Allen Cognitive Scale

Allen Cognitive Scale of Levels and Modes of Performance

Influenced by Piaget’s theory of stages of cognitive development, the original Allen Cognitive Scale was comprised of six levels from 1 (profound disability) to 6 (within normative range). It was developed for systematically describing the progression of increasing or decreasing cognitive complexity that could be inferred based on observation of persons as they performed routine (everyday) tasks defined as “the activities a person does on a daily basis” (Allen, 1985, p.9). Cognitive complexity refers to how difficult or complicated various cognitive function/processes, functional performance abilities, and activity demands are. Systematic observations of task performance by skilled practitioners and research evidence suggested that a more sensitive scale was needed to describe improvements and/or declines in functional cognitive capacity within the six original levels (Allen & Blue, 1998, p. 226). Therefore, the original scale was expanded to the current 27-point scale (Allen, 1992a, pp.85-86), which is referred to as the Allen Cognitive Scale of Levels and Modes of Performance (Allen Cognitive Scale). Each level/mode in the expanded scale reflects the progression of increasing or decreasing complexity of functional cognitive capacity, including learning potential, for engaging in a variety of everyday self-care, work, leisure, and social activities (Allen, 1992a, pp. 85-102).

The Allen Cognitive Scale is characterized as being (McCraith & Earhart, 2018, p. 475):

• Hierarchical – To reflect their hierarchical, progressive nature, the levels and modes are indicated by a number from 1 to 6 for levels, followed by an even numbered decimal (.0, .2, .4, .6, and .8) for the modes within each level. Functional cognitive capacity and functional performance abilities that require that capacity increase in cognitive complexity from Level 1 (least complex) to Level 6 (most complex).
• Cumulative – The same point on the scale identifies both the severity of cognitive disability (limitations) and a person’s functional cognitive capacity and functional performance abilities that require that capacity (assets/strengths). Therefore, as the levels and modes progress/increase in complexity, all previously available, less complex capacity and abilities are retained as strengths. Those capacities and abilities higher in the progressions of complexity reflect limitations in capacity and abilities. When the progression is reversed, capacity and abilities become progressively unavailable for use with each successive decline in complexity. Therefore, limitations in capacity and abilities increase and strengths decrease.
• Ordinal – The scale describes a qualitative progression of functional cognitive capacity and functional performance abilities that require that capacity. Therefore, the difference between one level/mode and the next cannot be assumed to be quantitatively equal or the same. Although numbers/decimals are used to denote the levels/modes and the ACL Screen scores criterion-referenced to them, these scores should not be used for arithmetic computations such as averaging (Manikandan, 2011, p. 141.)

Similar to the levels, the modes in the expanded scale describe a pattern of capacity and abilities which follow a hierarchical, cumulative, ordinal progression. This pattern repeats itself within each cognitive level as described below (Allen, 1992a, pp. 85-86):

The Allen Cognitive Scale has some parallels with the acquisition of cognitive capacity and associated performance abilities in typical growth and development. However, it is misleading to equate the cognitive levels and modes with specific developmental or maturational ages of typically developing children, particularly for adults. The influence of adult life experiences complicates this comparison. Therefore, Allen preferred not to associate the cognitive levels with age. Statistically significant support for the validity of the levels/modes for the Allen Cognitive Scale was reported by Austin (2009; McCraith, Austin, & Earhart, 2011) with the Allen Diagnostic Module-2nd edition assessment (ADM-2; Earhart, 2006), and by Su, et al. (2011) and Park and Lee (2020) with the ACL Screen. Refer to Section 9, Psychometric Properties of the ACL Screen for more detail regarding these studies.

Although the Allen Cognitive Scale is a single scale, it can be used to estimate both the cognitive complexity of functional cognitive capacities of people and the cognitive complexity of activity demands for activities people need and want to do. For this reason, it is best understood as consisting of two inter-related, parallel hierarchies (Allen,1985; Austin, 2009; McCraith, Austin, & Earhart, 2011; McCraith & Earhart, 2018).

• The Hierarchy of Functional Cognition describes the inferred continuum of increasing complexity of functional cognitive capacity and functional performance abilities such as observations of sensory cues that capture a person’s attention and the person’s voluntary actions, use of objects, sequencing and timing, and verbal/non-verbal and social behaviors for engaging in everyday activities that are theoretically available at each level/mode.
• The Hierarchy of Cognitive Activity Demands describes the continuum of increasing cognitive complexity of the components or aspects of activities that are typically required for their performance, such as relevance, objects used and their properties (e.g., tools, supplies, equipment), actions and performance skills, social behaviors, steps and processes, and space and time requirements. These components are collectively referred to as the activity demands.

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