Functional assessment in traumatic brain injury

Functional assessment (FA) is critical for identifying rehabilitation needs, selecting appropriate treatments, evaluating treatment effectiveness, and for identifying accommodation and support needs to enhance functioning in the community. This chapter discusses the reasons for and some methods of capturing the subjective valuing of functional states along with more traditional FA methodologies and measures. Acquired brain injury and, specifically, moderate or severe traumatic brain injury, has cognitive, emotional, and physical consequences that affect functioning, clinicians need to be familiar with FA measures for patient assessment and monitoring. Two aspects of functioning are commonly distinguished: capacity and performance. In line with the capacity/performance challenge, consideration of ecological validity poses additional substrates and yet another level of dichotomy to FA. Metrology is a major concern in all science disciplines, and the developers and users of FA instruments have mostly relied on the methodologies for instrument development originating in psychology.