The cdt can be applied in different ways and scoring procedures also vary. Tip sheet 4 the clock drawing test cdt what is the cdt. Likely to maximize clinical time, clock scoring criteria are basic with 1 point per clock contour, numbers and hands. Specific algorithm method of scoring the clock drawing test. Pdf simple scoring of the clockdrawing test for dementia. Repeat instructions as needed as this is not a memory test. Now the physician draws a big circle on the back of the paper and asks. Give patient a sheet of paper with a large relative to the size of handwritten numbers predrawn circle on it. It is a component of the minicog assessment, also serving the function of distracter for the threeword recall. Instruct the patient to draw the face of a clock, either on a blank sheet of paper, or on a sheet with the clock circle already drawn on the page. This instrument is a popular clinical tool widely used in screening for cognitive disorders and dementia. It is often used in combination with other, more thorough screening tests, but even when used by itself, it can provide helpful insight into a persons cognitive ability. The choice of a scoring system ultimately depends on the specific needs and goals of the clinician or researcher. The clock drawing test instructions abilitylab home.
The clock drawing test cdt best practice update in stroke and complex neurological conditions march 20 the cdt is a quick and easy way to screen for visuospatial andor executive difficulties. Pleaseput in thehourmarkers and thetimeat tenminutes to eleveno clock. A normal clock must include all numbers 112, each only once, in the correct order and direction clockwise. The clock drawing test the montreal cognitive assessment. Useful adjunct to the mmse test in cognitive screening. Instruct the patient to listen carefully to and remember 3 unrelated words and then to repeat the words. More recently, automatic tools for assessing such tests have been developed. While drawing the clock, different cortical systems work simultaneously, including the frontal, parietal, and temporal lobes. Clock drawing test an overview sciencedirect topics. Furthermore, the clock drawing test is suitable for nonenglish speaking populations, whereas the mmse does have some language bias.
Usually, a medical expert assesses the sketches to discover any deficiencies in the cognitive processes of the patient. A normal clock has all numbers placed in the correct sequence and approximately correct position e. The value of clock drawing in identifying executive cognitive. Indicate the right third of the space and give the following instructions. Inability or refusal to draw a clock abnormal 0 points. Instructions for the minicog test administration the minicog test is a 3minute instrument to screen for cognitive impairment in older adults in the primary care setting. Clock drawing serves as a miniscreening tool for all cognitive domains. The clock drawing test was administered during an office visit prior to the road test. Clock drawing in the montreal cognitive assessment.
He or she is instructed only to draw a clock that says 1. Jul 03, 2011 10 scoring approaches for alzheimers clock draw test alzheimers early detection drawing a clock by hand is one of easiest to administer and one of the most popular screening tools that can help to detect mild cognitive impairment, dementia, or alzheimers among new patients. The examiner allows the patient to observe him or her drawing a clock in the circle provided on the scoring sheet. Quantitative and qualitative analyses of clock drawings in alzheimers and huntingtons.
Put in all the numbers and set the time to 10 after 11. Equipment required includes a blank sheet of paper, a sheet of paper with a clock on one side, a pen, and a chairtable for ease of drawing. The cdt may be used in addition to other quick continue reading clock drawing test cdt. Pleaseput in thehourmarkers and thetimeat tenminutes to elevenoclock. There are as many as 15 different ways to score this test. Clock drawing test interpretation system sciencedirect. Clock drawing test ratings by dementia specialists. A clock drawing test with a predrawn circle 10 cm in diameter performed by in a 76yearold woman with alzheimers disease. The clock drawing test cdt is a common neuropsychological measure sensitive to cognitive changes and functional skills e.
The minicog uses a threeitem recall test for memory and a simply scored clockdrawing test cdt. Within the moca, clock drawing is one test item involving 3 of the total 30 points possible. A scoring template, drawn on a seethrough sheet of plastic, is placed over the patients drawing. For the clock drawing test, we used the scoring method described by mainland and shulman 15. Using the same scoring system as freund and colleagues 2005, participants were given a blank piece of paper and instructed to draw a clock. This task can be readministered to sample and monitor examinees progress, deterioration, or stability across several cognitive domains. One point is allocated for each of the following three criteria. This test provides a quick screening test for cognitive dysfunction frontal and temporo. The clock drawing test cdt component of the minicog allows clinicians to quickly assess numerous cognitive domains including cognitive function, memory, language comprehension, visualmotor skills, and executive function and provides a visible record of both normal and impaired performance that can be tracked over time.
Thus, different cognitive abilities can be measured, such as selective and sustained atten tion, auditory comprehension, verbal working memory. Ways of performing the clockdrawing test and scoring system s. A normal clock must include all numbers 112, each only once, in. The participant is first asked to draw a clock on a blank page.
Scoring consists of the evaluation of errors andor distortions in the form of omissions of numbers and error. Individuals may be presented with a predrawn circle and need only place the numbers and hands on the clock face or the clock may be entirely selfgenerated. The patient is allowed to copy the examiners clock. A4365 january 2012 with 2,683 reads how we measure reads. I am going to say three words that i want you to repeat back to me now and try to remember. There are a number of scoring systems used in the literature but no one scoring system. Clock drawing test cdt useful adjunct to the mmse test in cognitive screening tests executive function primarily has widespread clinical use despite inconsistent scoring and interpretation visual record for the chart takes less than a minute to perform reflects change in cognition over time. The clock drawing as a neurocognitive screening youtube.
For a brief description of the fds test, patients were asked to turn over 16 wooden sticks on a board. A comparison of scoring protocols on the clock drawing test in relation to ease of use, diagnostic group, and correlations with minimental state examination. However, normative data have not been adequately developed. Diagnostic value of digital clock drawing test in comparison. This study aimed to develop an optimized scoring methodthe west havenyale cdt why. Assessing cognition using the cognitive linguistic quick test. The clock drawing test and dementia doctor dementia and the. Furthermore, the clock drawing test is suitable for nonenglish speaking populations. Ask the patient to repeat the 3 previously presented word.
Three word recall scoring look directly at person and say, please listen carefully. Clock drawing as a screen for impaired driving in aging and. Diagnostic value of digital clock drawing test in comparison with cerad neuropsychological battery total score for discrimination of patients in the. Clock drawing test this test provides a quick screening test for cognitive dysfunction frontal and temporoparietal functioning secondary to dementia, delirium, or a range of neurological and psychiatric illnesses. Edith kaplan loved clock drawings and often offered prizes to the best clocks submitted by her residents and graduate students. There are at least a dozen different methods for performing and scoring the clockdrawing test, 2, 4, 5 some of which have intricate grading systems that defeat the tests simplicity. The clock drawing test cdt is an inexpensive, fast and easily administered measure of cognitive function, especially in the elderly.
Watch carefully as examinees draw the dock and note the strategies used. Mendez mf, ala t, underwood kl 1992, development of scoring criteria for the clock drawing task in alzheimers disease. This study compared clock drawings by 42 medically hospitalized patients with a mean age of 51. The clock drawing test cdt is a measure of dementia severity.
Comparison of scoring criteria for clock drawing test. Give 1 point for each recalled word after the cdt distractor. Alternatively, a scoring template drawn on paper, is placed under the patients drawing so that the scoring template clock shows through the patients drawing paper above it. The clock drawing test as a screening tool in mild cognitive impairment and very mild dementia.
Instruct patient to draw numbers in the circle to make the circle look like the face. The clockdrawing test is a simple tool that is used to screen people for signs of neurological problems, such as alzheimers and other dementias. The scoring template shows the clock circle, already divided in to eighths. Simple scoring of the clockdrawing test for dementia screening article pdf available in danish medical journal 591. Jul 09, 2015 the clock drawing test has also been advocated over the mmse as an office screening test for dementia in community clinics and in acute hospital settings. Page 1 the clock drawing test instructions general information. The version used most often is the predrawn circle which you can find on strokengine.
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