Objectives: Kennedy Krieger Institute's Cognitive and Linguistic Scale (CALS) is an assessment instrument designed to quantify cognitive and linguistic recovery following traumatic brain injury (TBI) or acquired brain injury (ABI) in children during acute inpatient rehabilitation. This study investigates the psychometric properties of the CALS. Hypothesis: Adequate reliability and validity was expected. Participants: Included in this study were 67 children, aged 2-19 years, who had diagnoses of TBI or ABI and who required inpatient rehabilitation. Methods: Participants were administered the CALS at admission and discharge. Reliability was explored through internal consistency and interrater agreement (collected on a subset of 3 patients). Validity was examined by factor analysis and correlation with the Functional Independence Measure for Children (WeeFIM). Sensitivity to recovery was examined by comparing scores at admission and discharge. Results: Internal consistency was 0.96. Total scores of 2 raters were highly correlated. Factor analysis revealed 2 factors (basic responding and higher level cognitive skill). Correlations with WeeFIM ranged from 0.63 to 0.94 with the highest correlation between WeeFIM cognitive and CALS total score. Scores for 20/20 CALS items and total score improved significantly between admission and discharge. Conclusions: Reliability and validity of the CALS is adequate and the measure is sensitive to cognitive recovery. The CALS is a promising measure to track cognitive and linguistic improvements in children with TBI or ABI during inpatient rehabilitation, and can be used in combination with the WeeFIM to obtain more detailed information about cognitive and linguistic recovery.

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