The Sensory Modality Assessment and Rehabilitation Technique (SMART): A Comprehensive and Integrated Assessment and Treatment Protocol for the Vegetative State and Minimally Responsive Patient

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Abstract
The assessment of the vegetative and minimally responsive patient requires a comprehensive programme of assessment and intervention. The Sensory Modality Assessment and Rehabilitation Technique (SMART) is a unique protocol that requires the SMART assessor, the team, and the family and friends of the patient to work as a collaborative team to observe response to sensory and environmental stimulation. This paper identifies the two formal and two informal components of the SMART protocol. The formal assessment programme is conducted by the SMART assessor and includes the structured assessment of the patient's behaviour and observation of response to a sensory stimulation programme. The informal component relies on the team, friends, and relatives to make observations of the patient's response to day-to-day activities and environmental stimulation. The features of existing assessment tools will be discussed to allow comparison to the SMART, and research-based practice is described. This paper proposes the SMART protocol as an effective and unique tool for accurate assessment and diagnosis of the vegetative state and minimally responsive patient.