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.

  • At Special Tree we work with a variety of consulting physicians, allowing you to enjoy the consistency of care from your primary rehabilitation provider with access to expertise from our team in areas that include specialties such as physical medicine and rehabilitation, psychiatry, vision therapy, pediatrics, and other neurorehabilitation expertise. Your doctor will remain the primary overseer of your rehabilitation, looking out for your medical management, safety, and progress to restore your level of function to the highest degree possible.

    Our Physician Services include the expertise of a Physician Assistant who specializes in neurorehabilitation and is on-site regularly to assist with ongoing care of clients.

  • Respiratory Therapists (RT) are uniquely trained to evaluate and manage the respiratory needs of clients who have impaired lung function and related needs. On site at the NeuroCare Center 24 hours per day, Special Tree Respiratory Therapists work aggressively to help clients regain their freedom by reducing or eliminating their dependence on mechanical ventilation and artificial airways and weaning clients from ventilators and tracheotomies whenever possible.

  • Rehabilitation Nurses provide highly specialized services for clients dealing with issues relating to traumatic brain, spinal cord, and multiple trauma injuries in addition to traditional nursing care. Always on-site, nurses are an integral component of the interdisciplinary rehabilitation team, working closely with RSTs, dietary and nutrition services, respiratory specialists, physicians, therapists, case managers, and others to provide for clients’ day-to-day needs.

  • Rehabilitation Service Technicians (RSTs) help clients with personal care and activities of daily living. Special Tree RSTs complete extensive classroom and hands-on training, and participate in continuing education to maintain skills and stay current with best practices in care, safety, and rehabilitation.

  • All clients receive a nutrition assessment upon admission to help develop a nutrition care plan based on their individual needs. The nutrition status of each client is monitored through dietary intake, tube feeding intake, fluid intake, weights, laboratory values and input from their support system and Special Tree staff.

  • The NeuroCare Campus includes a totally comprehensive rehabilitation clinic which provides a full range of on-site therapy and treatment services. Patients who are not ready for traditional rehabilitation may greatly benefit from treatment customized to the needs of persons with emerging consciousness. As their needs progress, therapy is increased as appropriate. For detailed information about our rehabilitation services, click here.

  • Your Special Tree Case Manager is the vital link between you and those involved in your care. Your Case Manager will assist you and your family with scheduling doctor appointments, transportation needs, progress reports, resolving day-to-day problems that may arise, and discharge planning.

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.