The Bicycle Drawing Test in Neuropsychological Assessment

The Bicycle Drawing Test (BDT), like other free drawings by patients, has been included in developmental and neuropsychological assessment for many decades. Free, drawings are able to reflect cognitive impairment in a variety of ways. A system of formally evaluating free bicycle drawings that was proposed by Lezak was used and refined by the authors, with more explicit scoring rules. Based oil a sample of 200 neurological patients who underwent neuropsychological assessment, data oil the reliability and validity of the BDT are presented. With the refined scoring system, an interrater agreement of 0.95 was found. Retest reliability after one to three days was 0.67. Male patients scored higher than female patients, and test scores were significantly correlated with age (r = -0.32) and years of education (r = 0.25). Patients with left-hemisphere damage scored lower on the BDT than those with right-hemisphere lesion. Moderate correlations were observed between BDT scores and some other neuropsychological test measures. The BDT and other free drawings appear to reflect visuo-constructive impairment in patients and may be used as a screening instrument in neuropsychology.