The person is usually compliant with matching a standard of performance and will be able to independently compare / match two features at a time and correct matching errors.
Time
People operating within ACL 4.4 frequently ask for the name of the day and the date, in an effort to keep track of the passage of time. In an institutional setting they anticipate a different rhythm to weekdays versus weekend days.
The rhythms of social events are adjusted to, including holidays and monthly checks.
Space
When walking, they tend to look straight ahead, without turning their head to the side, which has driving implications.
When seated at a table they may look up enough to see something 3 to 4 feet (1 m) in front of them or on either side. The objects must be in plain sight on a table or a counter to be seen. The set up for supplies and the sample must be within 2 to 3 feet (60 to 90 cm) in front of them or to the unaffected side of their visual field.
Noticing objects placed on their non-dominant side (left side if right handed, or vice versa) is not expected in the scale until ACL 4.4. Left neglect may be a characteristic of a cognitive disability and not a complication of a cerebral vascular accident. If so, training to overcome left neglect could be a waste of time.
Trunk flexibility and balance are a concern within ACL 4.4. They may bend at the waist or cross to their left / right side to reach for objects. They also may try to bend over objects to reach the back, but they do not turn the object while they are working on it. Bending while seated is usually not a balance problem, but crossing the mid-line while standing is a potential balance problem.
Sense of Self
Left and right neglect, neglect due to a cognitive disability, or due to hemiplegia might be separated in ACL 4.4. We already know that people with a cognitive disability pay less attention to their non-dominant side.
Personal space is established in selected drawers and closets and they will get things out when they can see the whole item when they open the storage space. Putting things away so that they can be found later is less likely.
Other People
People are often aware of the fact that a cognitive disability is being considered and know that they need to act in a self-controlled manner to demonstrate reliability.
They can keep track of whose turn it is while playing games. While taking turns, they learn that rotation is occurring in a clockwise or a counterclockwise direction.
Social Rank
Social rank is important and recognised. Authoritative figures are respected. If non-compliance is an issue, use the statement: "It's the doctor's order".
Visual Field
Within ACL 4.4, they match striking features, two features at a time. The striking features in the picture below are colour, shape, size, and number, but they will only select two at a time.
The transparent, plastic tray is shallow enough to see into. To test a container, sit down and place the tray in front of you. Place your chin on your chest. What you see is what they are apt to see between ACL 4.0 to 4.4. Move the container around to experience what is apt to enter their visual field. After you have adjusted to having your head down, pick your head up and look around the room. The experience will help you understand the difference between ACL 4.4 and 4.6, because your attention shifts from a focus on the tray to the whole physical environment.
Material Objects
The ability to match using two striking features at a time increases the person's speed and accuracy. They can make a checkerboard design. Tasks that use both horizontal and vertical line information are apt to capture their attention.
Samples & Errors
The person is apt to refer to a sample after each step, if the sample is placed within arm's reach. They correct errors, one pair at a time and they may require repeated demonstrations. For example, the correction in colour and number may need to be corrected in several rows. When they recognise errors in two features they may ask for help. A demonstration to correct errors is usually imitated.