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Around the clock surveillance: simple graphic disturbance in patients with hemispatial neglect carries implications for the clock drawing task
  1. A D Smith1,
  2. I D Gilchrist1,
  3. S H Butler2,
  4. M Harvey2
  1. 1Department of Experimental Psychology, University of Bristol, Bristol, UK
  2. 2Department of Psychology, University of Glasgow, Glasgow, UK
  1. Correspondence to:
 Dr Alastair D Smith
 Department of Experimental Psychology, University of Bristol, 8 Woodland Road, Bristol BS8 1TN, UK; alastair.smith{at}


Background: Drawing, and the clock drawing task in particular, is widely used as a diagnostic tool in the study of hemispatial neglect. It is generally assumed that the errors in graphic production, such as the misplacement of numbers, reflect a visuospatial deficit, and that drawing production itself (for example, producing the circle) is unimpaired.

Objectives: To test this assumption by examining whether the production of simple circles is affected by neglect.

Methods: 16 right hemisphere stroke patients copied circles of various sizes and their drawings were measured for size accuracy.

Results: Patients with more severe neglect produced greater scaling errors, consistently drawing the circle smaller than the original. Errors were not in the horizontal axis alone—shrinkage occurred equally in both height and width axes.

Conclusions: Neglect can co-occur with constructional difficulties that serve to exacerbate the symptoms presented. This should be taken into account in the assessment of even apparently simple drawing tasks.

  • BIT, behavioural inattention test
  • CDT, clock drawing test
  • hemispatial neglect
  • clock drawing

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  • Competing interests: none declared