Table 2

KOSCHI category definitions

Category Definition
2VegetativeThe child is breathing spontaneously and may have sleep/wake cycles. He may have non-purposeful or reflex movements of limbs or eyes. There is no evidence of ability to communicate verbally or non-verbally or to respond to commands.
3Severe disability(a) The child is at least intermittently able to move part of the body/eyes to command or make purposeful spontaneous movements; for example, confused child pulling at nasogastric tube, lashing out at carers, rolling over in bed. May be fully conscious and able to communicate but not yet able to carry out any self care activities such as feeding.
(b) Implies a continuing high level of dependency, but the child can assist in daily activities; for example, can feed self or walk with assistance or help to place items of clothing. Such a child is fully conscious but may still have a degree of post-traumatic amnesia.
4Moderate disability(a) The child is mostly independent but needs a degree of supervision/actual help for physical or behavioural problems. Such a child has overt problems; for example, 12 year old with moderate hemiplegia and dyspraxia insecure on stairs or needing help with dressing.
(b) The child is age appropriately independent but has residual problems with learning/behaviour or neurological sequelae affecting function. He probably should have special needs assistance but his special needs may not have been recognised/met. Children with symptoms of post-traumatic stress are likely to fall into this category.
5Good recovery(a) This should only be assigned if the head injury has resulted in a new condition which does not interfere with the child's well being and/or functioning; for example:
• Minor headaches not interfering with social or school functioning
• Abnormalities on brain scan without any detectable new problem
• Prophylactic anticonvulsants in the absence of clinical seizures
• Unsightly scarring of face/head likely to need cosmetic surgery at some stage
•  Mild neurological asymmetry but no evidence of affect on function of limb. Includes isolated change in hand dominance in young child.
(b) Implies that the information available is that the child has made a complete recovery with no detectable sequelae from the head injury.