When you get a referral, read the person's medical records. The following information is related to the ability to function:

When you start working with a person a standardised evaluation of activity performance helps to establish an objective perspective which is why the Allen Cognitive Level Screen (ACLS) test was created and has been revised so many times. Before you plunge into administering a test learn what you can about the person's medical condition as it affects their past current and future ability to function.

This section aims to expand the way everyone in occupational therapy thinks about actions and activities. Normally we think about the content, e.g. work, rest, and play, or self-care, exercises, housekeeping, cooking, crafts, etc. The content is associated with customary supplies and behaviours. The content, supplies and behaviours will be added to, but by the information they each contain, which pulls them all together. The same information that arouses the person's attention can be found in the content and supplies required to do actions and activities.

The purpose of this discussion is to alert you to common difficulties when comparisons are made between the ACLs and other scales. There are rules for qualifying for each type and rules about the application of the scores:

The Allen Cognitive Levels is an ordinal scale that measures the type of sensorimotor information that arouses attention. An ordinal scale is also a hierarchical scale, which means that the scale measures both abilities and disabilities simultaneously.

The Allen Cognitive Levels scale has been divided into three different sections to serve different purposes:

The Allen Cognitive Levels is a categorisation of the quality of information that arouses attention and guides what the person does and says, from a coma to normal adulthood and can be used to describe a person's global ability to function.

The age of onset of a cognitive disability seems to effect the person with either getting stuck with an obsolete identity or having a better identity.

People who have a history of functioning normally will probably continue to believe that they still can. Lots of evidence to the contrary rarely affects their sense of self. A few changes in their methods of doing activities may be negotiated.

An obsolete identity is a memory of how the person functioned before the onset of a cognitive disability. Learning and memory since the onset of a cognitive disability are reduced, making an update of the identity impossible. They may be aware of the mistakes they make, may not remember the frequency of their mistakes and rarely understand the implications of potential disasters. Insufficient cognitive abilities to pay attention to abstract information causes a lack of awareness of the need to adjust their evaluation of what they can and cannot do or say now.

The reduction in information that arouses their attention creates a different perspective. Their sense of identity and their memories of the past are narrowed down to the information that arouses their attention. Those memories are probably stored in the same region of the cortex. Their sense of other people and what they are doing is connected to the information that arouses their attention too. Their senses of space, direction and time have been woven into the methods for selecting and presenting actions and activities.

The reductions in the physiological operations of the brain have an effect on the person's abilities to:

• pay attention to information,
• access procedural and long-term memories,
• retain information in working memory,
• learn and remember new information,
• talk,
• coordinate their gross, fine motor and bilateral movements,
• understand what they read,
• write or text a message, and
• comprehend what money is.

All these reductions reduce their capacity to manage their own affairs.