Comparing ways of measuring constructional praxis in the well elderly

The purpose of this study was to explore ways of testing three-dimensional constructional praxis in the independently living well elderly. The testing instruments used were adaptations of the block construction portion of the Boston Diagnostic Aphasia Examination, the block construction portion of the Hemiplegic Evaluation, and the Three-Dimensional Constructional Praxis Test. For each instrument, three types of test administration were developed: models, photographs, and drawings of block constructions. Twenty-four subjects, all more than 70 years old, were tested individually with the 3 three-dimensional constructional praxis tests on the three types of test administration. The effect of order was controlled by counterbalancing. For all three tests, administration with models resulted in the highest performance scores. Although no difference in scores existed between photographs and drawings on the Boston Diagnostic Aphasia Examination and the Three-Dimensional Constructional Praxis Test, performance scores for photographs were significantly greater than scores for drawings on the Hemiplegic Evaluation. Since constructional praxis ability is an important component of many activities of daily living, the findings have strong implications for testing and for teaching new skills to both the well elderly and those disabled by neurological disorders.