When the person can sit up and walk, regular schedules need to be coordinated with bathing, eating and toileting because their orientation to time depends on events. Without regularity in their sense of time, insecurity and agitation can increase fall risks.

When the person lacks head control, day or night, sleep or awake are differentiated and contribute to their sense of security. Turning the lights out at night helps to maintain circadian rhythms.

Role Classifications

Roles are not identified, but people are connected to pain, fear, comfort and safety. The connection is limited to specific events and the person may really be known by the colour of their clothing.

Whereabouts

To let family and friends know about changes in your whereabouts is a social norm that is assumed that every adult understands and has a right to make a choice about.

Their bed, blanket and bathrobe maybe the last possessions that they recognise and cherish.

An incorrect sense of independence is not a problem within ACL 1, 2, and 3 when the person cannot act on it. When they wander off and get lost, a sense of independence does not occur to them.

With little to no language ability, we must rely on those emotional expressions and gestures that the person can make. Their perspective is directly connected to the quality of information that captures their attention and the effects that they are able to cause.

Within ACL 3 Low, equivalent information includes linear, movement and sensory information that is synthesised to create what the person experiences as their sense of identity. Causing an effect with an object makes sense to the person when their grasp and release is intentional.

In ACL 3 Low, you are seeing if the person can use their hands to grasp and release objects.

To Verify

Can the person sustain their attention to grasp, release and with different objects and motions? If the person can consistently grasp and release different objects this verifies ACL 3 Low.

To Rule Out

To rule out ACL 3 High, you simply need to see if the concept of a line captures their attention strongly enough so that they can colour within a line and up to the line.

What Makes Sense

• I can use objects.

Expected Task Performance

• Participates in simple actions using simple grasp and release and well learnt procedural memories.

Assistance Required

• Hands-on assistance and constant cueing is required for most self-care tasks with the person able to complete some well learnt or simple tasks, such as toileting.
• Provide material objects that stimulate well learnt manual action activities.
• Constant supervision is required to keep the person safe from falls, abrasions, choking or other

Within ACL 3 Low, the person has a sense of causing an effect by doing something with an object held in their hand. Scribbling with a crayon or a pencil is the classic but any object in their hand can be moved that way, e.g. bar of soap, wash cloth, dust cloth, or toothbrush.

In order to provide sensory information, supplies are required. What supplies are used is dependent on your location. Keep in mind the sensation you are wanting to produce while you are carrying out your everyday activities. The materials must also be safe for the person to use.

Within ACL 2 High their sustained attention is so short that leaving the supplies at bedside seems to be a necessary means of reducing the hassle of setting up several times a day.