A client successfully completes three running stitches during an Allen Cognitive Level (ACL) Screen. What should the therapist do next?

The selection of instructing the client to imitate a whip stitch and complete three stitches is appropriate within the context of the Allen Cognitive Level (ACL) Screen, which focuses on assessing cognitive functioning through task performance. Successfully completing three running stitches indicates that the client has reached a certain cognitive level where they can follow structured, simple tasks and may understand basic verbal instructions.

Demonstrating the whip stitch introduces a new challenge that builds upon the skills they have already demonstrated with running stitches. This step allows the therapist to assess the client’s ability to learn a new skill and apply what they have learned, which is critical in evaluating cognitive and motor function within the context of occupations. By doing this, the therapist can gain insight into the client's skill acquisition and adaptability, which are important aspects to address in therapy.

Introducing a new skill as a next step also helps maintain engagement and challenges the client appropriately, promoting further development rather than stalling the assessment process or moving forward too quickly without ensuring the client has adequately grasped the necessary foundational skills. Thus, the choice to demonstrate the whip stitch is aligned with the goals of the ACL Screen and effectively supports ongoing cognitive assessment and intervention planning.