When assessing a child with an acquired brain injury, what is most important to compare to set appropriate goals?

• A. Evaluate pragmatics through a structured language test
• B. Ensure administration of an intelligence test
• C. Compare premorbid performance with present performance
• D. Compare nonverbal performance with verbal performance

Answer: (C)

The key idea is using premorbid functioning as the baseline for guiding goals after a brain injury. When a child has acquired brain injury, knowing what they could do before the injury lets you see exactly what has changed and what might be recoverable. This baseline helps you set realistic, meaningful goals that target the skills most affected and tailor interventions to the child’s actual potential, rather than guessing from current performance alone. It also supports tracking progress over time by comparing present abilities back to the child’s previous level.

To get this baseline, you’d gather information from school records, prior assessments, teacher and parent reports, and any previous functional or academic data. While other assessments (like current pragmatic language skills, an overall intelligence screen, or a profile showing disparities between nonverbal and verbal abilities) provide valuable context, they don’t establish a clear pre-injury reference point for setting goals and measuring change.