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.
The person's attention is focused on what they can do with their hands and they like to fiddle with everything that they see. Their visual field is limited to what is in front of them on the table, dresser, counter, shelf, etc. Other objects can be moved lower, higher and behind. Doing the same action over and over again may produce a sense of interest and intellectual stimulation.
Obvious effects on objects usually include back and forth motions or placing objects in a row, which can be done with crayons, felt tip pens, spoons, wash clothes, soap, green sink cleaner on a white sink, dust clothes, sanding blocks without sandpaper and any other object that can be used without putting it in their mouth and choking.