Assessment
Who is the ACL appropriate for?
pts with dementia or Alzheimer's, psychiatric conditions, and TBI
Providing sensory stimulation such as music or light touch as the primary intervention method is best for patients at which ACL level?
Level 1: Automatic actions
Patient withdrawals from noxious stimuli
1.0
Patient is able to self-feed with finger food although unable to maintain upright sitting position
1.8 - raising body part
You're doing great!
:)
You are administering the ACL assessment to Joe with schizophrenia. You just demonstrated the whip stitch and he was able to perform this task correctly. What do you do next?
A. introduce the single cordovan
B. introduce the double cordovan
C. produce a cross back error ask the pt to correct mistake
D. terminate the test
C.
If the patient made an error on their own and was able to correct mistake you can move onto single cordovan without manufacturing mistakes
Kate's patient suffered a TBI and is an ACL level 4.8 and she has been treating him in rehab for the last 3 weeks. During the team meeting she reports that she feels he is safe to discharge home to live alone. Do you agree with her recommendation, or do you make a suggestion?
You support the recommendation to live alone as long as he is able to get daily assistance for safety and problem solving.
TRUE or FALSE: A person with ACL level 1.4 may open mouth in anticipation of food.
TRUE
specific localized reactions to stimuli
person is able to consider hypothetical plans and establish criteria for the best plan
6.0
name ACL 1, and ACL 2
1 = automatic actions/awareness
2 = gross body movements/postural actions
You want to administer the Allen Cognitive Assessment screen to a resident in a long term care facility. You realize that she is unable to complete the assessment due to some deficits, so you administer the LACL and you find that this was a better option. What are 2 possible deficits that she might have?
visual deficits
deficits in hand function
The Large Allen Cognitive Level Screen is a better option for those with these deficits
Your patient suffered a TBI (ACL 5.6) and you would like to include him in a cooking/meal prep group. Which intervention would be most appropriate for a pt of this level?
A. explanation of why sanitization must occur after raw meats touches surfaces
B. planning for making a thanksgiving side dish
C. assigning him to butter bread for grilled cheese sandwiches
D. provide stimulation by encouraging exploration of smells
A.
Why?
Pts at this level are able to understand explanations of standard safety precautions (flammables, toxins, contaminants, allergens, sharp tools) and follow standard protocols and precautions.
correctly order these actions in the ACL level 1 category. (1.0-1.8)
raising body parts
locating stimuli (localizing)
rolling in bed
withdrawal from noxious stimuli
responding (generalized)
1.0 - withdrawal from noxious stimuli
1.2 - responding (generalized)
1.4 - locating stimuli (localizing)
1.6 - rolling in bed
1.8 - raising body parts
person is able to overcome gravity to gain seated position
2.0
name ACL 5 and 6
5 = learning new activity/ exploratory actions
6 = planning new activity/ planning new actions
Kate attempts to administer the ACL to her patient but he does not reach for leather or attempt to grasp lace although when placing leather in his hand, he grasps. What level is her pt?
Level 2
2.8 pt is able to grasp although grasping is not intentionally directed at objects
if pt activity reached for lace and attempted to grasp he would be 3.0
making a simple abstract collage, requiring manipulation of paper and repetitive motions would be the best for a patient at which level?
level 3
why? Pts at this level may are interacting with objects. Repetitive actions and short activities (30 min) are best.
3.0 - grasping
3.2 - distinguishing objects
3.4 - sustaining actions on objects
3.6 - noting effects on objects
3.8 - using all objects
correlate completion of each stitch with a general ACL level.
running - level 3
whip - level 4
cordovan - level 5
person has righting reactions (postural stability) safe for transfers although requires max A for safety
2.2
name ACL 3 and 4
3 = manual actions
4 = goal directed/familiar actions
How many times can you demonstrate each stitch?
2
Morgan has a patient (ACL 5.4) and is training him to navigate familiar routes to drive to his OT appointments and doctor's appointments. Is this intervention appropriate?
note - watch for poor judgement and impulsivity, this may impact safe driving
ACL 4 requires extensive situation specific practice to learn new skills and carryover is unlikely
level 5 is able to learn new skills through trial and error and is able to generalize skills to new situations, still requiring assistance to problem solve
person may consult with others to plan for future events
5.8
name ACL 0
comatose