Bender test: characteristics, functions, and how it is used

The Bender test is an assessment tool used with children and based on drawing.

One of the classic tools in child psychology is the Bender test, of Gestalt origin, which has proven to be a very effective instrument in child psychology.The Bender test, of Gestalt origin, has been shown to be a very effective instrument in the detection of possible developmental problems.

It is a test in which children must try to copy exactly a series of cards in which geometric shapes and lines appear.

We are going to learn a little more about this test, as well as to understand how it is corrected and the expected scores according to the age range.

What is the Bender test?

The Bender test is a test linked to gestalt psychology used to evaluate the development of intelligence in children.and possible disorders and disabilities they may present.

This test was created by the American psychiatrist Lauretta Bender between 1932 and 1938, based on the theoretical principles of Gestalt. According to this approach, the organism does not react to local stimuli with local responses, but responds to sets of stimuli with a total process.

It is based on the idea that, by attending to the visuomotor function, different functions such as visual perception, fine motor skills, memory and awareness of space and time can be evaluated.. In addition, it is believed that visual perception depends on the degree of maturation of the central nervous system, so that developmental problems could be detected with this test.

Despite the fact that the approach from which it is based is today highly criticized, the truth is that the Bender test is considered a very good tool for detecting developmental problems, being considered an exception within the tests proposed by Gestalt.

It is a very reliable and valid instrument, which also has a high correlation with other psychological tests, including the WISC. It is also widely used because it involves very little intrusion for the children.The only thing they have to do is to copy the drawings of the test.

How is it applied?

The test consists of asking the child to copy 9 figures on a blank piece of paper with a pencil, as shown on an example sheet. The figures are:

• Circle-square
• Dotted line
• Three dotted lines arranged as a ladder
• Four dotted lines making waves
• Uncomplete square and curved line
• Curve and diagonal line made of dots
• Two curves that intersect perpendicularly
• Overlapping crystals
• Small crystal inside a large crystal

The child, when trying to copy all the figures, has to carry out several visual and motor processes. First, he has to see the figure to copy, make a mental representation of it, try to remember it, take the pencil, try to draw the figure and check if he is on the right track.

The test can be applied to children over 4 years of age, and children 11 years of age or older, in most cases, are able to copy the drawings of the test without errors.. If there are too many errors or if the resulting figure is very different from the one presented to them, the possibility of a perceptual, intellectual and motor problem is considered.

Koppitz Protocol

One of the figures who has most researched the Bender test is Elizabeth Koppitz (1918-1983), who provided a protocol through which it can be assessed:

• Learning maturity
• Problems in reading
• Emotional difficulties
• Possible brain injury
• Mental deficiencies.

Edited a book with scoring norms applicable to all children between the ages of 4 and 11 years old, regardless of their intelligence or type of problems.regardless of their intelligence or the type of problems they present. They are also applicable to mentally handicapped subjects with a chronological age of no more than 16 years but with a mental age of less than 10 years.

The Koppitz system takes into account 25 items to be evaluated after the application of the test.. Each item will be scored with a 0 or a 1, depending on whether or not the copy of the figure has been made correctly. The higher the score, the greater the possibility of a problem.

Koppitz's protocol is not very different from how Bender herself applied the test, although she did specify that during the test one should avoid suggesting to the child to be as exact and meticulous as possible or to draw the pictures as quickly as possible.

The child is told that he has nine drawings and that he must try to copy them.. He should be given a single blank sheet of paper and a pencil and, should he ask for another sheet of paper later, it will be given to him but indicating that he has done so. It is important that during the test the evaluator does not make any comments.

The copying should begin with card A (circle-square), showing the child the rest of the cards as he/she finishes with the last drawing he/she has done, and going in order from 1 to 8.

If during the test the examinee counts the points or becomes overly concerned about a particular aspect, a neutral response should be given, such as "do it as close to the card as possible" or "do it as close to the card as possible".for example "do it as close as possible to the card". If the child insists too much, it can be assumed that this is a case of a perfectionist or compulsive child. The child should be prevented from helping himself by rotating the card in any direction, indicating to him that he should draw it from the position the card has been given.

There is no time limit for the administration of this test, although it has been it has been considered that the maximum time for each card should be about 5 minutes, bearing in mind that it is rare for the child to draw the card from the position given to him/her.The maximum time for each card should be about 5 minutes, taking into account that it is rare for the child to draw the picture in less than 3 minutes.

If the time is exceeded, this incident should be noted, assuming that it could be a slow or methodical child. On the other hand, if the child does not take more than 3 minutes, it is possible that this is a case of a somewhat compulsive, impulsive or unreflective child.However, of course, this should be combined with other tests.

In any case, if you think that some of the items that the child has tried to copy have been done too quickly and do not reflect his/her real skill, he/she can be asked to do it again. In this case, it should be noted in the protocol that the child has done it again.

Correction

Scores on the Bender test by age are as follows:

• More than 13 points or errors - 5 years
• 10 errors - 5 and a half years
• 8 errors: 6 years
• 5 errors: 7 years
• 3 or 4 errors: 8 years
• 2 or less errors: 9 or 10 children

When correcting the test, the following errors can occur.

1. Confusion of the sequence

The drawings do not follow the expected sequence, producing changes in the directions and breaking the logical or expected progression.

2. Collision

Different designs are stacked on the sheet of paper or the end of one design is allowed to touch another.

3. Superimposing designs

The figures are drawn on top of each other.

4. Review

The line of a part or of the whole figure is outlined.

5. Irregular quality of the line

Irregular lines are drawn, or the line is drawn with some tremor. This error is especially striking when it occurs in older children.

6. Difficulty of angulation

Noticeable distortion in the angles of the figures.

7. Perseveration

A complete design or a part of the figure is drawn repeatedly. It is usually more evident in drawings made by rows of dots.

8. Line extension

Making a line longer or adding lines that are not present in the example drawing.

9. Contamination

Combining parts of two different test figures.

10. Rotation

Rotating one or more figures by more than 45º from their standard shape.

11. Omission

Leaving space in a figure that is not in the example, or only reproducing part of it. Separate or fragment parts of a design.

12. Regression

Replacing lines or dots with circles, dashes with dots, or filling in the figure.

Correlation between Bender's test and the WISC

Different studies have shown a high correlation between the executive part of the WISC (Wechsler Intelligence Scale for Children) tests and the Bender test.. This seems to occur independently of age, which confirms that the Bender test measures many of the functions that are also evaluated in that particular part of the WISC, and in some cases, serves as a substitute or as a control test.

Another interesting fact is that in children between 7 and 10 years of age there is a correlation between the scores obtained in the WISC arithmetic test and the Bender test. This is explained by the fact that the arithmetic test involves part-whole relationships and numerical concepts that are also found, although in a somewhat more masked form, in the Bender test..

Neurological problems and the Bender test

The Bender test can help us to suspect neurological lesions, especially if the child is over 11 years old and does not perform the test correctly.

However, it should be noted that the ability of this test to detect possible neurological alterations is low, since there are many reasons for this.There are many reasons why a child may not perform the test correctly, without the need for a brain injury. In addition, there may be a brain injury that does not affect the visuospatial ability and, therefore, is not reflected in the results of this test.

Emotional indicators

The Bender test has also been associated with emotional problems, although, as with neurological problems, this test is not reliable enough to diagnose a mood or anxiety problem. is not reliable enough to diagnose a mood or anxiety problem, but it can help us suspect that something is wrong..

However, it can help us to suspect that something is not going well in the close environment of the person being evaluated, and that a more in-depth anamnesis should be carried out to evaluate the emotional aspects.

Likewise, and from a very gestalt perspective, several explanations have been proposed behind the different errors that can occur during the test.

1. Confusing order of the drawings

This indicator seems to be related to the child's lack of planning and organization.. This is normal in younger children, specifically in the 5 and 7 years age range, since they still draw pictures in a somewhat confusing way.

The indicator does not acquire diagnostic significance until the age of 8 years, when the arbitrary distribution throughout the leaf is something that should already be taken into consideration as an indicator of a possible problem.

2. Wavy line

The wavy line in Figures 1 (dotted line) and 2 (three lines) is associated with a lack of emotional stability. is associated with a lack of emotional stability. In young children it is possible that, as they still do not control much what they draw, they do it a little irregular, but in children closer to 8 years this is already a reason for suspicion of emotional problems.

3. Substitution of circles for stripes

In adults it is associated with some type of emotional disturbance and it is not common. In younger children it is related to impulsivity and lack of interest or attention..

4. Progressive increase in size

This has been related to a low tolerance to frustration and impulsivity. In the clearest cases, it may be indicative of disruptive or violent behavior, as well as ADHD.

5. Large size of the figures

It is associated with externalizing behavior. They are usually children with obsessive and demanding patterns.

6. Small size of the drawings

It is associated with internalizing behavior, withdrawal, shyness and anxiety.. It acquires diagnostic significance in children from 8 to 10 years old. If the drawings are concentrated in a concrete area of the paper they would confirm even more the suspicion of withdrawal, in agreement with the gestalt hypothesis.

7. Fine line

It is associated with shyness and withdrawal in young children, although not so clear in older children.. It has been hypothesized that in older children it could be between laziness, perfectionism and emotional weakness.

8. Review of figures and lines

It is related to aggressiveness and impulsivity.

9. Second attempt

It is related to anxiety, impulsivity and various emotional problems. There are children who, after the first attempt, are not happy with their drawing, see that they have done it wrong but do not know how to rectify it, so they make a new attempt on another side of the sheet.

10. Expansion and use of more sheets

This is an indicator of disruptive, explosive and even violent behavioral tendencies.. It is related to poor planning and poor use of space. It has been related to neurological deterioration and externalizing behaviors.

11. Constriction or reduced use of the blade

It is related to problems such as withdrawal, shyness and depression.

Bibliographical references:

• Moetesum, M. & Siddiqi, I. & Masroor, U. & Djeddi, C. (2015). Automated Scoring of Bender Gestalt Test Using Image Analysis Techniques. ICDAR 2015.
• Bender, L. (1997). Visuomotor Gestalt Test (B.G.). Paidós. p. 15-16. ISBN 84-7509-308-6.