The Brief Test of Head Injury (BTHI) can quickly probe cognitive, linguistic, and communicative abilities of patients with severe head trauma. 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 (25 to 30 minutes to administer and 10 minutes to score).
BTHI can be given to an individual in one or more short sessions, 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 in advising other team members on the best approaches for communicating with a patient and structuring individualized treatment. Experienced clinicians can identify problem areas to investigatge more thoroughly, using modality specific standardized tests or informal measures.
Item clusters include Orientation and Attention, Following Commands, Linguistic Organization, Reading Compre-hension, Naming, Memory, and Visual-Spatial Skills. The test yields cluster raw and standard scores and a total. The Total Raw Score can be converted to a percentile rank, standard score, or a normative Severity Score (Severe, Moderate, Mild, Borderline Normal).
Internal consistency coefficients were generally high: .65 to .86 for item clusters and .95 for the BTHI Total Score. Test-retest (average 17 days interim) yielded significantly higher retest means. Correlations with the Glasgow Coma Scale at admission (.29) and at time of BTHI testing (.35) were low.
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