Designed for assessing an individual’s ability to function independently, the Allen Cognitive Level Screen (ACLS) is of great help to operational therapists. They use its results to develop a care and lifestyle planning program for a particular patient. This raises the question of the Allen Cognitive Level Screen scoring and the correct interpretation of the results.
This Allen cognitive test involves learning and performing three tasks (making stitches of different complexity) with the help of instructions. To complete them, the person needs to be attentive, to understand the directions and cues and to use them. Like all the cognitive tests from the Allen Battery, this one is also based on the Allen Cognitive Levels.
The number of the points a person can get in the ACLS depends on the complexity of the task and his or her ability to complete it. Each next stitch is more difficult than the previous one, so the score is higher provided the person completes the task correctly. Scores correspond with the levels of care the person may need. Their range in this Allen cognitive test is from 3.0 (the lowest score) to 5.8 (the highest score).
But assessing a person’s cognitive function is just an initial step. The next step is accurate interpretation of the scoring. This makes it possible to give recommendations to each individual and their caregivers or even develop an individualized wellness program. For this, specialists who are in charge of the Allen cognitive test administration and score interpretation register the results and other observations in Scoring Tables. They also take into account other information concerning the individual’s current and past interests, history, etc., which makes interpretation more reliable.
An operational therapist’s task is to redesign the person’s environment in accordance with the results of the ACLS so as to compensate for the lost abilities and encourage them to take advantage of the remaining ones.
Let’s see how to do this.
|Type of the Stitch||ACL Mode||Scoring||Possible Recommendations|
|Running stitch (shows the remaining abilities in daily activities, i.e. dressing, etc.)||3.0||When asked to make running stitches, the person either pushes the piece of leather away or grasps it and attempts to move the lacing but does it in a random way.||manipulations with objects (grasping, throwing, catching)|
walking up stairs
|3.2||Makes at least one stitch, maybe incorrectly.||simple repetitive tasks (sorting cards, beads, polishing, etc.)|
moving objects in different motions
actions with objects and naming the object and the action
|3.4||After 1-2 demonstrations succeeds in at least three stitches, no errors.||putting objects in a row|
|Whipstitch (shows the remaining problem-solving abilities, i.e. cooking, taking medications, etc.)||3.6||Makes stitches of which at least one is correct||sorting objects by color, size, etc.|
|3.8||Unconcerned about twists, crosses and other errors.||imitating three actions in sequence|
|4.0||Recognizes errors but will not correct them, except, perhaps, errors in running stitches.||finding objects (not hidden)|
|4.2||Untwists the last whipstitch, unable to untwist with the lacing in the hole.||preparing simple meals|
|4.4||Untwists one stitch with the lacing in the hole.||orientation activities|
|4.6||Removes the stitch to correct an error but again fails||communication activities|
playing matching games
|Cordovan Stitch (abilityto process information)||4.8||Does not tighten the lacing in sequence.||using a checklist to avoid possible problems|
learning new housekeeping procedures, new recipes, etc.
recollecting events from the person’s life
|5.0||After a second demonstration improves the performance, yet, with errors.||using a memory book|
competing with other people in an activity
|5.2||The only error is a little loose tension.|| |
using memory aids for appointments
talking during a motor activity
|5.4||Performs the task after one demonstration, corrects errors.||social activities|
|5.6||Needs no demonstration, only a cue. Succeeds in three stitches.||traveling to new locations|
mastering new recipes
|5.8||Needs neither demonstration nor cue to complete three stitches.||education on how to avoid injuries |
education on how to compensate tiredness
use of written instructions
games involving problem solving, memory activities of a high level, interaction
discussing current events
On the whole, all possible recommendations come to the following:
- a calm and safe environment;
- engagement in an activity either with demonstration and cues or without them.
Thus, interpretation of the Allen Cognitive Test results obtained by using the leather lace cognitive test is a necessary condition for patient-specific lifestyle planning. As many cognitive conditions usually aggravate, a follow-up program is a must so as in case of changes in the person’s abilities to produce a revised plan for functional maintenance.