USING THE BICYCLE DRAWING TEST WITH ADULTS
Anita M. Hubley & Lydia Hamilton
University of British Columbia
Vancouver, BC, Canada
Poster presented at the 22nd Annual Meeting of the National Academy of
Neuropsychology,
Miami, Florida, USA, October 9-12, 2002
Correspondence: Dr. Anita M. Hubley, Dept. of ECPS, 2125 Main Mall, University of
British Columbia, Vancouver, BC, Canada, V6T 1Z4; E-mail: [email protected]
ABSTRACT
The Bicycle Drawing Test (BDT) was first developed as a measure of children’s
higher conceptual reasoning (Piaget, 1930; Taylor, 1959), but has since been described
as a measure of visuographic functioning and mechanical reasoning (Lezak, 1995).
The BDT is currently used in clinical settings with both children and adults. Greenberg,
Rodriguez, and Sesta (1994) presented a standardized administration and scoring
system for the BDT and provided reliability and validity evidence to support its use with
children. Using the administration and scoring system developed by Greenberg et al.,
the present study provides preliminary reliability and construct validity evidence with
respect to the use of the BDT with adults and introduces a copy trial to supplement the
“free drawing” portion of the test. In a sample of 50 community-dwelling men and
women ages 20-80 years, mean performance on the BDT is described, one-week testretest reliability coefficients are computed, gender differences and correlations with age
are reported, and correlations of the BDT with other visuospatial measures (i.e., ReyOsterrieth Complex Figure, WAIS-III Block Design, Hooper Visual Organization Test)
and a verbal measure (i.e., Rey Auditory-Verbal Learning Test) are examined.
INTRODUCTION
The Bicycle Drawing Test (BDT) currently is used as a measure of mechanical
reasoning and visuographic functioning in both children and adults (Lezak, 1995). An
advantage of the BDT over other drawing tests is the opportunity to measure visuospatial and visuographic functioning using a commonly encountered, yet complex,
object with which most adults and children are familiar. The BDT has been shown to be
useful in evaluating the effects of damage or lesions to different areas of the brain (e.g.,
Lebrun & Hoops, 1974; McFie & Zangwill, 1960; Messerli, Seron, & Tissot, 1979) and
assessing the effects of treatment for individuals with multiple sclerosis (e.g., Sandyk,
1997) and Parkinson’s disease (e.g., Sandyk, 1996). Greenberg, Rodriguez, and Sesta
(1994) developed a standardized administration for the BDT and a scoring system that
yields subscores for categories of errors rather than a simple composite score. They
also provided reliability and validity evidence to support the use of the BDT and their
scoring system with children. Using the Greenberg et al. system, the present study
provides preliminary reliability and construct validity evidence for the use of the BDT
with adults and introduces a copy trial to supplement the “free drawing” portion of the
test.
METHOD
Participants
Participants consisted of 50 community-dwelling adults (22 men, 28 women) aged
21-80 years (M = 49.4, s = 17.9) whose education ranged from 10-21 years (M = 15.0, s
= 2.7). All participants scored > 24 on the Mini-Mental State Examination (M = 28.2, s =
1.4) and < 13 on the Geriatric Depression Scale (M = 4.9, s = 3.6).
Procedure
Participants were administered a battery of tests over two sessions scheduled one
week apart. The tests administered included the Bicycle Drawing Test (BDT), ReyOsterrieth Complex Figure (ROCF), WAIS-III Block Design, Hooper Visual Organization
Test (HVOT), and the Rey Auditory-Verbal Learning Test (RAVLT) List A. Participants
were asked to draw a regular bicycle without a rider in both sessions. Participants were
not told in advance that they would be asked to draw the bicycle a second time. In the
retest session, participants were also asked to copy a drawing of a bicycle (see Figure
1).
RESULTS
Bicycles were scored using Greenberg et al.’s (1994) scoring system (see Figure 2).
Mean Performance: Mean performance on the test, retest, and copy trials of the BDT
is presented in Table 1. Only Mechanical Reasoning showed a significant increase at
retest, t(49) = -3.84, p < .001, which also resulted in a significant increase in Total Score
at retest, t(49) = -2.70, p < .01. As expected, mean copy trial performance shows few
errors.
Test-Retest Reliability: One-week test-retest reliability estimates were as follows:
Parts/Complexity: r = .70; Motor Control: r = .62; Spatial Relationships: r = .52;
Mechanical Reasoning: r = .79; Total Score: r = .77 (all: p < .001).
Gender Differences: Mean performance on the BDT (at test) by gender is shown in
Table 2. Gender differences were found only on Mechanical Reasoning, t(48) = 3.30,
p < .01, and Total Score, t(48) = 2.31, p < .05, with men outperforming women.
Age Effects: Younger adults tended to obtain higher scores on the BDT (at test) than
older adults, but this was only statistically significant for Total Score (p < .05).
Correlations of the BDT with age were as follows: Parts/Complexity: r = -.14; Motor
Control: r = -.24; Spatial Relationships: r = -.26; Mechanical Reasoning: r = -.23; Total
Score: r = -.28.
Convergent and Discriminant Validity: Correlations of the BDT (at test) with
visuospatial measures (i.e., ROCF, Block Design, and HVOT) and a verbal measure
(i.e., RAVLT) are shown in Table 3.
DISCUSSION
The present study shows community-dwelling adults’ performance on the BDT when
the Greenberg et al. (1994) system is used. One week test-retest reliability estimates
suggest stability in performance over a relatively short period of time. The increase in
Mechanical Reasoning scores (and subsequently Total Scores) upon retest is likely due
to participants’ further reflection on how a bicycle must fit together to function and
examination of bicycles after the test session. The finding that men scored significantly
higher on Mechanical Reasoning (and subsequently Total Scores) than women is
consistent with Greenberg et al.’s gender findings with children. The slight tendency for
younger adults to obtain higher scores on the BDT than older adults on most of the
scoring categories except Parts/Complexity is counter to the findings of Ska, Désilets,
and Nespoulous (1986). The pattern of correlations between the BDT and the ROCF,
WAIS-III Block Design, and the HVOT support interpretation of the BDT as a measure
of visuographic functioning and provide convergent and discriminant validity evidence
for the Greenberg et al. scoring categories. The low and nonsignificant correlations
between the BDT and the RAVLT provide discriminant validity evidence supporting the
interpretation of the BDT as a measure of visuospatial ability that is not affected by
verbal recall.
Future research needs to (a) examine the utility of the BDT and the validity of the
Greenberg et al. scoring system with a variety of clinical samples (e.g., individuals with
brain-injuries, dementia, multiple sclerosis, HIV/AIDS) and (b) explore the kinds of
errors that community-dwelling adults make on the BDT so this can be used to provide
a baseline comparison for use with clinical subgroups.
REFERENCES
Greenberg, G. D., Rodriguez, N. M., & Sesta, J. J. (1994). Revised scoring, reliability, and
validity investigations of Piaget’s Bicycle Drawing Test. Assessment, 1, 89-101.
Lebrun, Y., & Hoops, R. (1974). Intelligence and aphasia. Amsterdam: Swets & Zeitlinger.
Lezak, M. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.
McFie, J., & Zangwill, O. L. (1960). Visual construction disabilities associated with lesions of the
left cerebral hemisphere. Brain, 83, 243-260.
Messerli, P., Seron, X., & Tissot, R. (1979). Quelques aspects des troubles de la
programmation dans le syndrome frontal. Archives Suisse de Neurologie, Neurochirurgie et
de Psychiatrie, 125, 23-35.
Piaget, J. (1930). The child’s conception of physical causality. New York: Harcourt Brace.
Sandyk, R. (1996). Brief communication: Electromagnetic fields improve visuospatial
performance and reverse agraphia in a Parkinsonian patient. International Journal of
Neuroscience, 87, 209-217.
Sandyk, R. (1997). Progressive cognitive improvements in multiple sclerosis from treatment with
electromagnetic fields. International Journal of Neuroscience, 89, 39-51.
Ska, B., Désilets, H., & Nespoulous, J.-L. (1986) Performances visuo-constructives et
vieillissement. Psychologica Belgica, 26, 125-145.
Taylor, E. M. (1959). Psychological appraisal of children with cerebral deficits. Cambridge, MA:
Harvard University Press.
Figure 1
Bicycle Model for Copy Trial
© 2002, A.M. Hubley
Figure 2
Greenberg et al. (1994) Scoring Categories for the Bicycle Drawing Test
Greenberg et al. (1994) Scoring Categories
Parts/Complexity (7 items): Scores for essential elements that must be present for a
bicycle to take on its characteristic form (e.g., two wheels, gear assembly, complete
frame).
Motor Control (5 items): Evaluates pencil control and psychomotor regulation (e.g.,
no perseverations, lines meet target destination, no irrelevant lines).
Spatial Relationships (9 items): This broad category assesses good planning,
proper placement of parts, appropriate spatial orientation and relationship among
parts, consistent sizing of parts, symmetry, and logical perspective.
Mechanical Reasoning (5 items): Evaluates ability to convey how a bicycle is
powered and how it can move through placement and orientation of parts (e.g., chain
is connected to rear wheel center, steering control appears possible).
Table 1
Mean Performance on the Bicycle Drawing Test at Test, Retest, and Copy
Trials
Max.
Possible
Score
Test
Retest
Copy
Parts/Complexity
7.0
5.3
(1.08)
5.5
(1.03)
6.6
(0.51)
Motor Control
5.0
4.4
(0.71)
4.5
(0.68)
4.8
(0.52)
Spatial Relationships
9.0
7.4
(1.28)
7.5
(1.25)
8.8
(0.52)
Mechanical Reasoning
5.0
2.8
(1.83)
3.4
(1.68)
4.9
(0.35)
Total Score
26.0
19.9
(3.77)
20.9
(3.69)
25.0
(1.23)
Scoring Categories
Note: n = 50
Table 2
Mean Performance on the Bicycle Drawing Test at Test by Gender
Gender
Men
(n = 22)
Women
(n = 28)
Parts/Complexity
5.6
(1.08)
5.2
(1.06)
Motor Control
4.3
(0.84)
4.5
(0.58)
Spatial Relationships
7.7
(1.08)
7.1
(1.37)
Mechanical Reasoning
3.6
(1.50)
2.1
(1.78)
Total Score
21.3
(3.33)
18.9
(3.82)
Scoring Categories
Table 3
Convergent and Discriminant Validity: Correlations of the Bicycle Drawing Test with
Measures of Visuospatial and Verbal Ability
Convergent and Discriminant Measures
BDT Scoring
Categories
ROCF
Block
Design
HVOT
RAVLT
.38b
.46c
.30a
.08
Motor Control
.32
a
.28
.20
.19
Spatial Relationships
.30a
.41c
.13
.17
b
c
a
.01
a
.12
Parts/Complexity
Mechanical Reasoning
b
Total Score
a
.48
.51
b
c
.47
c
.52
.35
.33
Note: p < .05; p < .01; p < .001; n = 50
BDT = Bicycle Drawing Test scores at test; ROCF = Rey-Osterrieth Complex Figure immediate
recall scores; Block Design = age corrected WAIS-III Block Design scores; HVOT = Hooper
Visual Organization Test; RAVLT = Rey Auditory Verbal Learning Test List A total acquisition
scores (summed over 5 trials).