A research study investigating the relationship between the recovery of occupational performance skills in severely head injured patients as defined by the Vona du Toit Model of Creative Ability (VdTMoCA) and more traditional neurobiological indices of head injury recovery.  The literature review identifies varied approaches in the field of head injury with either an adaptive or remedial focus.  The VdTMoCA, with its developmental basis and understanding of cognition is suggested as appropriate as a tool for evaluating recovery for head injury.  The authors suggest that coma may correspond with Tone level of creative ability, post traumatic amnesia with that of Self-differentiation, and post-concussional syndrome with that of Passive Participation.  A limited study (small sample size and short implementation period) was conducted with a sample of 16 patients aged admitted to a male surgical ward (aged 16-60) during a 6-week period with a severe head injury.  A creative ability scale and a neurobiological scale were used each time a patient was assessed, administered by two independent raters.  Inter-rater reliability of the scales had been ascertained in a previous study.  Results suggested a general relationship between the pattern of recovery (or deterioration) after head injury as measured by both the creative ability and the neurobiological scale.  Authors concluded that assessment of creative ability appears to offer a practical approach to establishing and recording neurobiological status of patients with head injury, although further studies are required to validate the tools.