Disorders of Consciousness

Special Tree is one of the earliest rehabilitation centers of its kind to focus on medical care and rehabilitation following traumatic brain injury. Our highly specialized program for persons with varying levels of consciousness builds upon more than four decades of neurorehabilitation experience.

Our interdisciplinary team approach marries exceptional medical care with pre-rehabilitation stimulation to optimize healing and promote recovery.

Our CARF-accredited program incorporates years of experience in supporting persons with limited or emerging consciousness.

A severe traumatic or acquired brain injury can sometimes result in disorders of consciousness, altering a person’s wakefulness, responsiveness, and awareness of their environment. Over several decades, Special Tree’s interdisciplinary care team customized treatment for hundreds of patients with varying levels of consciousness, slowly cultivating a highly sophisticated Disorders of Consciousness program. Patients who are not ready for traditional rehabilitation may greatly benefit from treatment customized to the needs of persons with emerging consciousness.

As an accredited provider by the Commission on Accreditation of Rehabilitation Facilities (CARF), we are focused on providing the highest levels of quality for rehabilitative care.

Goals of the program include:

  • Medical Management

  • Nutrition Management

  • Facilitation of Arousal, Communication, and Cognitive Recovery through interdisciplinary team including:

    • Physical Therapy

    • Speech and Cognitive Therapy

    • Occupational Therapy

  • Family Caregiver Support and Education

  • Facilitation of Optimal Positioning, Seating and Mobility

Our NeuroCare Campus is uniquely designed to support patients with challenging rehabilitation needs.

Specialty Services include:

  • Sensory Room Therapy

    Patients with emerging consciousness especially benefit from our on-site multisensory environment. Working with trained therapists, activities facilitate the perception, organization, interpretation and integration of different stimuli to arouse responses which can help engage functions of the brain such as sensory perception, cognition, motor control, emotions, awareness, communication, and more.

  • Synchrony Surface Electromyography (sEMG)

    Synchrony uses evidence-based protocols, Surface Electromyography (sEMG) and “PENS” e-stim technology to help patients with dysphagia. Synchrony provides visual biofeedback for swallowing and oral motor exercises that promote improved swallow mechanics, normalized muscle function and tone, increased muscle strength and coordination, and pain reduction.

  • Patterned Electrical NeuroStimulation (PENS)

    Critically ill patients may experience muscle damage following extended hospital stays. Patterned Electrical Neuromuscular Stimulation (PENS) uses the electrical stimulation of sensory and motor nerves to aid in correct firing of the cranial nervous system for swallowing. PENS works by helping to change the way pain nerves relay their pain message.

  • Augmentative Communication Devices

    An augmentative and alternative communication (AAC) device is a tablet or laptop that helps someone with a speech or language impairment to communicate. Therapists incorporate a number of assistive devices including Eyegaze devices. The Eyegaze has a special eye tracking camera to observe one of the user’s eyes and then uses sophisticated image processing software to determine where the user is looking on the screen.

  • Neuromuscular Electric Stimulation Biking (RTI Biking)

    RTI bikes combine activity-based therapy and functional electrical stimulation to help people living with paralysis or lowered function restore muscle mass in leg, arm, and core muscles. Electric stimulation aides in correct firing for arm and leg muscle movement. RTI biking can help with fatigue for persons who are non-ambulatory and unable to propel a standard stationary bike.

  • Upright Postural Control

    Postural Control, or maintaining the body in space, requires both stability and orientation. This core function is essential to embarking upon a rehabilitation program and increased independence in activities of daily living. Methods include tilt table standing, standing frames — for proprioceptive feedback, tone reduction, upright trunk and postural control — and more.

  • ZeroG Gate + Balance System

    The ZeroG Gait and Balance Training System is a robotic body-weight support system that enables individuals recovering from traumatic injury to participate in safe, high-intensity rehabilitation much sooner in the treatment process, igniting the body’s recovery. ZeroG provides interactive balance programs and games, with biofeedback, challenging the patient physically and cognitively while teaching them how to anticipate a loss of balance.

  • Bracing and Splinting

    With assistance from orthotists, Special Tree Occupational Therapists employ and sometimes build specialty splints and braces to assist with positioning, supportive bracing, joint mobilization and more. This can be especially critical for patients with limited mobility. Support from the day-to-day direct care team including Nurses, Rehabilitation Service Technicians, and others is critical in carrying out this rehabilitative component of patients’ medical care.

  • Wheelchair Seating Evaluation

    Experienced therapists evaluate patients to help determine mobility needs and assist with securing appropriate durable medical supply needs. Rehabilitation frequently includes positioning and postural control as well as guidance in the use of wheelchairs, mobility aides, prosthetics, and other assistive devices. Special Tree has a wide network of resources to assist with securing safe, effective mobility products customized to each individual’s needs.

Our experienced interdisciplinary team provides medical management and support customized for each individual.

Never assume quiet is weak and loud is strong.

Family + Caregiver Resources

  • Ranchos Scale

    The Rancho Los Amigos Scale (RLAS), also known as the Ranchos Scale, is a widely accepted medical scale used to describe patients as they recover from brain injury, especially relating to their cognitive and behavioral patterns.

  • Levels of Consciousness

    Neurological trauma can result in altered consciousness impacting a person’s wakefulness, responsiveness, and awareness of their environment.

  • Glasgow Coma Scale

    The Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients. The scale assesses patients according to three aspects of responsiveness: eye-opening, motor, and verbal responses.