistance


Confused-appropriated: Moderate assistance


Automatic-appropriated: Minimal assistance for daily living skills


Purposeful-appropriate: Stand-by assistance

2.3.1 Ranchos Los Amigos Level III – RLA-III

This patient is an RLA-III.  Describe how an RLA-III patient typically presents.

  1.  Patient reacts specifically but inconsistently to stimuli.
  2. May follow commands.
  3. May show a bias toward responding to some persons, in particular family and friends, but not others.

RLA-III is referred to as Localized Response:

  •  The patient will react specifically but inconsistently to stimuli presented.
  • The response by the patient is directly related to the stimuli present (patient will turn heard toward noise or focus on objects presented to them).
  • If stimulus is painful, you may see the patient withdraw (pull away from the pain) or react vocally to it.
  • The patient may show his or her awareness to any discomfort he/she is feeling by attempting to remove tubes, catheters, restraints etc.
  •  Simple commands may be followed; however the patient may do this in an inconsistent or delayed manner.
  • The removal of external stimuli may result in the patient laying quietly.
  •  Patient may respond to family and friends but not to others 2.