Child psychology: Bender test

10.08.2020

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

It is a test in which the 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, in addition to understanding its correction and the expected scores according to the age group.

What is the Bender test?

The Bender test is a test linked to Gestalt psychology used to evaluate the development of intelligence in children , as well as possible disorders and disabilities that 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 starts from the idea that, taking care of the visual-motor function, different functions can be evaluated, such as visual perception, fine motor skills, memory and awareness of space and time . In addition, it is believed that visual perception depends on the degree of maturation of the central nervous system, with which developmental problems could be detected with this test.

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

It is a very reliable and valid instrument, and it also has a high correlation with other psychological tests, including the WISC. It is also widely used because it involves very little intrusion for children , since all they have to do is copy the pictures from the test.

How does it apply?

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

  • Circle-square
  • Dash line
  • Three dotted lines placed like a ladder
  • Four dotted lines making waves
  • Not complete square and curved line
  • Curve and diagonal line made of points
  • Two curves that intersect perpendicularly
  • Crystals that overlap
  • Small crystal within large crystal

The child, when trying to copy all the figures, has to carry out various visual and motor processes. First, you have to see the figure to be copied, make a mental representation, try to remember it, take the pencil, try to draw the figure and check if you are on the right track.

The test can be applied to children over 4 years old, and children aged 11 and over, in most cases, are able to copy the test drawings without errors . In case there were too many errors or that the resulting figure was very different from the one presented to them, the possibility that there is some kind of problem would be considered, both at a perceptual, intellectual and motor level.

Koppitz protocol

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

  • Maturity for learning
  • Reading problems
  • Emotional difficulties
  • Possible brain injury
  • Mental deficiencies

He edited a book with scoring standards applicable to all children between the ages of 4 and 11 , regardless of their intelligence or the type of problems they present. They are also applicable to subjects with mental disabilities with a chronological age of not more than 16 years but with a mental age of less than 10 years.

Koppitz's system takes into account 25 items that must be evaluated after applying the test . Each item will be scored with a 0 or a 1, in case the copy of the figure has been made correctly or not. The higher the score, the more likely there is some kind of problem.

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

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

The copy should start with card A (circle-square), showing the child the rest of the cards as he finishes with the last drawing he has made, and going in order from 1 to 8. He will be told on each card that You must copy the drawing that is presented to you.

If during the test the evaluated person counts the points or worries too much about a specific aspect, they should be given a neutral answer , such as "do it as close to the card" as possible. If you insist a lot, it can be assumed that you are dealing with a case of a perfectionist or compulsive child. The child should be prevented from helping himself by rotating the card in any direction, indicating that he must draw it from the position the card has been given to him.

There is no time limit for the administration of this test, although it has been considered that the maximum time for each card should be about 5 minutes , taking into account that it is rare that the child does the drawing in less than 3 minutes.

If it exceeds the time, this incidence should be noted, assuming that it could be a slow or methodical child. On the other hand, if the child takes no more than 3 minutes, it is possible that this is a case of a somewhat compulsive, impulsive or not very reflective child , although, of course, this should be combined with other tests .

However, if it is believed that some of the items that the child has tried to copy have been done very quickly and do not reflect his real skill, he may be asked to do it again. In this case, it should be noted in the protocol that the child has done it again.

Correction

The Bender test scores by age are as follows:

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

When correcting the test, the following errors may occur.

1. Sequence confusion

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

2. Collision

Different designs are piled up on the sheet of paper or the end of one of them is allowed to touch another.

3. Layout overlap

Figures are drawn on top of each other.

4. Review

The line of part or all of the figure is highlighted or reviewed.

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 part of the figure is drawn repeatedly. It is usually more evident in drawings made by rows of dots.

8. Extension of the line

Make a line longer or add lines that are not present in the example drawing.

9. Pollution

Parts of two different test figures are combined.

10. Rotation

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

11. Omission

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

12. Retrogression

Replace lines or points with circles, lines with dots, or fill the figure.

Correlation between the Bender 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 happen regardless of age, which confirms that the Bender test measures many of the functions that are also evaluated in that specific part of the WISC, and in some cases, serve as a substitute or as a control test.

Another interesting fact is that in children between 7 and 10 years old there is a correlation between the scores they obtain in the WISC arithmetic test and the Bender test. The explanation for this is that the arithmetic test involves part-whole relationships and number concepts that are also found, albeit in a somewhat more disguised way, in the Bender test .

Neurological problems and the Bender test

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

However, it must be said that the ability to detect possible neurological alterations of this test is low , since there are many reasons why a child does not do the test correctly, without the need to speak of brain injury. In addition, there may be a brain injury that does not affect the visual-spatial 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, in the same way that we spoke with the case of neurological problems, this test is not reliable enough to diagnose a problem with mood or anxiety .

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

Likewise, and from a very Gestalt perspective, several explanations have been proposed behind the different errors that can occur while the test is being carried out.

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 the youngest children, specifically in the 5 and 7 year age range, since they still draw pictures in a somewhat confused way.

The indicator does not acquire diagnostic significance until 8 years of age, when the arbitrary distribution throughout the sheet 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 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 bit irregular, but in children closer to 8 years this is already a reason for suspicion of emotional problems.

3. Substitution of circles for lines

In adults it is associated with some type of emotional disturbance and 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 linked to a low tolerance for frustration and impulsivity. In the clearest cases, it can be indicative of disruptive, violent behaviors and also 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 drawings

It is associated with internalizing behavior, withdrawal, shyness, and anxiety . It acquires diagnostic significance in children aged 8 to 10 years. If the drawings are concentrated in a specific area of ​​the paper, they would further confirm the suspicion of withdrawal, according to the Gestalt hypotheses.

7. Fine line

It is associated with shyness and withdrawal in young children, although not as 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 impulsiveness.

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, they see that they have done it wrong but do not know how to correct it, so they make a new attempt on another side of the page.

10. Expanding and using more sheets

It is an indicator of trends in disruptive, explosive and even violent behavior . It is related to little planning and poor use of space. It has been linked to neurological impairment and externalizing behaviors.

11. Constriction or reduced use of the blade

It is associated with problems such as withdrawal, shyness, and depression.

Psychotherapy is not simply about meeting with the psychologist and telling him out loud about the frustrations that we have been carrying over the last days or weeks; nor is it going to informative sessions in which as patients we internalize theoretical knowledge about what happens to us and we let go of false beliefs.

The concept of "addiction" usually goes hand in hand with that of "drug", but in practice, this is not the case. There are addictions in which the consumption of any addictive substance is not involved, and in fact, they are not statistically rare cases.

Dynamic Psychology is an approach oriented to the study of the forces that act in the individual , between the organization of the personality and the consequences of these.