ALL THAT FROM A CLOCK?
The clocks above represent a variety of patient drawings. The clock affords the neuropsychologist a view of several important cognitive functions in the person who is asked to draw the clock. Drawing a clock is not threatening to patient’s – who can become defensive and angry when they first realize the reason why they were dragged to the neuropsychologist in the first place. Many forget after their anger after a period of rapport has been established. The clock is one of my favorite cognitive tasks. Unfortunately these did not reproduce very clearly for the website. No identifying data is displayed.
COGNITIVE FUNCTIONING
The clock tell you about many cognitive features including problem solving, visual organization, graphic formulation, spatial planning, long-term memory, short-term memory, and a few other things. It takes no artistic ability whatsoever. Some patient’s become very frustrated and draw so quickly it is difficult to attribute their construction to anything except their behavior. It can be a rich experience when you gain a compliant effort on the clock drawing. I usually ask the patient “what do you think about your clock?” Many reply “I’m no artist ” with insulted incredulity but are able to tolerate the task itself. It takes only 15 minutes and it lends itself to a good neurocognitive screening. Better yet, you have the chance to join with a patient on a 1:1 basis and experience a snapshot of what they are dealing with and why they were referred to you for evaluation. See for yourself by watching the YouTube video that is below. I hope you enjoy it.
Concussion Assessment and Management Program 
See the clock of the week! Send your clock to Dr. Sefton’s service for review and sharing.
Issues with this test:
Patients given the test on a clipboard while sitting on an exam table in a gown. There is no hard surface, desk or table. They have to hold a clipboard on their lap. It is nearly impossible to draw a decent circle in this way. Being in a vulnerable position, eg gowned, and not in one’s clothing, or sitting at a desk where one might sit up straight, hold a pencil, work in a normal writing position, further impacts how the clock appears. And patients have every right to be furious or miffed at being forced to take this ‘test’ when they are already in a vulnerable position with a wobbly clipboard on their knees, hunched over this clipboard in a way that they would not normally draw or write when in their own home. The test is further often administered in a rude way and is typically a surprise.
It gives the doctor way too much power to also give a negative and life changing diagnosis to a patient for whom they may not have much regard. This test is not done in a controlled way.
The doctor in charge of the test could be a real asshole. No one knows. The patient may be taking tranquilizers or some other drug that impacts their drawing ability, making the execution of a perfect circle difficult.
I think this test is only being used to give healthy adults more medications that may not be needed and about which little is known about possible long term effects.
If some asinine govt agency wants me to draw a clock, they can let me draw the clock at a table, fully dressed, seated in a normal chair.
The test as it is, and given under conditions that are not controlled already sets people up. Ever since being given this test whilst sitting on an examining table in a gown with a clipboard wobbling on my knees, I bring a drawing compass, and a few art pens and pencils to all medical
Maybe everyone age 50 and above should get away from the North American continent as soon as possible if the U.S. and Canada are both involved in perpetuating this fraudulent test with no controls.
The most frightening thing is the way the medical establishment treats people . We can no longer trust doctors without testing THEM.