Allen's Cognitive Level Screen

Overview 

Authors: Allen, C.K., Austin, S.L., David, S.K., Earhart, C.A., McCraith, D.B., Riska-Williams, L. 

Year of Publication: 2007 

Publisher: ACLS & LACLS Committee

Type of Assessments: 

• Standardized

• 
  

Cost: $$

How to Access: https://allencognitive.com/acls-5-lacls-5/ 

Age: Adolescents & Adults

Diagnoses: psychiatric & mental health disorders (schizophrenia), neurodegenerative conditions (dementia), TBIs, CVAs, visual/hand impairments, or other cognitive disorders

Setting: inpatient psychiatric rehab, 

Areas Assessed:

• Functional cognition - with persons whose cognitive abilities appear to be in the range of 3.0 to 5.8

• Motor imitation & attention

• Procedural learning 

• Error detection

• Problem-solving

• Executive functioning

Administration

Time: 20 mins

Group/Individual: Individual

Subtests: Cognitive levels 3 (running stitch), 4 (whipstitch), and 5 (single cordovan stitch)

• Running Stitch - Levels 3.0-3.4 - tests motor imitation and attention to task

• Whip Stitch - Levels 3.6-4.4 - tests procedural learning and error detection 

• Cordovan Stitch - Level 5.0-5.8 - assesses problem-solving and executive function 

Instructions: The leather-lacing tools require assembly & set up prior to administration by completing three running, whip, & cordovan stitches 

• Running stitch: 

  • Thread leather lace through the first hole from back to front

  • Leave a short tail in the back and do NOT tie a knot.

  • Demonstrate one simple over-under stitch (like sewing) through pre-punched holes.

  • Let the client copy 3 stitches.

• Whip stitch: 

  • Start at a new hole after running stitches.

  • Thread lace from back to front and wrap it around the edge, inserting the lace from back to front through the next hole.

  • Demonstrate one or two whip stitches, looping around the edge of the leather.

  • Leave errors uncorrected if the client makes them.

• Single Cordovan Stitch: 

  • Start at a fresh set of holes.

  • Demonstrate once if needed:

  • Thread lace from front to back through hole 1,

  • then weave the lace over the edge and under the stitch just made, creating a locking stitch.

  • Ask the client to complete 3 stitches without demonstration after the first one, only verbal cues.

• Foster rapport before introducing the screen

• Each stitch has associated instructions for the administrator to read from

  • Introduce the screening tool and stitch task

  • Provide 1st demonstration

    • If the person meets, the first demonstration, note the behavior and continue to the whipstitch task 2

    • If the person does not attempt to complete the stitch even after encouragement, note the behavior & continue to the second demonstration

    • If the person makes errors, note behavior and allow person time to recognize & correct errors

    • If task is met, note behavior and continue to next task

    • If task is not met, no problem-solving cues are provided, note behavior & continue to 2nd demonstration

  • Provide 2nd demonstration

    • Remove incorrect stitches and use same instructions & encouragement as described for 1st demonstration

    • Whether or note the person meets the task after time and encouragement, note behavior, acknowledge their efforts, and continue to next stitch task

• Similar instructions apply for the other 2 stitch tasks

• The assessment will end if the client:

  • Completes all three stitching tasks

  • Fails to correct an error in single cordovan stitch after a second demonstration and person's problem-solving behavior continues to be ineffective (as evaluated by administrator)

  • Refuses the first or second demonstration for the single cordovan stitch

  • Requests that assessment end or refuses to continue at any point

  • Expresses significant anxiety (verbal & non-verbal), frustration, and person's problem-solving behavior continues to be ineffective

Materials: ACLS-5 package includes: 1 pre-punched 4x5 inch rounded, tan leather rectangle finished on one side; one large-eyed, blunt sewing needle; two brass, threaded, locking needles, one hank of leather lace with two visibly distinct sides, one hank of waxed linen thread

User Qualifications: administered by occupational therapists or by other health care professionals that received training in the use of cognitive disabilities model & related assessments

Scoring Procedures

How to Score: Scores is based on the administrator's observation of the person's patterns of behavior and performance up to and including the point at which the person either completes all of the stitches successfully or administrator choses to end. 

• There are scoring tables for each task

Score Indications: Based on the client's ability to complete the task and their associated cognitive level, functional hypothesized abilities can be determined and what level of functioning and activities the client can complete.

Psychometrics

Reliability: 

• Interrater: moderate to high

Validity: Good

Pros & Cons

Strengths: -

Weaknesses: -

References

• Allen, C., Austin, S.L., David, S.K., Earhart, C.A., McCraith, D.B., & Riska-Williams, L. (2007). Manual for the Allen cognitive level screen-5 (ACLS-5) and Large Allen cognitive level screen-5 (LACLS-5). Camarillo, CA: ACLS and LACLS Committee.