WESTBOROUGH, MA September 7, 2018 Here is the Clock of the Week for the week of September 10, 2018. It is an interesting clock that illustrates both confusion and intrusion errors. The task is simple. It involves a 3- step process of drawing the circle, placing the numbers, and correctly placing the hands to read 11:10. I have espoused this task for several years now and publish interesting clocks. Last week, I was sent a clock that a speech pathologist here at the hospital was able to obtain from one of her patients. This clock was drawn by a 85-year old male diagnosed with Parkinson’s Disease (PD). He is right handed and has had PD for 15 years. He has also had a prior stroke which complicates the interpretation of this drawing.
What is interesting about this clock was the written language that appears in the middle of the clock face. This is an intrusion error from the prior task I had given him. He was asked to write a sentence. He completed the sentence and later, components of the same sentence showed up as a perseveration that intruded on the task at hand (the clock drawing). This is a sign of a lost cognitive “set”. He was drawing a clock and trying to place the numbers when just as quickly he began writing the prior sentence. Interestingly, the clock has no features in the lower quadrants of the drawing. He was able to roughly construct a circle but was stuck with the upper components of the clock. It looked to me that he understood that setting the clock for 11:10 meant that he needed to focus on the upper left and upper right sides of the drawing. As he drew the clock he seemed to get stuck drawing the hash marks of the numerals.
He has significant problems with both immediate and remote memory. PD has a life expectancy of 10-15 years. His case is complicated by a prior CVA and will likely result in a loss in his independence for going home.