The person requires assistance and constant supervision to complete their self-care activities.

Within ACL 2 Low, they are assisted with eating, drinking, toileting, bathing, and dressing. Caregivers are required to plan, guide and assist with all activities of daily living.

Things that produce sounds vary. Everyday objects can produce a sound. It can vary in volume and pitch. If the person has a favorite instrument see if a relative will bring it in if it is portable. Find recordings of their favorite familiar music. Keep beats and rhythms simple. Other sounds that capture attention are things like bike bells.

Simple few word commands are understood like "stand-up", "eat" and "shower".

Taste preference is also very individualized. You may have siblings with very similar backgrounds who have very different food preferences. This preference can also occur in people with a cognitive disability. Give them a variety of tastes to awaken their senses. Of course, adhere to swallowing precautions. Some strong taste experiences are salty, sour, sweet and bitter.

A person's sense of smell may diminish as their cognition drops. The smell will have to be very strong in order to gain their attention. Mustard, garlic, lemon, perfumes and various herbs and spices produce strong distinct smells.

Primary contrasting colors are noticed in ACL 2 Low when their vision is intact. There should only be one subject with a bland or blurry background.

Busier pictures maybe ignored as the information is not processed.

Familiar furniture are vaguely recognized and items can be mistaken. When there is too much information present, confusion or ignoring the visual cues may occur.

A person's sense of touch may vary and may be affected by their medical diagnosis. If they have had a cerebral vascular accident or an acquired brain injury, their sensation maybe affected. One side maybe more affected than the other. Approach the person from their better side first and then alternate to their affected side. Note their response. Did the person's facial expression change as a result of the sensation. Do they appear more relaxed after the sensation?

Different textures produce various touch sensations like smooth, rough, slippery, furry, fluffy, bumpy, squishy, etc.

The signs of sensory deprivation intensify when their movements are restrained. Frantic, constant attempts to get up and move, fighting against restraints, rocking, head banging, kicking, and pounding intensify or only appear when restrained, which can be a necessary temporary evil to rule out pain. If the person cannot weight bear, pushing them around in a manual wheelchair still provides a sense of movement and being upright. Panicked calls for help at odd hours for no apparent reason are signs of sensory deprivation; as is the loss of circadian rhythms.

The person knows the difference between being upright and moving, and lying down and resting. Both experiences are needed every day to maintain circadian rhythms.

The person is aware of their body's position in space and they want to be upright when they are awake. They will try to stand up and assist with transfers in ACL 2.0. At ACL 2.2, they can make a step and enjoy walking with the assistance of two staff members or with the use of a forearm support frame. At ACL 2.4, the person can walk on their own. They lack a sense of direction and often walk in an arc with no destination in mind. The person pays attention to bold sensory information.