Using the Allen Cognitive Levels (ACL) with Parkinson’s Disease Clients
Question:
Can I use the Allen Cognitive Level Screen (ACLS) with clients who have Parkinson’s disease?
Response:
Yes, the ACLS is a transdiagnostic assessment tool designed to understand global cognitive impairment by observing patterns of performance at specific cognitive levels or modes. It is used in occupational therapy practice with Parkinson’s disease (PD) clients, even though there is limited direct research specifically validating the tool for this population. Most evidence comes from broader studies on cognitive impairment and functional performance. More PD-specific research is needed to establish best practices.
Question:
Is there research evidence supporting the use of the ACLS with Parkinson’s disease?
Response:
Currently, there is limited direct research literature validating the ACLS specifically for Parkinson’s disease. Most published studies focus on cognitive impairment in general or other neurodegenerative conditions. However, the ACLS is widely used in clinical practice with PD clients to help understand and address occupational performance difficulties.
Question:
How can the ACLS help me in my clinical practice with Parkinson’s clients?
Response:
The ACLS can be a useful screening tool to make sense of the occupational performance difficulties experienced by clients with Parkinson’s. It helps guide your clinical reasoning and care planning, especially when cognitive impairment is suspected.
Question:
What are some practical tips for using the ACLS with Parkinson’s disease clients?
Response:
Verify the result: Take extra care to confirm the accuracy of the score, as motor symptoms may impact performance.
Assist with the task: You can help by stabilizing the leather lacing board if tremor or rigidity is present.
Allow extra time: Parkinson’s clients may need more time to complete the screen due to bradykinesia or fatigue.
Document accommodations: If you use the result in a report, always include any accommodations made and your clinical reasoning for them.
Use as a guide: You can use the ACLS as a guide, with or without formal scoring, to correlate with your functional observations.
Question:
Should I rely solely on the ACLS for cognitive assessment in Parkinson’s disease?
Response:
No. The ACLS should be used as one part of a comprehensive assessment. Combine it with other cognitive and functional assessments, and always use your clinical judgment. Time and experience will help you understand the strengths and limitations of the tool in your setting.
Question:
Is there an opportunity for further research?
Response:
Absolutely! There is a need for more PD-specific research on the ACLS. If you are interested, consider conducting a small study or case series to share your findings with the OT community.