Claudia Kay Allen first began to develop the Allen Cognitive Levels (ACLs) when she changed from working with small children with cerebral palsy to adults with mental disorders. The similarities in the activities that they could do were intriguing then and still are 50 years later. The original 6 ACLs were influenced by Piaget’s description of six stages during the sensorimotor period. The first two years of the lives of his children are a part of the tradition of watching the cognitive development of our children and grandchildren.
The behavioral scales that brought orderly classifications to the chaos of psychiatric diseases were imitated to describe what the person could do. Gail Fidler’s use of activity analysis was applied to describe the matching actions and activities in the first textbook in 1985. In 1987, receiving the Eleanor Clarke Slagle Lectureship added a sense of responsibility for people with lifelong mental disorders.
For Claudia, the population has had a vexing habit of expanding. One therapist after another would apply the ACLs to another medical classification, which she understood as long as the classification was in neurology. Then application to burns was reported. No way was her first response. When brain damage caused by smoke inhalation lengthened the time needed for rehabilitation, oxygen and glucose began to ring alarms about cognitive disabilities. As the numbers increased, the need for public and peer professional education has led to the development of educational materials in the Allen App and downloads.
The Allen Cognitive Disability Model (ACDM) started by being provoked about the mean therapy done, undercover and sanctioned as a solution to poor motivation. The difference between can, will, and may do provide a biopsychosocial framework. When staff members understand that troublesome behavior is not the will to be nasty but a need to do what they can, mean therapy stops and kindness takes place. Kindness has expanded to the right to be accepted as they are now and the methods to form a sense of being respected as a human being.
The Allen Cognitive Level Screen (ACLS) started as a portable method to stop talking and see what the person could do. Early on we realized that people with a cognitive disability talk better than anything they do. For 40 years, three stitches in quick succession anchored the 6 ACLs and 25 ACL modes. Mounting concerns about dependence on a single activity prompted the expansion to additional activities with actions tailored to ACL 1, 2 and 3.
The Allen App started as a need to get scattered bits of knowledge organized and internationally accessible. The bigger picture in the neurosciences, international health care of the cognitively disabled, the USA Supreme Court decision in favor of maintenance care, the suicides and homelessness of soldiers returning home with head injuries, prompted a deep concern about people with lifelong cognitive disabilities.
The time has come, she hopes, that the world can accept people with a cognitive disability as they are now.
Acceptance is the pre-requisite to being respected as a human being and the right to human dignity.