Allen's Cognitive Levels

Question 1

Level 1

Answer 1

• Characterized by automatic actions and awareness
• Client is DEPENDENT on caregiver for ADLs
• Participants would not benefit from the dynamics of a group for therapy (i.e., individual treatment only)
• Clients at Level 4 and below require 24-hour, close supervision and support for all needs (including all/some self-care)

Question 2

Level 2

Answer 2

• Characterized by postural actions (gross body movements)
• For group therapy, participants will be successful in situations in which they can move about and copy movement that is modeled
• Clients at Level 4 and below require 24-hour, close supervision and support for all needs (including all/some self-care)

Question 3

Level 3

Answer 3

• Characterized by manual actions and manipulating objects
• For group therapy, participants focus on elements of repetition and manipulation
• Activities involve relatively repetitive and routine tasks
• Clients at this level are NOT able to be goal directed and would do best with projects/activities that are unstructured and focus on object hands-on manipulation and tactile cues
• Clients at Level 4 and below require 24-hour, close supervision and support for all needs (including all/some self-care)

Question 4

Level 4

Answer 4

• Characterized by goal-directed, familiar activities
• For group therapy, participants work on goal-directed activities, such as craft projects
• Activities typically require a model of the completed project for the client to imitate as a guide to task completion, simple directions, and un-shared tools
• Clients at this level will have difficulty with problem-solving and require supervision for cues and guidance when needed
• Clients at Level 4.0 should live in a supported living arrangement, but would be expected to complete habitual routines independently (e.g, morning self-care)
• Clients at Level 4 and below require 24-hour supervision

Question 5

Level 5

Answer 5

• Level 5 is characterized by exploratory actions
• Client abilities include performing dressing, eating, and grooming activities WITHOUT assistance
• For group therapy, participants engage in activities with a graded structure, such as a clay modeling or mosaic project
• These activities allow participants to exercise control over the medium and require them to control their impulses (e.g., when they have difficulty placing the tiles within the boundaries of a mosaic tile base or feel the urge to smash a clay form)
• Activities typically include mostly familiar steps, but have one or two steps requiring new learning
• Clients at Level 5 are still challenged by problem-solving, but can engage in trial-and-error learning and use inductive reasoning to find new ways of performing activities
• A client at Level 5.2 could be discharged home alone with weekly checks for novel safety issues and health maintenance needs/reminders

Question 6

Level 6 - Groups

Answer 6

• Characterized by planned actions
• Client is INDEPENDENT
• For group therapy, activities are designed to encourage relatively independent planning and organizing to complete tasks
• Clients at Level 6 can anticipate problems and resolve problems or challenges mentally

Question 7

Cognitive Disabilities Model

Answer 7

• Assesses the client’s current cognitive functioning to maximize supports in the environment that will facilitate maximal occupational performance
• Focus is on using the client’s strengths to allow for function, with appropriate environmental supports