Allen's Cognitive Levels

Question 1

FIM & levels of assistance for ACL levels

Answer 1

I: Automatic Actions: complete dependence (TOTAL ASSIST)
II: Postural Actions: complete dependence (MAX ASSIST)
III: Manual Actions: modified dependence (MOD ASSIST)
IV: Goal-directed Actions: modified dependence (MIN ASSIST)
V: Exploratory Actions: supervision (SBA)
VI: Planned Actions: MI-I (INDEPENDENT)

Question 2

attention span in ACL levels

Answer 2

I: Automatic Actions: seconds
II: Postural Actions: minutes
III: Manual Actions: 30 minutes
IV: Goal-Directed Actions: 1 hour
V: Exploratory Actions: weeks
VI: Planned Actions: defined by desires/priorities

Question 3

global cognition impairment in ACL levels

Answer 3

I: profoundly impaired
II - III: severally impaired
IV: mod impaired
V: mild impaired
VI: no impairment

Question 4

level 1 ACL intervention

Answer 4

sensory stimulation, positioning, skin integrity, hand-over-hand oral feeding

Question 5

level 2 ACL intervention

Answer 5

movement/exercise groups based on IMITATION

Question 6

level 3 ACL intervention

Answer 6

repetitive tasks including ADLs (supervision & assistance)
- simple crafts
- supported employment, unskilled work in sheltered workshop with SUPERVISION
- bed alarm to prevent falling out of bed, wander guard to prevent wandering

Question 7

ACL Level 1

Answer 7

Automatic Actions
- RESPONSE: only internal cues
- instinctual, reflexive behavior
- automatic actions: walking, standing, eating, drinking

Question 8

ACL Level 1 sequence

Answer 8

1.0: withdrawing from noxious stimuli
1.2: responding to stimuli with one sensory system
1.4: locating stimuli
1.6: rolling in bed
1.8: raising body part

Question 9

ACL Level 2

Answer 9

Postural Actions
- RESPONSE: only proprioceptive cues to move body in space or overcome gravity effects
- comfort or discomfort is motivation
- WANDERING
-can IMITATE GM/ADLs
- feed self with finger food
- AWARE OF: large objects
- NOT AWARE OF: effects actions have

Question 10

ACL Level 2 sequence

Answer 10

2.0: overcoming gravity & sitting
2.2: righting reactions & standing
2.4: aimless walking
2.6: directed walking
2.8: using grab bars

Question 11

ACL Level 3

Answer 11

Manual Actions
- RESPONSE: manual (tactile cues- touches & manipulates)
- REPETITION
- uses hands to manipulate items
- cause & effect
- NO SEQUENCING, GETS LOST
- familiar ADLs independently- needs supervision & assistance
- easily distracted, short attention span

Question 12

ACL Level 3 sequence

Answer 12

3.0: grasping objects
3.2: distinguishing objects
3.4: sustaining actions on objects
3.6: noting effects on objects
3.8: using all objects

Question 13

ACL Level 4

Answer 13

Goal Directed Behavior
- purposeful activities, short tasks
- min a with familiar, goal directed tasks
- CUES: VISUAL NEEDED, REPETITION, FAMILIAR ROUTINES REINFORCED
- assistance with new tasks
- unable to adjust to changes
- intact BADLs
- MAY BE ABLE TO LIVE ALONE: 4.6

Question 14

ACL Level 4 sequence

Answer 14

4.0: sequencing familiar actions
4.2: differentiating features of objects
4.4: completing a goal
4.6: personalizing features of objects
4.8: learning by rote memorization

Question 15

ACL Level 5

Answer 15

Exploratory actions
- New learning, generalizes skills
- TRIAL AND ERROR
-Can learn independently through exploratory actions
-Poor JUDGEMENT, organization, planning and socialization, IMPULSIVE
-Participates well in concrete tasks

Question 16

ACL Level 4 intervention

Answer 16

• 4.0: fix self cold meal/snack, small neighborhood purchases
• 4.2: spend daily allowance, walk to familiar places in neighborhood, simple/familiar bus route
• 4.4: manage daily allowance, go to familiar neighborhood places
• 4.6: reminders to attend familiar community events, or to do anything in addition to daily household routine.
• 4.8 – May get self to a regularly scheduled community activity, supportive employment

Question 17

ACL level 5 intervention

Answer 17

• 5.0 - 5.2: live alone with weekly checks for safety, check problem-solving, supportive employment with job coach
• 5.4: live alone, job with wide margin of error
• 5.6: drive, suitable job, reliable with safety

Question 18

ACL Level 6 intervention

Answer 18

competitive employment

Question 19

What can an individual accomplish at Allen’s Cognitive Level 1?

Answer 19

automatic actions

Question 20

What functional activity can a person at Allen’s Cognitive Level V do?

Answer 20

learn new skills

Question 21

What can an individual accomplish at Allen’s Cognitive Level 2?

Answer 21

awareness of large objects & very simple tasks

functional task: poor imitation of posture

Question 22

What can an individual accomplish at Allen’s Cognitive Level 3?

Answer 22

• use hands for simple, repetitive tasks
• Unlikely to produce consistent end product

functional task: sand wood

Question 23

What can an individual accomplish at Allen’s Cognitive Level 4?

Answer 23

• copy demonstrated directions
  (ie - visual and verbal cues) presented one step at a time
• copy a sample plan to follow
  directions

functional task: match colors of clothing

Question 24

What can an individual accomplish at Allen’s Cognitive Level 5?

Answer 24

perform tasks involving three familiar steps and one new one
- New learning occurs

functional task: understand cause and effect

Question 25

What can an individual accomplish at Allen’s Cognitive Level 6?

Answer 25

• anticipate errors and plan ways to
  avoid them
• follow written directions
  -operate at normal capacity

Question 26

An individual functions at level 5 according to the Allen Cognitive Test. The highest level task that the individual can perform is to:

Answer 26

Carry out a task with three familiar steps and one new step