We may feel stressed when we feel things are being taken from us. This may include opportunities to go out or the right to use our own space as we wish.

Being assertive is saying how we feel without hurting the other person's feelings.

We say:

"I feel … when …"

"I would like to … instead."

We need to avoid speaking aggressively. Saying, "I hate you because you won't let me go out" will upset the other person and make the argument worse.

Skills development programs are used to help a person functioning within ACL 5 Low to obtain new skills. This is often required if the person has never functioned higher than ACL 5 Low. The person does not have the well learnt past memories formed when they were functioning without a cognitive disability.

It is easy to take for granted that the person requires a few demonstrations to form an appropriate mental image for novel tasks. This means that the person cannot be just provided information from a phone call. Sometimes watching a video recording may help provide the information they need to perform an unfamiliar task.

Within ACL 5 Low, training becomes somewhat easier as information is stored more easily in their short-term memory. Re-learning is however still harder as they need to inhibit the old habits or procedural memory. With a physical disability, new techniques and equipment maybe required to maximize the person's independence. The benefit of using such aids may not be immediately recognized.

Abstract cues are common but are often ignored by people within ACL 5 Low. Hints and verbal explanations of such cues may also be ignored. Make use of an authoritarian instructions such as "this is the Dr's orders" or "these are the house rules". Abstract cues are intangible and include unseen things like the feelings of other people. Unseen forces such as electricity, chemical reactions and heat which should be paid to attention maybe ignored with their negative consequences like electrocution, poisoning and fire risks.

Secondary consequences are not paid attention to as long-term knowledge may not spontaneously be recalled. Past secondary results from primary effects on physical tangible objects are not noticed till after the incident occurs. This reduces the person's ability to prevent negative secondary consequences. Common errors may be warned ahead of time with preventive rules put in place. Anticipating all errors are difficult. Having understanding caregivers who can rescue the person when a negative effect occurs is important. The risk involved must be weighed up with the person's freedom.

Within ACL 5.0, the person may forget discovered solutions to problems and may abandon tedious tasks. Within ACL 5.2, a few demonstrations maybe used to assist with learning a new task. Within ACL 5.4, a demonstration will suffice.

Demonstrate safety procedures that can be learned by rote such as turning pot handles inward, or unplugging appliances after use, or angling cuts away from fingers.

Memory aides maybe used to prompt the person to carry out activities like attend to an appointment on time. Many of these memory aids are common and readily available. The difference between a person with a cognitive disability versus someone functioning in level 6 or higher is that without these aides, they have a higher chance than normal of forgetting these appointments. Some memory aides are wall calendars, diaries, and electronic apps on the person's smart phone.

Demonstration with standby supervision is required when the person has had any medical problem that has secondary consequences, e.g. hip and knee replacements, unhealed fractures. They are not apt to comprehend the consequences, nor are they apt to follow precautions due to impulsivity.

ACL 5.0 - 5.2

Range of motion exercises maybe followed from a demonstration.

Someone will need to count with them and correct improper positioning.

Non-Weight-Bearing Adherence

The person will have reduced ability to inhibit the action of non-weightbearing. The use of non-weight bearing boots maybe used to remind them to not weight bear.

Their learning of a transfer sequence is more fluid. Demonstration with practice is required for them to master the task. Reminders will be required to reinforce safety procedures such as locking brakes.