As with any activity, it is possible to train a person to make a stitch they otherwise cannot imitate or discover on their own. The test ceases to be a test of new learning and problem solving when this occurs. Time lapse between administrations of the ACLS to minimize the impact of learning has not been studied but as with other activities, is influenced by the person’s cognitive level. Clinical observations of performance in ADM assessments with a similar range of task demands suggests that persons functioning in level 3 always require demonstrations and prompts to engage in actions that they have been trained to perform previously. Persons functioning in modes 4.0 – 4.4 who are trained to do a series of new actions similar to the single cordovan stitch (ADM Ribbon Card) are apt to forget the series after approximately two weeks. Persons functioning in modes 4.6 – 5.0 who are trained to do a new series of actions similar to the single cordovan stitch (ADM Needlepoint Key Ring) will likely remember it with some prompting several weeks later. Persons in modes 5.2 and above usually recall sequences similar to the single cordovan stitch they have learned without assistance several weeks later (ADM Needlepoint Key Ring.)