Introduction to the Independent Living Scale

The Independent Living Scale (ILS) was developed and refined over 15 years of clinical application in a post-acute traumatic brain injury (TBI) rehabilitation setting. The ILS assesses three main areas: activities of daily living (ADL's), behavior and initiation. The ADL sub-scale consists of 17 items (e.g. dressing, hygiene/grooming, etc.). The behavior sub-scale assesses 11 behaviors scored on an hourly interval basis. The initiation sub-scale examines skills across 16 ADL sub-scale items.

The ILS is designed as a 100-point scale comprised of scores across the three sub-scales. Observational data is collected by staff assigned to a given patient over a 1-week period. The ADL sub-scale is worth 61 points, the behavior sub-scale 30 points and the initiation sub-scale nine points. Point totals for sub-scales were derived from a poll of clinical professionals representing a cross-section of allied health disciplines as to relative importance of each scale to overall independence, as well as from a literature review of existing functional assessment scales during development.

Each ADL and behavior sub-scale item is "weighted" for scoring according to its regarded value to independent living. For example, "Dressing" is worth five points out of the 60 sub-scale points, compared to the "Leisure" item, which is worth two points. Likewise, for the behavior sub-scale, "Physical Aggression" is worth four sub-scale points out of 30, compared to two points for "Perseverative Speech". All initiation sub-scale items are worth two points out of nine.

The ADL sub-scale items are both descriptive and prescriptive. The scale is designed to be descriptive of an individual's skills. Each items is also task-analyzed, thus the training steps necessary to complete the task are implicit to the measurement system. The ILS allows for systematic comparison of an individual's scores over time, as well as a primary too, outlining areas of competence and areas requiring additional instruction.

Information regarding the ILS was contributed by Centre for Neuro Skills by Craig S. Persel. For more information please contact Craig Persel at .

If you find the information in the COMBI useful, please mention it when citing sources of information. The information on the Independent Living Scale may be cited as:

Persel, C. (2012). The Independent Living Scale. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/combi/ils ( accessed ).