The assessment was created by an educator and occupational therapist named Claudia K. Allen and colleagues.
It was first published in 1985 and has been changed several times since then.
What Is the ACLS?
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Tests that evaluate memory and reasoning are calledcognitive tests.
Most of these tests ask questions that measure your thinking ability and skills (cognitive function).
The ACLS is different from other cognitive tests.
One side of the string is light-colored and the other is dark-colored.
There are different versions of the test materials:
The ACLS is based on Allen’s Cognitive Levels.
The levels are on a scale from 0 to 6.
Each number is matched to a level of cognitive ability and function.
In general, the ACLS should not take longer than 20 minutes to complete.
People with higher cognitive levels will likely finish sooner.
Tasks In the ACLS
The ACLS uses sewing stitches to measure a person’s level of cognition.
With each step, the tasks require more understanding to complete.
Here is what it’s like to do the ACLS test.
The final scores are turned into numbers that match a certain level.
Scores of the ACLS range only from 3.0 to 5.8.
If you’re at a cognitive level below 3, you would not be able to do the test.
The ALCS cannot be used to determine levels below 3 or level 6.
Here are Allen’s cognitive levels and what being at each level means.
They can’t move or respond to their environment.
This is described as beingcomatose.
Level 1: Awareness
This level means that cognition and awareness are very impaired.
At this level, people will need total care, 24 hours a day.
They would need help with all activities of daily living, such as bathing, eating, andhygiene.
They might need to be cued to do a task.
For example, having someone hand them a toothbrush to check that they brush their teeth.
Safety issues and problem-solving can be hard to manage.
For example, if something unexpected happens, they should know to call a loved one for support.
Level 5: Learning New Activity
A score between 5.0 and 5.8 means thatcognitive impairmentis mild.
They can still function well on their own and learn new things.
Level 6: Planning New Activity
Level 6 is the highest level.
At this level, a person is able to work out problems and make decisions using good judgment.
This process is calledexecutive functioning.
They also are likely to have complex thought processes that help make plans for the future.
For example, theMini-Mental Status Exam (MMSE)scores a person’s cognitive abilities.
It can be used with other screenings and medical tests in the process of diagnosing these conditions.
Most cognitive screening tests are given by a social worker, psychologist, or another healthcare provider.
The ACLS is usually given by an occupational therapist.
Other providers can also be trained to use it.
The ACLS tries to bridge that gap.
How Is This Test Used?
This is called functional cognition.
People in different situations can benefit from being tested with the ACLS.
For example:
How Accurate Is the ACLS?
The results of the ACLS test can often detect potential problems with independence.
Researchers have found it to be accurate by using a process called validation.
On the other hand, people with physical limitations may not be able to do the ACLS test.
For example, a person needs to be able to use both hands.
They also need to have good vision and hearing.
The ACLS can also be affected by something called test-retest learning.
And people who already know how to do the stitches could also do better on the test.
The ACLS is different from other cognitive tests.
Instead of asking questions, it has people complete a task with strings.
A person’s score on the ACLS is more than just a number.
Their level also determines how much help they need.
2017;24(4):290-298.
2013;13:89. doi:10.1186/1471-2318-13-89
American Academy of Family Physicians.Cognitive evaluation.
Allen CK.Cognitive disability and reimbursement for rehabilitation and psychiatry.Journal of Insurance Medicine.
1991;23 (4).
Earhart C.A brief history of the cognitive disabilities model and assessments.The Allen Cognitive Group.
The Allen Cognitive Group.ACLS-5 and LACLS-5 Test: Psychometric properties and use of scores for evidence-based practice.
The American Occupational Therapy Foundation.Research priority: Functional cognition.
