EXPRESSION

EXPRESSION: Expression includes clear vocal or nonvocal expression of language. This item includes either intelligible speech or clear expression of language using writing or a communication device. Evaluate and indicate the more usual mode of expression (“Vocal” or “Nonvocal”). If both are used about equally, code “Both”.

NO HELPER

7 Complete Independence—The patient expresses complex or abstract ideas clearly and fluently (not necessarily in English).

6 Modified Independence—In most situations, the patient expresses complex or abstract ideas relatively clearly or with only mild difficulty. The patient does not need any prompting, but (s)he may require an augmentative communication device or system.

HELPER

5 Standby Prompting—The patient expresses basic daily needs and ideas more than 90% of the time. Requires prompting (e.g., frequent repetition) less than 10% of the time to be understood.

4 Minimal Prompting—The patient expresses basic daily needs and ideas 75 to 90% of the time.

3 Moderate Prompting—The patient expresses basic daily needs and ideas 50 to 74% of the time.

2 Maximal Prompting—The patient expresses basic daily needs and ideas 25 to 49% of the time. The patient uses only single words or gestures, and (s)he needs prompting more than half the time.

1 Total Assistance—The patient expresses basic daily needs and ideas less than 25% of the time, or does not express basic needs appropriately or consistently despite prompting.

Do not use code “0” for Expression.

COMMENT: Examples of complex or abstract ideas include (but are not limited to) discussing current events, religion, or relationships with others. Expression of basic needs and ideas refers to the patient’s ability to communicate about necessary daily activities such as nutrition, fluids, elimination, hygiene, and sleep (physiological needs).