Date of Award


Degree Type


Degree Name

Master of Arts in Psychology



First Advisor

Allan Bernam


The Rey-Osterrieth Complex Figure (ROCF) is commonly used to assess visuospatial skills, visuoconstruction, visual memory, and executive functioning. In order to capture the sequential process used while drawing the figure, the order of pen strokes needs to be recorded. Two traditional methods are used to record this information, the flow-chart method and the pen-switching method. Although it has been suggested that pen-switching may interfere with performance, to date, no research has been conducted to assess whether ROCF performance significantly differs due to administration method. As part of routine neuropsychological evaluation, 100 inpatients and outpatients were randomly assigned to either administration method. The Boston Qualitative Scoring System (BQSS) was used to qualitatively assess any differences between methods. Additionally, BQSS quantitative summary scores and the 36-point scoring system were used. Results showed essentially no differences between methods using either the BQSS or the 36-point system. Unexpectedly however, the flow-chart group performed significantly worse than the pen-switching group on Copy Cluster Placement, Copy Planning, and Copy Fragmentation. Flow-charts also took significantly longer to score, though both procedures took the same amount of time to administer. Contrary to expectation, pen-switching did not unduly distract patients or negatively affect ROCF performance. In fact, pen-switching appears to be easier to administer, score, and may possibly contribute to optimal patient performance.



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