Complex disability is very difficult to manage. It usually subtends very serious clinical pictures, because it affect several body
systems, or because it is associated with intellectual disability and behavioral disorders. Often affected patients are unable to
communicate their basic needs. All these factors combine to make the management of these patients very complex, and those who
care for them realize how important it is to find a way to detect their state and to identify their potential capabilities.
Developing appropriate rehabilitation programs for these patients requires additional effort and an assessment capacity that is
as objective as possible. Few scales cited in the literature are capable of evaluating these aspects in patients with complex
disabilities, among them the Barthel Index (Mahoney & Barthel 1965) and the Vineland Adaptive Behavior scale II (Sparrow et al.
2005). The majority of these scales often tend to depict the data regarding the disease to a degree of severity that precludes adequate
individual rehabilitation program development. There is a dire need for a more appropriate instrument, an observational grid that is
capable of identifying the potential of this patient population and evaluate the effectiveness of rehabilitation interventions provided.
The aim of the study is to evaluate the efficacy of rehabilitation interventions in a group of patients with IQ <32 (determined by
the Vineland II scale) using an evaluation tool created ad hoc called D-Rubrics, designed with the intent to identify “microdifferences”
between baseline (T0) and post-rehabilitation (T1). The goal is part of a more long term-term objective which involves
developing an effective assessment tool for patients with complex disabilities. Such an assessment tool should be practical, easy to
administer and useful in both clinical and research settings
