Low Awareness / Impaired Consciousness (SMART assessment tool)

St Cyril's Rehabilitation Unit offers the Sensory Modality Assessment and Rehabilitation Technique (SMART) a comprehensive assessment and treatment tool developed specifically for identifying awareness in vegetative state (VS) or minimally conscious state (MCS) patients following severe brain injury. Patients in low awareness states are often difficult to diagnose. Their behaviour may suggest they are not aware of themselves or their environment. Unless provided with a comprehensive and structured assessment, meaningful responses can be missed, leading to misdiagnosis. The SMART assessment tool was developed in order to provide the best opportunity to demonstrate a patient's awareness and to enable them to communicate their needs. It is carried out by an accredited assessor who conducts a formal assessment using an extensive range of techniques to analyse and record the patient's behavioural repertoire, responses to a series of sensory modalities, functional ability and level of wakefulness.

A unique feature of the SMART assessment tool is the involvement of relatives, friends, carers and other members of the multidisciplinary team. Their feedback and observation of behaviours are incorporated into the final analysis. The tool provides a standardised approach ensuring that all potential abilities are fully explored, functional and communication capacity is optimised, so that an accurate diagnosis is made and an effective rehabilitation programme is formulated to optimise the patient's potential.