Goal-directed activities are important clinical measures of independence because the person knows what the next step is. Opportunities to have something to do and keeping them busy have to be fought for as a basic human right. Waiting to die is the alternative. With our help, they can enjoy life.
Time
Activities, within ACL 4.0, can fit into their day / night rhythms and schedules. Performance helps them keep track of the passage of time and stay oriented to date and time of day. Without scheduled activities, we all tend to become disoriented to the day, date and time of day.
Within ACL 4.0, the person becomes aware of the obvious time of day by paying attention to striking visual cues.
Seasonal classifications include holidays, rituals, feasts, decorations and dress / costumes.
Space
Territoriality is established for their bed and the chair they like to sit in to eat or during the rest of the day.
Someone else must set up to do an activity and clean up when they are finished. When left alone, neither is apt to happen, but carers tend to assume that it will. That often turns into a false hope when people are left home alone. They tend to sit and do nothing and then cause trouble later.
Their table top vision is still about the size of a placemat with concentration on what is in that space. A deck of cards placed in the area, or a video game can solve the problem.
The room and the chair they sit in to do activities are important markers of their engagement in doing scheduled activities. They may experience a need to go to a place that is not their bedroom or where they sit all day long. Carving out a designated space is a significant part of the daily ritual of something to do. Consider a scheduled time to take a walk outside.
Sense of Self
Possessions are classified as mine and not mine, but what belongs to someone else will probably not be noticed. Awareness of possessions, activities, and schedules are recognised when cued by someone else, but assistance is required to initiate activities.
During activity performance they are able to recognise a physical disability and the need to compensate for it. When demonstrated, small changes in their habitual movements can be imitated. They will probably need to be reminded each time they need to use the adapted movement for weeks and possibly months.
Other People
Communication skills include customs for friendly social greetings, essential good manners such as saying please and thank you, and using courtesy signs of social rank. The individual's personal habits explain many social differences. Reinforcing their use of good social skills will help them receive compassionate care.
Universal rules for reciprocity in trading possessions probably exist and they enter the scale in ACL 4.0. One can cleverly request an item by praising it "I think that is beautiful." Is a way of saying "Can I have it?" If you are given the item, the rules of exchange are that you should return something of equal social value. Small children and people operating within ACL 4 often fall short on the return side of the exchange.
Social Rank
Their awareness of other people includes cultural signs of rank and authority, different dress codes, customs, and standing versus seating arrangements. Teachers conducting craft groups stand up.
Finances
Money and possessions are abstract classifications with emotional meanings for some people, and none for others. Within ACL 4.0, most people can make small cash purchases, and their slowness is a clue that they cannot count their change. When vulnerable, on site observations are the only way to predict what will happen to their possessions and their money in the community because there are too many variables in individual cases.
Material Objects
Material objects may be used until they are done. Material objects now have a purpose.
Objects continue to exist after they are done working on them within ACL 4.0. People functioning within ACL 3.8 and below often leave their projects behind.
Possessions are taken with them and stored with their other possessions. Rejected projects are deliberately placed in the trash can.
Samples & Errors
The sample concretizes what they are doing and makes mistakes obvious. Errors are often accepted within ACL 4.0.