The ability to transfer off various surfaces at will reduces the risk of pressure sores.

Caregivers will still need to check for pressure sores due to poor fitting shoes and other poor fitting items.

If the person has reduced sensation, caregivers will need to provide appropriate pressure care as the person is unaware of the secondary consequences of poor pressure care.

Fall risks are increased by the fact that people functioning within ACL 4 rarely put things away and clutter accumulates around them. Their balance may not be steady enough for them to carry items around or up and down stairs.

Hair & Nail Care

May use one-handed nail clipper/file with supervision for safety. Remind to wash hair in the shower and make arrangements for haircuts. Remind to brush hair at routine times of the day.

Oral Hygiene

May learn new oral hygiene procedures slowly by rote.

May rigidly follow prescribed routines such as care of dental appliances.

Within ACL 4.8, the person can learn one-handed methods with more ease than within ACL 4.6.

Observations of eating become the evaluative activity of last resort when a person refuses to do any other activity. People who are trying to hide a cognitive disability often avoid doing anything that would give them away. Many people will do craft projects because they have no face validity.

Key eating observations are included in the following descriptions.

Routine toileting tasks maybe completed using usual manners. Missing items like finding the end of a roll of toilet paper maybe attempted.

Toileting may be independent if the person is not affected by physical disabilities within ACL 4.6, but they may take much longer than average to complete toileting.

The person can bath using familiar methods. They will search for missing items by scanning the environment.

The person is able to dress independently using familiar routines. They can search for hidden objects. They may be trained how to do more difficult tasks using rote learning. The inability to store information into long-term memory spontaneously results in them being slow although some may have been trained to hurry up, they still function slower than someone functioning in ACL 5.

The person can do all their self-care activities independently. Within ACL 4 High, they can look for supplies and ask for assistance in an appropriate manner.

These predictions should only be treated as a suggestion. There are many confounding factors which often skew these predictions. Factors which often affect predictions are a person's procedural memory, individual differences, physical abilities, age of onset and variation in the support provided by caregivers.

Living alone assumes that the person can do all of their self-care activities independently, but within ACL 4 High, some daily or weekly assistance is usually required. Household management tasks usually require even more assistance.

Sensory information is very calming for someone functioning in ACL 4 High. Sensory information may be directly focused on and allows them to use their mental energy. Bold striking features are what captures a person's attention in ACL 4 High. Group times may be used to provide different sensory information. The person is able to access supplies for sensory information by searching in well-known locations.