On the Use of Drawing Tasks in Neuropsychological Assessment

Drawing tasks have attained a central position in neuropsychological assessment and are considered a rich source of information about the presence (or absence) of cognitive and perceptuo-motor abilities. However, unlike other tests of cognitive impairment, drawing tasks are often administered without reference to normative models of graphic production, and their results are often analyzed qualitatively. I begin this article by delineating the different ways in which drawing errors have been used to indicate particular functional deficits in neurological patients. I then describe models of drawing that have been explicitly based on the errors observed in patient drawings. Finally, the case is made for developing a more sensitive set of metrics in order to quantitatively assess patient performance. By providing a finer grain of analysis to assessment we will not only be better able to characterize the consequences of cognitive dysfunction, but may also be able to more subtly characterize and dissociate patients who would otherwise have been placed in the same broad category of impairment.