Sustaining attention longer requires interesting sensory cues that use their ability to grasp, release and toss. One of the breakthroughs resulting from the focus on concrete information is a clearer understanding of grasp and new ideas about what people functioning within ACL 3.0 can do.
Bean Bag Toss
Bean bags may be quicker and easier to make than purchase. A waterproof vinyl fabric can be wiped clean. Select bright colours and cut squares that are about the width of the palm of their hands. They can be stuffed with rice or small beans that are too small to choke on. If infection control is an issue, they can be left in the individual's bedside table with their name on them in permanent ink.
Some family members, staff and visitors are especially appreciative of age and culturally appropriate targets for the bean bag toss. Three circles in the classic bow and arrow target style will work fine; just leave a hole in the middle. We need to get the clowns and other childish targets out of the facilities for the elderly. The reason is really not because people functioning this low notice, because very few do. The reason is that the general public does notice them because they are so big, which contributes to the prevailing negative attitudes about people with a cognitive disability. Teething toys are small (ACL2.8), not seen by many people, and serve to prevent serious injuries. Clown targets are a lot easier to replace. I rest my case.
Dropping Objects
New ideas occurred to me while I was writing this section, which I hope you will try. While thinking about dropping, I was reminded of my memories, shared by many parents, of when our kids discovered the wonders of dropping their food on the floor, over and over again. My guess is that people functioning within ACL 3.0 will be mesmerised too. Coming up with an idea for an attractive, noticeable, safe, repeatable, portable, and inexpensive object is always difficult. Until you have tried it, you have no idea how hard it is. Other people are annoying when they assume that it is quick and easy. URGH!
Dropping objects into metal buckets containing stuff that makes noise or does something else helps to sustain attention. The stuff in the bucket can be small if we keep it away from their hands. Does anybody have any ideas for objects to drop and bucket fillers? I came up with dropping apples, carrots, or rocks into a big pan of water (with a sponge mop for you to clean up within arm's reach). Then I found the water balls in the dollar store that float to the top of the bucket and do not splash much.
The lesson I have learned over and over in developing activities is that it pays to be stubborn about an idea that should work … and keep my eye open because something will come along that will work.
They may remember the names of familiar objects and colours, and saying the names helps maintain their use of their vocabulary.
Reaching through a Hole
Another idea that needs to be developed occurred while describing putting on a T-shirt. If they can reach out to put their hand into a sleeve, their attention might be captured by putting their hand through a hole to reach a target. The holes will have to be mounted on something that can be held up to eye level but the sizes and shapes could vary. The holes could be partially covered with strings of beads or bells. The target that will capture their attention could be noisy, brightly coloured or maybe even flashing lights. I'm still working on this idea.
This is an example of how activity development often gets started. A clinical observation of what they can still do is translated into some ambiguous concepts and transferred to other material objects. The next step is experimentation with materials, followed by pilot testing with people functioning within ACL 3.0. What starts out simple, tends to get very complicated before it gets simple again.
Ball Tossing
The industry for the elderly is developing some attractive sports equipment. With limited budgets, attention can probably be sustained just as long with a less expensive version of basketball seen in the photo.
Stamping & Colouring
The ACL range of stamping and colouring are both spectacular, providing discrimination criteria for nearly every mode between ACL 3.0 to 6.0
The picture displayed below has a little bit of various levels. The stamps in the corners will probably be ignored until ACL 5 because they have too much information.
Within ACL 3.0, grasp and release of the stamp is certainly expected. You would probably need to put ink on the stamp by using the stamp-pad for them to get them started. They might be able to stamp the paper several times and then need to take a rest. If learning can occur, they may be able to ink and stamp by the end of the session.
Inking and stamping is a back and forth motion observed within ACL 3.2. If they are unable to do the back and forth motion of inking and stamping, that would confirm ACL 3.0.
The random placement of the hearts, flowers, and bows is expected within ACL 3.0 and 3.2.
An inexpensive source of paper in the US can be found by buying placemats in bulk that fit hospital food trays. Washable non-toxic inks are available and laminating is a possibility.
When selecting stamps for ACL 3 and 4, keep them simple and stick to universal shapes. Avoid words because reading comprehension does not come into the scale until ACL 4.6.
Stamping was very popular a few years ago and thousands of stamps were available and probably show up now in garage sales or on eBay. Children's toys and scrap booking supply stores still carry an impressive assortment of stamps, and the simple universal shapes are still included.
Finding simple pictures to colour is a lot harder than it seems like it should be. Most colouring pictures are like the corner stamps, they contain too much information, and people functioning between ACL 3.0 and 4.4 reject them. Outside observers object to "childish" pictures and it took me years to figure out what the definition of childish is. It is silly, really. Kittens, puppies, children and toys are childish. Cat, dogs, adults, housekeeping chores and adult size cars, sporting equipment, etc. are adult.
We have included a few pictures that you can download here.
If you look for pictures on the internet, be prepared to scan through a lot of useless stuff because it is childish or too busy. Within ACL 3, use these and the picture in the ACLS-6 to set your expectations for a simple picture. The striking features of colour, shape, size, number of items (up to four), and linear information can set your expectations for pictures to colour within ACL 4. Those were the criteria used for the pictures selected for the ACLS-6.
Surface and spatial properties are the criteria for ACL 5, and guided the design of the picture in the ACLS-6. The ACDM does not operate under the mythological psychometric assumption that with one test score does all of the thinking and evaluating for you. The ACDM assumption is that you are thinking and evaluating all of the time. Part of your responsibility is learning how to select pictures to colour that evaluate ability to function. And who would have thought that you needed a university degree to select a picture to colour!