The CDT assesses visuospatial and praxis abilities (may reflect both attention and executive dysfunction).
1-2 minutes
Adults
18 - 64
yearsElderly Adult
65 +
yearsClock Drawing Test translations:
French (on p5):
http://fmc31200.free.fr/MG-liens/Neurologie/quatre_tests.pdf
German:
http://web48.s2.webseits.de/images/data/TEST-Teil6-Uhrentest-Sep05.pdf
Spanish:
http://marthacoronah.weebly.com/uploads/5/5/4/1/5541149/test_del_dibujo_del_reloj.pdf
These translations, and links to them, are subject to the Terms and Conditions of Use of the Rehab Measures Database. RIC is not responsible for and does not endorse the content, products or services of any third-party website, and does not make any representations regarding its quality, content or accuracy. If you would like to contribute a language translation to the RMD, please contact us at rehabmeasures@ric.org.
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Acute Stroke: (Suhr et al, 1998; n = 176 (105 = stroke, 71 community based elderly); mean age of both sample > 70 years; mean time since stroke = 26.13 (9.11) days)
Means and Standard Deviations for 6 Clock Scoring Systems
|
|
Sunderland |
Mendez |
Rouleau |
Watson~ |
Ishiai |
Freedman |
|
Normals |
8.69* (1.9) |
18.33* (1.9) |
8.59* (1.5) |
.83* (1.9) |
3.49* (1.1) |
13.14* (2.5) |
|
Stroke |
5.74 (2.3) |
14.31 (4.4) |
5.91 (2.4) |
4.36 (2.5) |
1.65 (1.5) |
8.67 (4.4) |
|
Right CVA |
5.44 (2.0) |
14.00 (4.1) |
5.54 (2.4) |
4.56 (2.4) |
1.52 (1.4) |
8.24 (4.4) |
|
Left CVA |
6.44 (2.8) |
14.89 (5.0) |
6.61 (2.5) |
4.41 (3.0) |
1.83 (1.6) |
9.61 (4.2) |
|
Bilateral |
6.00 (2.2) |
14.89 (5.0) |
6.56 (2.2) |
3.78 (2.7) |
2.00 (1.4) |
10.11 (3.0) |
|
Anterior |
6.27 (2.4) |
14.47 (4.8) |
6.20 (2.7) |
4.00 (3.0) |
1.73 (1.7) |
9.27 (5.2) |
|
Posterior |
5.67 (2.0) |
14.86 (3.1) |
6.05 (2.1) |
4.48 (2.6) |
1.57 (1.4) |
9.24 (4.0) |
|
Cortical |
5.73 (2.2) |
13.70 (4.3) |
5.61 (2.5) |
4.46 (2.7) |
1.55 (1.5) |
7.82 (4.8) |
|
Subcortical |
5.87 (2.5) |
14.70 (4.9) |
6.20 (2.4) |
4.00 (2.6) |
1.93 (1.4) |
9.23 (4.0) |
|
CVA = Cerebrovascular accident |
|
~For this scoring system, higher numbers mean worse performance. |
|
*p > .001. |
Acute Stroke: (Adunsky et al, 2002; n = 151, mean age = 73.7 (9.9) years, evaluated within 3 days of rehab admission)
Adequate concurrent validity with:
FIM- Cog Domain (r = 0.51)
MMSE (r = 0.59)
Acute Stroke: (Nøkleby et al, 2008; n = 49; median age = 62 years; median time since stroke onset 38 days)
|
CDT Sensitivity, specificity and cut scores: |
|
Assessment |
Subtest |
Cut-scores |
Sensitivity (95% CI) |
Specificity (95% CI) |
|
Visuospatia function |
CDT 7 minute |
5/6 |
55 (34–75) |
74 (58–91) |
|
Attention and neglect |
CDT 7 minute |
6/7 |
55 (23–83) |
42 (26–59) |
|
Attention and neglect |
CDT Manos |
9/10 |
55 (23–83) |
49 (31–66) |
|
Attention and neglect |
CDT Sunderland |
9/10 |
55 (23–83) |
42 (26–59) |
|
Speed (non-affected side) |
CDT Sunderland |
9/10 |
74 (56–92) |
59 (39–80) |
|
Impaired > 1 domain |
CDT Sunderland |
9/10 |
63 (49–78) |
67 (22–96) |
Alzheimer Disease: (Tuokko et al, 1992; Mendez et al, 1992)
Alzheimer Disease: (Tuokko et al, 1992; Mendez et al, 1992; Rouleau et al, 1992)
Medical Patients: (Manos & Wu, 1994)
Medical Patients: (Manos & Wu, 1994)
Surgical Patients: (Manos & Wu, 1994)
Surgical and Medical Patients: (Manos & Wu, 1994)
Adunsky, A., Fleissig, Y., et al. (2002). "Clock drawing task, mini-mental state examination and cognitive-functional independence measure: relation to functional outcome of stroke patients." Arch Gerontol Geriatr 35(2): 153-160. Find it on PubMed
Lorentz, W. J., Scanlan, J. M., et al. (2002). "Brief screening tests for dementia." Can J Psychiatry 47: 723-733. Find it on PubMed
Manos, P. J. and Wu, R. (1994). "The ten point clock test: a quick screen and grading method for cognitive impairment in medical and surgical patients." Int J Psychiatry Med 24: 229-244. Find it on PubMed
McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires, Oxford University Press, USA.
Mendez, M. F., Ala, T., et al. (1992). "Development of scoring criteria for the clock drawing task in Alzheimer's disease." J Am Geriatr Soc 40: 1095-1099. Find it on PubMed
Nokleby, K., Boland, E., et al. (2008). "Screening for cognitive deficits after stroke: a comparison of three screening tools." Clin Rehabil 22(12): 1095-1104. Find it on PubMed
Richardson, H. E. and Glass, J. N. (2002). "A comparison of scoring protocols on the Clock Drawing Test in relation to ease of use, diagnostic group, and correlations with Mini-Mental State Examination." J Am Geriatr Soc 50: 169-173. Find it on PubMed
Rouleau, I., Salmon, D. P., et al. (1992). "Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease." Brain Cogn 18(1): 70-87. Find it on PubMed
Ruchinskas, R. and Curyto, K. (2003). "Cognitive screening in geriatric rehabilitation." Rehabilitation Psychology 48(1): 14-22.
Suhr, J., Grace, J., et al. (1998). "Quantitative and qualitative performance of stroke versus normal elderly on six clock drawing systems." Arch Clin Neuropsychol 13(6): 495-502. Find it on PubMed
Tuokko, H., Hadjistavropoulos, T., et al. (1992). "The Clock Test: a sensitive measure to differentiate normal elderly from those with Alzheimer disease." J Am Geriatr Soc 40: 579-584. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.