Bender Gestalt Test

Definition

The Bender Gestalt Test, or the Bender Visual Motor Gestalt Test, is a psychological assessment instrument used to evaluate visual-motor functioning and visual perception skills in both children and adults. Scores on the test are used to identify possible organic brain damage and the degree maturation of the nervous system. The Bender Gestalt was developed by psychiatrist Lauretta Bender in the late nineteenth century.

Purpose

The Bender Gestalt Test is used to evaluate visual maturity, visual motor integration skills, style of responding, reaction to frustration, ability to correct mistakes, planning and organizational skills, and motivation. Copying figures requires fine motor skills, the ability to discriminate between visual stimuli, the capacity to integrate visual skills with motor skills, and the ability to shift attention from the original design to what is being drawn.

Precautions

The Bender Gestalt Test should not be administered to an individual with severe visual impairment unless his or her vision has been adequately corrected with eyeglasses.

Additionally, the test should not be given to an examinee with a severe motor impairment, as the impairment would affect his or her ability to draw the geometric figures correctly. The test scores might thereby be distorted.

The Bender Gestalt Test has been criticized for being used to assess problems with organic factors in the brain. This criticism stems from the lack of specific signs on the Bender Gestalt Test that are definitively associated with brain injury, mental retardation , and other physiological disorders. Therefore, when making a diagnosis of brain injury, the Bender Gestalt Test should never be used in isolation. When making a diagnosis, results from the Bender Gestalt Test should be used in conjunction with other medical, developmental, educational, psychological, and neuropsychological information.

Finally, psychometric testing requires administration and evaluation by a clinically trained examiner. If a scoring system is used, the examiner should carefully evaluate its reliability and validity, as well as the normative sample being used. A normative sample is a group within a population who takes a test and represents the larger population. This group's scores on a test are then be used to create "norms" with which the scores of test takers are compared.

Description

The Bender Gestalt Test is an individually administered pencil and paper test used to make a diagnosis of brain injury. There are nine geometric figures drawn in black. These figures are presented to the examinee one at a time; then, the examinee is asked to copy the figure on a blank sheet of paper. Examinees are allowed to erase, but cannot use any mechanical aids (such as rulers). The popularity of this test among clinicians is most likely the short amount of time it takes to administer and score. The average amount of time to complete the test is five to ten minutes.

The Bender Gestalt Test lends itself to several variations in administration. One method requires that the examinee view each card for five seconds, after which the card is removed. The examinee draws the figure from memory. Another variation involves having the examinee draw the figures by following the standard procedure. The examinee is then given a clean sheet of paper and asked to draw as many figures as he or she can recall. Last, the test is given to a group, rather than to an individual (i.e., standard administration). It should be noted that these variations were not part of the original test.

Results

A scoring system does not have to be used to interpret performance on the Bender Gestalt Test; however, there are several reliable and valid scoring systems available. Many of the available scoring systems focus on specific difficulties experienced by the test taker. These difficulties may indicate poor visual-motor abilities that include:

• Angular difficulty: This includes increasing, decreasing, distorting, or omitting an angle in a figure.
• Bizarre doodling: This involves adding peculiar components to the drawing that have no relationship to the original Bender Gestalt figure.
• Closure difficulty: This occurs when the examinee has difficulty closing open spaces on a figure, or connecting various parts of the figure. This results in a gap in the copied figure.
• Cohesion: This involves drawing a part of a figure larger or smaller than shown on the original figure and out of proportion with the rest of the figure. This error may also include drawing a figure or part of a figure significantly out of proportion with other figures that have been drawn.
• Collision: This involves crowding the designs or allowing the end of one design to overlap or touch a part of another design.
• Contamination: This occurs when a previous figure, or part of a figure, influences the examinee in adequate completion of the current figure. For example, an examinee may combine two different Bender Gestalt figures.
• Fragmentation: This involves destroying part of the figure by not completing or breaking up the figures in ways that entirely lose the original design.
• Impotence: This occurs when the examinee draws a figure inaccurately and seems to recognize the error, then, he or she makes several unsuccessful attempts to improve the drawing.
• Irregular line quality or lack of motor coordination: This involves drawing rough lines, particularly when the examinee shows a tremor motion, during the drawing of the figure.
• Line extension: This involves adding or extending a part of the copied figure that was not on the original figure.
• Omission: This involves failing to adequately connect the parts of a figure or reproducing only parts of a figure.
• Overlapping difficulty: This includes problems in drawing portions of the figures that overlap, simplifying the drawing at the point that it overlaps, sketching or redrawing the overlapping portions, or otherwise distorting the figure at the point at which it overlaps.
• Perseveration: This includes increasing, prolonging, or continuing the number of units in a figure. For example, an examinee may draw significantly more dots or circles than shown on the original figure.
• Retrogression: This involves substituting more primitive figures for the original design—for example, substituting solid lines or loops for circles, dashes for dots, dots for circles, circles for dots, or filling in circles. There must be evidence that the examinee is capable of drawing more mature figures.
• Rotation: This involves rotating a figure or part of a figure by 45° or more. This error is also scored when the examinee rotates the stimulus card that is being copied.
• Scribbling: This involves drawing primitive lines that have no relationship to the original Bender Gestalt figure.
• Simplification: This involves replacing a part of the figure with a more simplified figure. This error is not due to maturation. Drawings that are primitive in terms of maturation would be categorized under "Retrogression."
• Superimposition of design: This involves drawing one or more of the figures on top of each other.
• Workover: This involves reinforcing, increased pressure, or overworking a line or lines in a whole or part of a figure.

Additionally, observing the examinee's behavior while drawing the figures can provide the examiner with an informal evaluation and data that can supplement the formal evaluation of the examinee's visual and perceptual functioning. For example, if an examinee takes a large amount of time to complete the geometric figures, it may suggest a slow, methodical approach to tasks, compulsive tendencies, or depressive symptoms. If an examinee rapidly completes the test, this could indicate an impulsive style.

Resources

BOOKS

Hutt, M. L. The Hutt Adaptation of the Bender Gestalt Test. New York: Grune and Stratton, 1985.

Kaufman, Alan, S., and Elizabeth O. Lichtenberger. Assessing Adolescent and Adult Intelligence. Boston: Allyn and Bacon, 2001.

Koppitz, E. M. The Bender Gestalt Test for Young Children. Vol. 2. New York: Grune and Stratton, 1975.

Pascal. G. R., and B. J. Suttell. The Bender Gestalt Test: Quantification and Validation for Adults. New York: Grune and Stratton, 1951.

Sattler, Jerome M. "Assessment of visual-motor perception and motor proficiency." In Assessment of Children: Behavioral and Clinical Applications. 4th ed. San Diego: Jerome M. Sattler, Publisher, Inc., 2002.

Watkins, E. O. The Watkins Bender Gestalt Scoring System. Novato, CA: Academic Therapy, 1976.

PERIODICALS

Piotrowski, C. "A Review of the Clinical and Research Use of the Bender Gestalt Test." Perceptual and Motor Skills, 81
(1995): 1272-1274.

Keith Beard, Psy.D.