Objectives: To examine the predictive validity of neurobehavioral change derived from the Disorders of Consciousness Scale (DOCS). Design: Prospective observational predictive validity study. Setting: Inpatient rehabilitation hospitals and postrehabilitation residence. Participants: 113 persons with a mean age of 38±17.8 who were unconscious for >28 days consecutively after severe BI; 73% (83/113) with traumatic BI and 27% (30/113) with other BI. Interventions: Not applicable. Main Outcome Measures: The measures derived from the DOCS reflect changes in overall neurobehavioral functioning and changes in functioning according to modalities. The outcomes include return to consciousness 4, 8 and 12 months after severe brain injury (BI). Results: When controlling for injury type, the DOCS average as well as DOCS change between the first and second DOCS (DOCS1-2), first and fifth DOCS (DOCS1-5) and first and last DOCS (DOCStotalchg) significantly (P ≤.05) contributed to predicting recovery and lack of recovery of consciousness at 4, 8 and/or 12 months after injury. DOCS1-5 manifested the most balanced accuracy in predictions where predicting recovery of consciousness is accurate 87% of the time and predicting lack of recovery of consciousness is accurate 88% of the time. Modality measures derived from the DOCS being examined, at time of writing this abstract, include sensory, partial cognitive, higher cognitive, auditory, tactile and visual measures. Conclusions: For persons with prolonged disorders of consciousness, the findings indicate that evidence based prognostication for individual patients are possible. Modality measures may enhance accuracy. The implications for research are that the DOCS can be used as a meaningful, reliable and valid primary outcome to measure treatment effects in clinical trials. The evidence indicates further that DOCS measures merit inclusion in future research aiming to develop multivariate prognostication models.