Specific impairments are focal deficits which have limited impact on the brain's global ability to function. Adjusting and accounting for such specific impairments is important as these can artificially reduce the person's performance. The testing procedures in the ACLS-6 have attempted to screen out some of these specific impairments with questions and assessment tasks aimed at testing the person's eyesight and hand function. Clinicians will need to ensure adaptive equipment such as glasses and hearing aids are used when cognitive disabilities are accompanied by additional impairments.

Flexibility may be the value of the human brain, but the inconsistencies that the brain creates can be a nuisance when trying to predict. Problems with predictions occur because the quality of information is only one factor among the many that influence what people with a cognitive disability can, will and may do. Their effects are discussed throughout the Allen App. The point of putting them here is a convenient list to remind you to consider the common confounding factors. In no way should anyone think that this list includes everything.

When a person with a cognitive disability makes sense out of doing an action, activity or occupation, the outcome of the process is predictable when the quality of sensorimotor information is a determining factor. A higher accuracy is expected at the bottom of the ACL scale because less information and fewer behaviors are possible. More information, access to more memories, with more steps in the mental process, and storing new information in long-term memory reduces the predictive accuracy of a single activity.

The levels, profiles and modes apply the same definitions of sensorimotor information. The modes and profiles describe qualities of information. Within the modes and profiles, what makes sense to the person is applied to a selection of ordinary activities to describe a predicted pattern of activity performance.

Different ACL scores while doing different actions or activities are usually in adjacent modes and need further observations in equivalent actions or activities. It is important to establish a pattern of performance of the person's global ability to function.

In an ordinal scale, verifying the score and ruling out a higher score is important. Clinicians need to make sure the person is able to pay attention to the quality of information which their score represents. Be sure to carefully verify the ACL score and personally examine the real activity environment before you offer an opinion. Distortions and important omissions are common in these situations. Secondary gain with a history of good verbal abilities, charisma or theatrics has a tendency to make sustaining your objectivity difficult.

Informal conversations are more productive than standardized interviews and need to be adapted per cognitive level.

When the person cannot talk or talk very little, a family member or a friend may be used to obtain reliable information.

People functioning within ACL 4 and 5 can talk and tell you about their history in doing activities. Educational and work histories are safe places to start an interview. When the person is functioning at ACL 3 and below, an observation of their activities will be a more productive use of your time.

Learning how to do a quick estimate starts to focus in on the person.

Making a quick estimate is required to select actions or activities for the ACLS-6.

The activities in the ACLS-6 can be used to get an Initial Evaluation, but those activities may not all produce the same score. Ability to function is a general pattern of performance with exceptions that are often explained by other medical impairments and the person's personal history in doing activities.

If you are using only the stitching (or lacing) test, it is known to produce scores that do not always match the person's pattern of performance.

Causing effects are behaviors connected to the sensorimotor information that aroused attention. Causing effects includes explicit descriptions of mental control of physical actions, the manipulation of material objects, and the use of hand and power tools. The connection between the cue and the behavior can be predicted by the content of the information, i.e. it tastes good and licking their lips.

Getting the person to pay attention is not as simple as yes or no because sustained attention is not the same for every activity, every person or even the same person at different times of the day. While there is some predictability about how much attention can be aroused with each ACL, that too has variations. The goal is to get the best and most attention as possible.