Allen Cognitive Level Screen PDF

Allen Cognitive Level Screen Shane Jorwin Gemoto, OTD, OTR/L November 7, 2024  Outline 1. Allen Cognitive Level Screen Overview Administration 2. Allen Cognitive Levels  Allen Cognitive Level Screen-5 (ACLS-5) Leather lacing tool Identifies...

Allen Cognitive Level Screen Shane Jorwin Gemoto, OTD, OTR/L November 7, 2024  Outline 1. Allen Cognitive Level Screen Overview Administration 2. Allen Cognitive Levels  Allen Cognitive Level Screen-5 (ACLS-5) Leather lacing tool Identifies Allen Cognitive Levels of clients with Alzheimer's disease, dementia, TBI, CVA and other psychiatric disorders Quick measure of “Functional Cognition” Global cognitive processing capacities Learning potential Performance abilities Detect problems to functional cognition  ACLS-5 Overview Three visual-motor tasks (three leather lacing stitches) What does the client need? Attention Responsiveness to sensory and motor cues from materials (ex. Lather, lace and needles) Understanding to verbal/demonstrated instructions, cues and feedback from motor actions while making stitches Observe the client’s abilities and deficits Recognizing client’s abilities = Foster feelings of success and being useful Types of Stitches 1. Running Stitch 2. Whip Stitch 3. Single Cordovan Stitch https://www.youtube.com/watch?v=_1ouB1Jl34A  Start the stitch: Hold leather with smooth, finished side facing you Starting at the left-top corner, push needle through the whole back to the front and pull tight Work Clockwise, complete three running stitches  Administration of ACLS-5 Running Stitch Demonstrate stitch Demonstrate again as needed Completion Criteria: Three correct running stitches in consecutive holes Score observations then go to next stitch  Start the stitch: Starting at top left corner Insert needle from front to back Leave 1.5 inch tail Secure tail under the next Stitch Complete three whip stitches  Administration of ACLS-5 Whip Stitch Demonstrate stitch Completion Criteria: Three correct whip stitches in consecutive holes including recognizing and correcting errors Score observations then go to next stitch  Administration of ACLS-5 Error 1- Cross in Back ”Just do the best you can!” Note behavior and ability Success: Go to Single Cordovan Stitch  Administration of ACLS-5 Error 2- Twisted Lace ”I’m going to make a mistake to see if you can fix it!” Make two twisted lace errors “Please show me my mistake and please try to fix it!” Note behavior and score observations and go to next stitch  Start the stitch: Starting at top left corner Same as whip stitch Push needle through the next whole from front to back Pull lace through until ½ loop is formed Bring needle to the front and push it through the loop from the front Tighten stitch Complete three stitches  Administration of ACLS-5 Single Cordovan Stitch Ask client to engage in self-directed problem solving to complete stitch “Please make three stitches without me showing you how to make them. If you cannot figure it out, I will show you”. Verbal cues = Max. 1 Demonstrations = Max. 2 Completion Criteria: 3 correct single cordovan stitches stitches in consecutive holes Note/Score observations  Ending ACLS-5 Failure to complete 3 correction running or whip stitches is no longer criterion for ending assessment Criteria for determining ending the assessment Completing all three stitches Failure to correct error in single cordovan after second demonstration Refusal of first and second single cordovan demonstration Request to end or continue Anxiety and/or frustration Problem solving appears ineffective even with encouragement, demonstrations or verbal cues Scoring ACLS Allen Cognitive Levels  ACL 0 Coma Unable to respond  ACL 1 Automatic and Reflexive Min. response to environment 24hr care to illicit automatic actions Attention span - 1 second Total Assist  ACL 2 Postural and Gross Body Movements Changes posture for comfort Help caregiver with simple tasks ex. rolling for diaper change Attention span - ~2-3 minutes Maximum assistance with ADLs “It takes 2 to tango”  ACL 3 Manual and Repetitive Actions Learn simple tasks with repetition Tactile cues Attention span – 30 minutes Moderate assistance with familiar ADLs ACLS - running stitch  ACL 4 Goal Directed and Familiar Activity Do simple tasks Visual cues and matching Unable to learn new tasks or problem solve Routines become very important Attention span – hours long Minimal Assistance with ADLs ACLS – whip stitch 4.4 - 4.6 = Patient is able to go home from hospital and live alone  ACL 5 Exploratory and independent New learning and concrete tasks Overt trial and error Frustration tolerance and controlling impulse Attention span – weeks Standby Assistance with ADLs Weekly supervision ACLS – simple cordovan stitch  ACL 6 Planning and Mental Problem Solving No cognitive disability Multiple step tasks using analytic reasoning Independent with ADLs ACLS – cordovan stitches “Plan to meet at 6” Suggested Activities  YouTube Sources OT Miri - https://www.youtube.com/watch?v=mAhyx_kERTg OT Rex - https://www.youtube.com/watch?v=SMNOAybdMAk  “Once you understand someone’s cognitive level, you know how to care for them”. - Kim Warchol