Neuropsychological Instruments

Coma Recovery Scale-Revised (CRS-R)

The JFK Coma Recovery Scale was initially described by Giacino and colleagues in 1991. The scale was restructured by Giacino and Kalmar and republished in 2004 as the JFK Coma Recovery Scale-Revised (Giacino, Kalmar and Whyte, 2004). The CRS-R Administration and Scoring Guideline manual was updated in 2020 ( 

The purpose of the scale is to assist with differential diagnosis, prognostic assessment and treatment planning in patients with disorders of consciousness. The scale consists of 23 items that comprise six subscales addressing auditory, visual, motor, oromotor, communication and arousal functions. CRS-R subscales are comprised of heirachically-arranged items associated with brain stem, subcortical and cortical processes. The lowest item on each subscale represents reflexive activity while the highest items represent cognitively-mediated behaviors. Scoring is standardized and is based on the presence or absence of operationally-defined behavioral responses to specific sensory stimuli.

Good-to-excellent interrater, adequate-to-excellent test-retest reliability, good-to-excellent internal consistency, have been demonstrated. Concurrent validity has been established relative to the Disability Rating Scale, Glasgow Coma Scale (GCS), Full Outline of Unresponsiveness scale (FOUR), and Wessex Head Injury Matrix (WHIM). Predictive validity of the CRS-R is seen in correspondences with clinical diagnosis, language function, and cognitive performance during neuroimaging evaluations, at and after inpatient rehabilitation. Evidence of construct validity and empirical support for the theoretical hierarchy of behaviors assessed within each subscale has been shown using Rasch analysis and Item Response Theory.

Spanish, Italian, German, French, Polish, Dutch, Norwegian, Korean, Chinese, and Russian translations of the CRS-R are available. The CRS-R is a National Institute of Neurological Diseases and Stroke Common Data Element, and is recommended for use in clinical practice by the American Congress of Rehabilitation Medicine, American Academy of Neurology, and the National Institute on Disability, Independent Living, and Rehabilitation Research.

Click here to view the CRS-R training video. 


The Spaulding Disorders of Consciousness Comprehensive Evidence-Based Assessment Battery


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The purpose of the DOC COMPASS is to create a single comprehensive resource for
administration of a systematic evidence-based neurorehabilitation program for individuals with
disorders of consciousness. This binder includes assessment and treatment tools appropriate for
both clinical and research purposes. We intend to update this manual as additional evidence
accrues in the peer-reviewed literature.

This binder contains:

An overview of the SRN DOC Program

                  • A compilation of assessment and treatment protocols specifically designed for use in patients with DOC.
                  • Data collection forms for all assessment and treatment protocols.
                  • A sample Neurobehavioral Profile with data display.

For additional information, please contact:
Michael Bergin, PhD
Laboratory Manager, SRH Neurorehabilitation Lab



Information Packets



Resources Offered by the MSKTC To Support Individuals Living with Traumatic Brain Injury.

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The national Model Systems Knowledge Translation Center (MSKTC) facilitates the translation of research to health information in a format that is meaningful and easy to understand for families, caregivers, and patients with burn, spinal cord, and traumatic brain injury. The center reviews and synthesizes current research, publishes articles, and supports innovative projects in the delivery, demonstration, and evaluation of services designed to meet the needs of individuals with traumatic brain injury.  The MSKTC works closely with 16 TBI Model System research centers, including Spaulding Rehabilitation Hospital, to develop free evidence-based resources that provide information and help for people living with TBI and their families.

For more information and factsheets on Traumatic Brain Injury, visit the MSKTC-TBI website. Materials are available as printable PDF documents, videos, and slideshows.




TBI Model System-Sponsored Stakeholder Summit Briefing Book

Briefing Book capture

Rehabilitation Access and Outcome after Severe Traumatic Brain Injury

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