The ACLS-6 classifies a sequence of steps into an activity by doing three whip stitches. To do the whip stitch, they can group a set of three numbers into a complete set.
For the other activities, they are grouping a series of steps (actions) to do an activity.
Within the copying activity, the person can make a series of stripes to cover the surface. The stripes may be made without referring to the sample.
When completing a placement activity (e.g. flower pot), they have the concept of making a picture but the ability to follow the sample is vague and limited.
To Verify
Verification of the score is required at regular intervals if there may be changes in their ability to function due to their medical condition. This may be done through craft activities. When replicating a checkerboard pattern, alternating the pattern is too hard and they will make stripes. They will only know where their possessions are when they are placed in a routine spot or within a close visual field.
To Rule Out
When learning their way around the building or neighborhood is a part of the discharge considerations and you cannot take the person on-site, the alternative is checking how they keep track of their belongings. Confirming difficulties with locating their belongings and supplies in your venue is worth the time it takes to check their use of bedside cabinets and clinic storage spaces. The tendency is to assume that they have better awareness and control than they really do. People functioning within ACL 4.2 should be able to find their way around and locate their possessions; those people operating within ACL 4.0 probably will not.
The difference between ACL 4.0 and 4.2 is the ability to match using one striking feature. In an unfamiliar activity, see if the person is referring to the sample when not prompted. If the person is not checking the sample spontaneously, this confirms that they are only functioning up to ACL 4.0.