The assessment of competency in traumatic brain injury

Professionals who evaluate and treat persons with traumatic brain injury are often called upon to assess competency, yet few clinical guidelines exist for this purpose. This article discusses some issues relevant to both legal and clinical conceptualizations of competency and reviews methods of evaluation. A recommended model for competency assessment in TBI is outlined. This includes attention to common sequelae of TBI that can elude formal assessment: consistency, complex memory, self-monitoring, initiation and interpersonal factors. Given the subtle nature of some of these factors and the contribution of changes over time, a team evaluation embedded in treatment is ideal for the assessment of competency in TBI.