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Clock Drawing in Developmental Dyslexia

Department for Pediatrics, Georgetown University Medical Center, edeng{at}georgetown.edu

Frank B. Wood

Section of Neuropsychology, Department of Neurology, at Wake Forest University School of Medicine at Bowman Gray, NC

John F. Stein

University Laboratory of Physiology, Oxford, England

Although developmental dyslexia is often defined as a language-based reading impairment not attributable to low intelligence or educational or socioeconomic limitations, the behavioral manifestations of dyslexia are not restricted to the realm of language. Functional brain imaging studies have shed light on physiological differences associated with poor reading both inside and outside the classical language areas of the brain. Concurrently, clinically useful tests that elicit these nonlinguistic deficits are few. Specifically, the integrity of the dorsal visual pathway, which predominantly projects to the parietal cortex, remains underinvestigated, lacking easily administered tests. Here we present the Clock Drawing Test (CDT), used to test the visuoconstructive ability of children with and without dyslexia and garden-variety poor readers. Compared to typically reading children, many children with dyslexia and some garden-variety poor readers showed significant left neglect, as measured by the distribution of figures drawn on the left clock face. In the poor readers with dyslexia, we observed spatial construction deficits like those of patients with acquired right-hemisphere lesions. The results suggest that in some children with dyslexia, right-hemisphere dysfunction may compound the phonological processing deficits attributed to the left hemisphere. The CDT provides an easy opportunity to assess skills known to be associated with right-hemisphere parietal function. This test can be easily administered to children for both clinical and research purposes.

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