Stamps of various types like clear stamps maybe enjoyed. The person make decorative greeting cards. A grid maybe downloaded from the download section of the website. This helps people compensate for their reduced ability to space the stamps out. The grid also helps sustains the person's attention. Try it.

Stickers should work in any direction when working with people in ACL 4 Low. Circular shaped stickers are unidirectional.

Felt and fabric, as material objects, can be cut, glued, stitched, layered, overlapped, and adjusted with pressure and tension.

This project shows the preparation stitches done by someone else. The uneven stitches are not noticed by the person operating in ACL 4 Low.

Uneven stitching is not as noticeable on smaller projects.

This ACL 4.4 set up for a notecard allows the person to follow the sample without waiting for directions.

For storing and set up with stamps, stickers and other multiple, small pieces, your sanity can be preserved by storing items by theme or project within a larger box of similar items.

If you keep using the same objects they will learn, by rote, how to fit them into a box, like a shoe box. I'm a big believer in transparent boxes with everyone, but especially with people functioning within ACL 4 Low. They are likely to ignore objects placed in non-transparent boxes.

Getting serious about keeping people happily occupied requires serious attention to preparation time. When a person is occupied, they want to be doing something, not watching someone else flutter about doing the preparation work before they can get started. For the person who is conducting the crafts group that means the details should not dictate how time is spent during the group. Organizing the details takes great planning. Here are some tips for ACL 4 groups that we learned along the way.

The first rule for activity selection is that cues have got to capture the person's attention. Ignored cues are useless. Within ACL 4, cues are grouped or classified to assist the person with making their selections.

The person's information processing system synthesizes the information into a new experience that is: evaluated, compared with other experiences, and a choice is made about whether to sustain their attention, or not.

Sustained attention is a combination of personal choice and available mental energy.

Teaching the person functioning within ACL 4 Low on how to be polite and use their manners will require daily routine training. The person will require daily demonstrations and prompting to be polite.

We say, "Excuse me" if we need to interrupt someone.

We say, "May I please" if we want to do something.

We have to wait our turn in line.

We do not walk too close to someone. One arm's length is considered polite.

If someone gives you something, we say, "Thank you".

Skills development programs are used to help a person functioning within ACL 4 Low to learn a new daily skill. This is often required if the person has never functioned higher than ACL 4 Low. The person does not have the well learnt past memories formed when they were functioning without a cognitive disability.

Re-learning is harder than new learning. In a population that can only do new learning by repetitive rote learning, re-learning is extremely difficult because old habits often need to be inhibited. Within ACL 4 Low, it is not recommended that relearning be used as this population lack the mental energy to inhibit their old habits. If re-learning is attempted, follow-up studies are required to ensure this method is cost effective as fading will likely occur over time.

The inability to solve problems as they are unable to manipulate information often causes the person to blame others when a negative consequence occurs. Trying to explain this to the person often produces frustration. Using matching as a way to figure out if something is right can result in the person seeing things in a rigid way. It is either right or wrong and it is very difficult for them to accept there is anything in between. Caregivers will need to assist with problem solving tasks especially if mistakes will be a costly result.