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Updated: Jul 12, 2026
Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
Initial use of the Coma Recovery Scale for Pediatrics (CRS-P) in young children with disorders of consciousness
Morgan E Nitta1, Tyler Busch2, Stacy J Suskauer1
1Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
The Coma Recovery Scale for Pediatrics (CRS-P) effectively assesses responsiveness in children with disorders of consciousness (DoC) post-brain injury. The scale showed significant improvements, aiding in classifying DoC states and emergence from minimally conscious states.
Area of Science:
- Pediatric Neurology
- Neurorehabilitation
- Clinical Assessment Tools
Background:
- Disorders of consciousness (DoC) in children following brain injury present significant assessment challenges.
- Accurate assessment is crucial for guiding rehabilitation and predicting outcomes.
Purpose of the Study:
- To evaluate the utility of the Coma Recovery Scale for Pediatrics (CRS-P) in assessing responsiveness in young children with DoC.
- To determine if the CRS-P can track changes in responsiveness during inpatient rehabilitation.
Main Methods:
- A retrospective chart review of 18 pediatric patients (8 months to 6 years 10 months) admitted for brain injury rehabilitation.
- Data included demographic information and Coma Recovery Scale for Pediatrics (CRS-P) scores at admission and discharge.
- Statistical analysis was performed to compare CRS-P scores and identify significant changes.
Main Results:
- CRS-P total scores significantly increased from admission to discharge (p < .001).
- Auditory, visual, and motor subscales demonstrated sensitivity to change (p < .02).
- Seven patients (just over one-third) emerged from a minimally conscious state (MCS), with functional object use being the initial indicator.
Conclusions:
- The CRS-P is a valuable tool for classifying DoC states in pediatric brain injury.
- The CRS-P effectively tracks improvements in responsiveness and emergence from MCS in young children.
- Age at assessment did not significantly correlate with CRS-P scores, suggesting broad applicability.
Purpose:
The utility of the Coma Recovery Scale for Pediatrics (CRS-P) was evaluated as a measure for assessing responsiveness in young children in states of disorders of consciousness (DoC) after brain injury.
Methods:
Retrospective demographic and CRS-P data were abstracted from medical records of patients between 6 months and <7 years of age at admission to a paediatric inpatient brain injury rehabilitation program before September 2023 if administered the CRS-P at least once during admission.
Results:
The sample included children aged 8 months to 6 years and 10 months (N = 18) admitted for inpatient rehabilitation following a new brain injury. CRS-P total score was significantly higher at discharge compared to admission (p < .001). CRS-P auditory, visual, and motor subscales were sensitive to change (i.e. significant improvement in responsiveness) between admission and discharge (p's < 0.02). Just over one-third of patients (n = 7) emerged from a minimally conscious state (MCS), and functional object use was the first sign of emergence for all. Age at assessment was not significantly correlated with CRS-P scores. Conclusions: Results highlight the utility of the CRS-P for classifying states of DoC, as well as emergence, in young children with severe brain injury.
