Grasp and release of single pictures is encouraged from ACL 3.0. Pictures in picture frames or think photo albums may be used. The person often has procedural memory for using a pincer grasp when they used to be higher functioning.

Turning a few pages of a calendar can usually be expected within ACL 3.2.

Within ACL 3.4, recognition by naming familiar animals, people, objects, and places can be verified by the person's use of the correct noun.

The synthesis of information is limited within ACL 3 Low.

ACL 3.0

The person has the limited ability to use words or understand what they mean. Gestures such as patting a chair for them to sit on or opening your palm to hand you an item is more likely to be understood.

Additional sensory information includes recognizing colors such as crayons, paints and felt tip pens, pouring fluids, spreading pastes like peanut butter, the effects of soaps with lather, bubbles or foam, and textures such as wash clothes and napkins.

Lots of manual actions and hundreds of material objects can be used to form a concept of a line. Intentional grasp is associated with attention to more universal objects, which makes finding objects for them much easier than the highly personal objects required within ACL 2.

Common manual actions include washing, brushing, wiping, coloring, painting, folding, dropping, throwing, tearing, stacking and spreading.

The simplest shape for surfaces to place objects on seems to be a rectangle, which has corresponding horizontal and vertical lines.

The truth is that a sense of direction for walking enters the ACL scale in ACL 2.6. The differences between the automatic grasp of ACL 2.8 and the intentional grasp of ACL 3.0 is that the target for intentional grasp is chosen within the person's cerebral cortex. Intentional grasp is accompanied by intentional release and both enter the ACL scale in ACL 3.0.

Within ACL 3 Low, adults with a cognitive disability who have a history of abstract information for decades before the onset of a cognitive disability display the following pattern:

• No attention is paid to abstract information.
• An abstract word is seldom spoken. If one is spoken, it is usually a habit, done automatically.

Within ACL 3 Low, the person forms a sense of interest in the effects that their actions cause. Their interest is what holds their attention. When their interest fades away, they need a new action or a different material object.

Their sense of direction when walking around is limited to the location of their bed, toilet and eating area.

When the person uses their hands, their sense of space is limited to a small space on the table or counter in front of them. Their heads are often down, with their chin on their chest.

When the person is walking, their sense of space is connected to barriers, above their knees.

When they are sitting or lying, they sense the effects of gravity on the position of the body and track objects slowly in a small visual field.

When the person can sit up and walk, regular schedules need to be coordinated with bathing, eating and toileting because their orientation to time depends on events. Without regularity in their sense of time, insecurity and agitation can increase fall risks.

When the person lacks head control, day or night, sleep or awake are differentiated and contribute to their sense of security. Turning the lights out at night helps to maintain circadian rhythms.