For decades, we have watched people fiddle around with the single cordovan stitch in the ACLS. Some people keep trying until they get a stitch by chance, but they cannot repeat it. Give them enough time and there are people who will get a second stitch by chance. The third stitch was added because it takes too long to discover it a third time by chance. The odd thing that struck us was that they often recognised the correct stitch when it appeared, but they could not repeat it. The image of the correct stitch was retained in memory, but the process of producing it was not.
Different qualities of visual patterns are used in the copying activity. ACL 5.0 is scored when the person can copy Design C because it has a diagonal line and spacing problems. The information about the pattern must be retained in memory to copy the design. When the diagonal line pattern is completed by counting tiles, the ACL 5.0 score is probably incorrect, because counting seems to be an effective compensation in this activity with limited applications to additional activities.
Counting tiles to copy a diagonal line is an example of a compensation that is not seen in an end product. The end product (a picture of the completed design) can hide compensations. Compensations are great when the person is doing affirmative activities. However, the ACLS-6 is an initial evaluation that forms a foundation for making additional decisions and compensations must be excluded from the score. The correct score is probably ACL 4.8.
In the diamond colouring activity, adjacent triangles of the same colour are coloured in as a group including over diagonal lines. The overall image is retained. This leads to a big increase in their speed of performance.
The ability to retain an overall image in the kite placement activity results in a decrease in the need to refer to the sample. The sample is referred to after a group of actions. Surface appearance may be ignored and the subtle difference in the colours of the rhomboids may be ignored.
See if surface appearance capture's the person's attention when administering the sketching and peanut butter activity. An ACL 5.0 score occurs when the person outlines the apple shape without the ability to sketch by using shading. The oily residue left by the peanut butter activity is also not noticed nor cleaned off when surface appearance does not capture the person's attention.
Interviews
People functioning within ACL 5 can talk and tell you about their history in doing activities. Educational and work histories are safe places to start an interview. Standardised interviews rarely help in the selection of activities because the person usually tells you what they think you want to hear.
Asking them to describe a typical day prior to the onset of this decrease in ability to function can provide information about the number of hours that are apt to be vacant now. Listen for clues and ask questions about activities that contain the quality of information that captures their attention now. Informal conversations and reminiscing about activities they used to do can give you leads on the type of activities that are apt to appeal to them.
Can Say & Can Do
Try to verify their pattern of performance with activities that appeal to the individual. When the person is giving you no clues, use the examples of activities. No single activity can predict a pattern of performance because people are too variable.
When a person has a history of doing arts and crafts, do your best to verify their ACL score with an activity that is new to the individual. Within ACL 5, the evaluation of overt trial and error learning abilities is apt to be too high when the person uses prior knowledge. The repeated question is; "Have you ever done anything like this before?" If yes, try to identify an activity they have not done and is not toxic. Iron-on bonding for fabric appliques is often an unfamiliar product.
Getting Acquainted
Do strive to get a comprehensive picture of who this person is, which should include: how well they are functioning now (current ACL), how well they have been functioning (prior ACL), what kind of activities they like to do, and what kind of social and financial supports they can depend upon.
To Verify
Verification of an ACL score is needed to support the assumption that the same quality of information is guiding the same quality of behaviour while doing different activities. A selection of different visual patterns and materials should be used to support the assumption.
The ribbon card is suggested because weaving was not included in the ACLS-6 activities. Even spacing in sewing stitches is different too.
Within ACL 5.0, the most troubling inconsistencies raise questions when the person has a history of doing arts and crafts. Prior knowledge can produce artificially high ACL scores. Imitation of physical exercises that require crossing the midline is recommended.
To Rule Out
To rule out attention to surface appearances (ACL 5.2), cleaning activities offer many choices, but procedural memories are hard to eliminate. My experience is that cleaning activities are good affirmative activities but not good evaluative activities.