Watch sign test
The clock-sign test according to Shulman (1993) is a widespread rapid screening to test the construction of vision ( parietal function) and problem-solving ( frontal function), for example during the first diagnostic work-up of dementia .
execution
The patient is given a piece of paper with a printed circle and is asked to write the digits of a clock in the circle and then draw the hands in such a way that they represent a given time (“11:10 am”, “ten past eleven”) . It takes 2–5 minutes to complete.
evaluation
Conclusions about the extent of the brain dysfunction can be drawn on the basis of the deviations in the representation from the "normal performance" (division of the dial, the writing of the numbers, lack of pointers and the like). Depending on the deviation, 1–6 points are awarded, with a score ≥ 3 being an indication of dementia.
- Score 1 = clock is perfect (digits 1–12 in the right place, correct time shown)
- Score 2 = slight visual-spatial errors (e.g. uneven spacing between the digits, digits outside the dial, use of lines for orientation, twisting of the dial)
- Score 3 = faulty clock with preserved visual-spatial representation (e.g. only one pointer drawn in, time as text, no time)
- Score 4 = moderate disorganization, correct drawing of the clock impossible (e.g. very irregular spaces, no digits, digits> 12, right-left reversal, dysgraphy )
- Score 5 = severe visual-spatial disorganization (like 4, but more pronounced)
- Score 6 = no display of the clock
A list of further tests for checking the visual construction can be found in the article Clinical Neuropsychology under the neuropsychological tests for visual construction .
literature
- S. Brunnhuber, S. Frauenknecht, K. Lieb: Intensive course in psychiatry and psychotherapy . Urban & Fischer, Munich 2005, ISBN 3-437-42131-X .
- KI Shulman, DP Gold, CA Cohen, CA Zucchero: Clock-drawing and dementia in the community. A longitudinal study . In: International Journal of Geriatric Psychiatry . tape 8 , 1993, pp. 487-496 , doi : 10.1002 / gps.930080606 (English).