In ACL 4 High, the person is more able to follow the steps required to complete household management tasks. They are able to scan the environment looking for supplies required to complete their household management tasks. They have more ability to apply more pressure to different objects though this maybe hitting it harder or longer which may result in breakage. The ability to read simple instructions and follow a checklist also improves their independence. They do however have difficulty understanding verbal and written instructions in unfamiliar activities.