With the stitching activity, observe the person's ability to retain an image using directionality as well as difficulty in three-dimensional space. While doing the single cordovan stitch, the person goes from front to back, and front to back again, with the tip to the left at least twice, but the person does not tighten in sequence.

ACL 4.8 displays an awareness of directionality that is absent in ACL 4.6.

Rote learning is a memorization technique. Repetition is a substitute for understanding the reasoning and relationships in the information. The exception to this general rule is the formation of an image which was discovered while watching people copy a design.

The diamond coloring in the ACLS-6 provides an opportunity to observe a person during the process of forming an image within ACL 4.8. There is tedious checking of the sample and coloring a section and checking and coloring and checking and coloring.

Stamps with left and right orientation like up or down can be used now without assistance with orientating the stamps.

This watermelon beading activity can be used to observe linear counting of the beads. A person functioning within ACL 4.6 should be able to carry out this activity when they count the beads row by row. They usually work slowly, counting and matching line by line. The therapist will need to make a sample for the person to study. Instructions for this activity can be found in the download section of https://acdmweb.com.

The overlap on the ribbon flower pot is refused in ACL 4.4 and done easily in ACL 4.6. The torn masking tape is done with difficulty and may not be completed.

The torn masking tape is irregular and harder within ACL 4.6, but done with less effort, within ACL 4.8. The stain is shoe polish on the outside and wood stain on the inside.

Overlapping parts of objects on a flat surface usually is possible for people functioning within ACL 4.6.

This card activity requires placement of shapes using the horizontal and vertical axis. Additional information involves overlapping shapes. Try making a greeting card with the duck swimming in a pond of cellophane blue water. Instructions for this activity can be found in the download section of https://acdmweb.com.

For the fan, the lines of the fabric maintain the horizontal line that enters the scale in ACL 4.0. Other placements must be spaced and the smoke must overcome the lines on the fabric to form a curve, which is usually possible in ACL 4.6.

Some simple games use classifications (Clue / Cluedo) as a part of the method for winning the game. They can often play concrete games if they can use their familiar "strategies."

For people who prefer paper and pencil activities, intellectual appearances are often important to them. I have seen people sit with a book and pen in their hand all day long, with the book upside down. My recommendation would be to let them keep the book, but try to find some other activities that capture and sustain their attention.

Within ACL 4.6, they notice the buildup of trash but have difficulty problem solving complex trash removal routines. They may complete routine trash removal if it is their usual custom, otherwise the trash is often left where it is. When living alone, the tendency to not remove the trash often becomes a health hazard.