The Cognitive Levels

Welcome to Allen Conferences, Inc.’s web page,

The official web site of Allen Cognitive Levels.

Allen’s Cognitive Levels

There are six levels ranging from Coma (0.8) to “Normal” (6.0). Each level has three components: Attention, Motor Control, and Verbal Performance.

Attention: The type of information that is noticed and used in each mode. Use of information can be expressed in motor and verbal performance, in isolation or simultaneously.

The research used to develop the levels are described in the books: Occupational Therapy Treatment Goals for the Physically and Cognitively Disabled, by Allen, Earhart & Blue, AOTA, 1992; and Cognition and Occupation in Rehabilitation; edited by N. Katz, AOTA, 1998.

Modes Further Define the Levels

We found that the six levels did not offer sufficient discrimination. A patient’s cognitive progress is a continuum along two paths:

Motor Performance
Verbal Performance
which are Linked by attention.

Modes of Performance

The following designations were added to each mode to allow the therapist to more precisely locate the patient’s function level:

.0 – An aggregate: bits of information of the whole level.

.2 – Distinctive characteristics of time and place; easily overwhelmed.

.4 – Consolidate the level; repeated use of the information. Point 4 is the classic description of the level. 

.6 – Open to the next level; thought orientation shifts up.

.8 – Composite adds information from the next level but cannot understand how the pieces fit together; inflexible.

Ability and the Functional Levels

Function is what people do.
Functional ability is the capacity to use mental energy to guide motor and speech performance. Acceptable activities are a combination of:

What a person Can Do: Realistic and/or Biological
Can Do is limited by their lack of ability (i.e. their disabilities).

What a person Will Do: Relevant and/or Psychological
Will Do is limited by the amount they are willing to change.

What a person May Do:     Possible and/or Social
May Do is limited by their social support system.

Global Ability and Focal Deficits

A Global Ability to function must be present before a focal deficit can be accurately evaluated. (Can Do)

Example: Hemiplegia is a focal deficit. It can not be evaluated before the patient has the ability to move their arms and legs (@ ACL 1.8).

Example: Aphasia can not be evaluated before the patient has the ability to talk.

Functional Milestones:

This table contains milestones that happen at particular levels.

ACL and Activities

6.0   Premeditated activities            

5.6   Social Bonding
Anticipates safety
Child care

5.0    Intonation in speech                 

4.6    Live alone                                

4.2    Discharge to street               

4.0    Independent Self Care

3.6    Cause & Effect

2.8    Grab bars

2.2    Walking

1.8    Pivot Transfer

1.4    Swallow

1.0    Conscious

The Allen Battery

The Allen Battery is the combination of all items designed for use with the Allen Cognitive Levels.

The Allen Battery consists of:


ACL Screens – The ACLS and the LACLS


ADM manual and the related projects from S&S


Sensory Stim Kits for low ACLs


Safety Series for high ACLs


The three books:




Occupational Therapy Treatment Goals for the Physically and Cognitively Disabled, Allen, Earhart & Blue, AOTA, 1992


Understanding Cognitive Performance Modes, Allen Earhart & Blue, 1995

  Structures of the Cognitive Performance Modes, Allen, 1999

Cognitive and Physical Disabilities

Treatment and assessment are occurring at the same time. Cognitive and physical components have been historically assessed and treated separately. In truth, they are intrinsically related, since the brain guides physical behavior. Therapists should always be looking for “Best Ability To Function”.

Functional Outcomes & the Allen Battery

Functional ability is the capacity to use mental energy to guide motor and speech performance. Severity of Functional Disability is measured by the Allen Battery. The accuracy of the ACL from the screen is verified by a project from the ADM. The severity is reassessed by use of the ADM and the RTI.

Strive for the Best Ability To Function

BATF = Best Ability To Function

The Allen Battery is the best tool towards BATF. Low functioning patients (which have   been notoriously overlooked) are addressed. Probes for improvement are part of Allen Battery.