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The Bender-Gestalt II

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 American Journal of Orthopsychiatry
2006, Vol. 76, No. 1, 10 –12
The Bender-Gestalt II
Gary G. Brannigan, PhD
State University of New York-Plattsburgh
In 2003, the Bender-Gestalt II was published. In the present article, the revision process is described, and
major changes to the test are discussed. These changes include additional designs, a memory (recall)
phase, Motor and Perception supplementary tests, a detailed observation form, a global scoring system,
and a large, nationally representative normative base. Directions for future research are also provided.
Keywords: Bender-Gestalt, visual-motor, memory
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
The Visual Motor Gestalt Test (Bender, 1938), more commonly
referred to as the Bender-Gestalt Test, has been one of the most
popular assessment devices for over a half century. Its clinical
utility in diverse settings and with a broad age range has been well
documented (e.g., Brannigan & Brunner, 2002; Lacks, 1999; Tolor
& Brannigan, 1980; Tolor & Schulberg, 1963) and may be sum-
marized by Piotrowski’s (1995) conclusion that the measure has
been a
“mainstay in the assessment battery . . . as an assessment tool in
appraisal of intelligence . . . as a screening technique for neuropsy-
chological dysfunction, a clinical tool for sampling visual-motor pro-
ficiency, and as a standard projective technique in the assessment of
personality.” (p. 1272)
According to Schilder (2003), Lauretta Bender experienced learn-
ing problems herself and struggled during her early school years.
However, over time, her academic performance improved mark-
edly. She graduated as the valedictorian of her high school class
and went on to earn a bachelor’s degree in biology and a master’s
in pathology from the University of Chicago. She then entered the
medical school at the University of Iowa. It was there that she
worked with Samuel Orton and determined that a dyslexic condi-
tion had contributed to her early learning problems. Following her
medical training in neurology, she began work on the Visual Motor
Gestalt Test.
Intrigued by Wertheimer’s (1923) studies of the gestalt theory of
perception, Bender (1938) adapted nine of his configurations and
transformed the technique from a visual–verbal one to a visual–
motor one. After years of experimentation, her groundbreaking
monograph A Visual Motor Gestalt Test and Its Clinical Use was
published by the American Orthopsychiatric Association (AOA) in
1938. In this work, she provided clinicians with an elaborate
scoring system and normative data on the maturation of visual–
motor gestalt functioning as well as detailed descriptions of the
performance of individuals with various organic and functional
Gary G. Brannigan, PhD, Department of Psychology, University of New
York-Plattsburgh; Scott L. Decker, PhD, College of Education, Georgia
State University.
For reprints and correspondence: Gary G. Brannigan, PhD, Department
of Psychology, Plattsburgh State University of New York, Plattsburgh, NY
12901. E-mail: gary.brannigan@plattsburgh.edu
10
Copyright 2006 by the American Psychological Association
0002-9432/06/$12.00 DOI: 10.1037/0002-9432.76.1.10
Scott L. Decker, PhD
Georgia State University
pathological conditions (e.g., organic brain disorder, schizophre-
nia, psychoneuroses). In the most comprehensive review of the
early research on the Bender-Gestalt Test, Tolor and Schulberg
(1963) praised Bender’s work and noted its tremendous impact on
research and clinical practice.
Although there have been many significant research accom-
plishments over the years, we only focus on the research threads
that link the Bender-Gestalt Test to the Bender-Gestalt II. Bender
(1938) operated under the assumption “that the visual gestalt
function is a fundamental function associated with language ability
and closely associated with various functions of intelligence such
as visual perception, manual motor ability, memory, temporal and
spatial concepts and organization” (p. 112). As such, she used the
test to study the “gestalt function in . . . different organic and
functional nervous and mental disorders” (p. 4).
Bender’s (1938) scoring system evaluated the overall quality of
each design on a scale that ranged from 1 to 5 on one design
through 1 to 7 on others. She provided detailed descriptions of
each point on the scale for each design. On Design 6, for example,
a score of 1 was given for an inhibited scribble, a score of 4 was
given for two wavy lines crossing at right angles, and a score of 6
was given for perfection. Although her scoring system did not
withstand the test of time, she still advocated the use of global
scoring systems over error-based systems, which she felt oversim-
plified the processes involved and failed to do justice to the test.
One of the earliest global scoring systems to emerge was de-
veloped by Keogh and Smith in 1961. Their scoring system in-
volved rating each design on a 5-point scale on the basis of the
overall quality of the production. A score of 1 would be given
when a figure was unrecognizable, and a score of 5 would be given
when all parts of the figure were present and recognizable. Al-
though the system generated some research, the authors never
provided normative data.
The second scoring system was developed by deHirsch, Jansky,
and Langford (1966), in collaboration with Bender. They also
modified the test by eliminating three of the more difficult designs
to match their research interest in preschool screening. The scoring
system used a single global inspection procedure that yielded a
pass or fail for each design. The system evaluated the essentials of
the gestalt and the degree of differentiation of each design. In
1972, Jansky and deHirsch further simplified and refined the
scoring system by providing specific guidelines for scoring each
 THE BENDER-GESTALT II
design to determine whether a pass or fail should be given. On
Design 6, for example, “lines should cross at or near the center, but
need not be wavy” (p. 151) for a pass.
The work of these early researchers served as the basis for the
development of a more elaborate series of studies beginning in the
1980s. Brannigan and Brunner (1989, 1996, 2002), like Bender
(1938), believed that a global approach to scoring provided the
most accurate assessment of visual–motor functioning. They re-
fined and extended the early research in formulating the Qualita-
tive Scoring System. Using the same six designs (A, 1, 2, 4, 6 and
8) as had deHirsch et al. (1966) and Jansky and deHirsch (1972),
they devised a 6-point scoring system for greater differentiation in
scoring each design. Scoring ranged from 0 (random drawing,
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
scribbling, having no concept of the design) to 3 (all major
This document is copyrighted by the American Psychological Association or one of its allied publishers.
elements present and recognizable with only minor distortions) to
5 (accurate representation). Extensive normative data were pro-
vided for children aged 4 years 6 months to 8 years 5 months.
The Bender Visual–Motor Gestalt Test—Second Edition
(Bender-Gestalt II; Brannigan & Decker, 2003) is an extension of
this early research in two fundamental ways. First, it is a modified
version of the original test. Second, it uses a quality-based method
of scoring. As we discuss, though, there are a number of other
significant developments and refinements in the revision. (See
Brannigan, Decker, & Madsen, 2004, for a detailed comparison of
the Bender-Gestalt Test and the Bender-Gestalt II.)
The Revision
The decision to revise the Bender-Gestalt Test was made years
before the work actually was initiated. The AOA, which owned the
copyright to the Bender-Gestalt Test, was interested in revising the
test. Ernie Hermann of AOA and John Wasserman of Riverside
Publishing were instrumental in finalizing an agreement to transfer
copyright to Riverside Publishing as well as in developing a
preliminary blueprint for the revision. A large advisory panel,
which included Lauretta Bender’s son Peter Schilder, was estab-
lished to provide input on the revision and monitor its progress.
The process of revising the test proved to be exciting and
challenging. The large group of advisors, with different theoretical
orientations, provided a wealth of ideas. Agreement did not always
come easily. In the end, though, four guidelines emerged:
1. Keep the original nine designs, but increase the number
of designs in the test.
2. Include a memory (recall) procedure.
3. Compare both deviation- and quality-based scoring sys-
tems.
4. Obtain a large, nationally representative sample.
To extend the measurement scale at both the lower and the
higher end, the researchers generated many potential designs.
Expert judges rated these designs to determine appropriateness of
difficulty and how well they fit with the original test designs.
Sixteen new designs were retained for further consideration (6 at
the lower end and 10 at the higher end of the scale of difficulty).
Following a pilot study, which used an item-response analysis to
11
evaluate the designs, 7 designs (4 easier, 3 more difficult) were
selected for inclusion in the Bender-Gestalt II.
The Bender-Gestalt II is composed of 16 designs, broken into
two separate tests: 13 designs (original 9 and 4 easier) for indi-
viduals below age 8, and 12 designs (original 9 and 3 more
difficult) for individuals aged 8 and older.
The addition of a memory (recall) procedure was based on
previous research studies that suggested that the inclusion of a
memory (recall) procedure would be useful in a variety of clinical
applications. Additionally, numerous testimonies from clinicians
revealed that a recall procedure was frequently added to the testing
procedure, but because normative information was scarce, it was
subjectively interpreted. The utility of the recall procedure comes
from the measurement of related yet different cognitive processes
involved in nonverbal recall of information. Because each individ-
ual must initially copy the designs, exposure to the items is
ensured, and inattention during exposure is reduced. This proce-
dure compliments verbal recall procedures, which are frequently
measured in psychological test batteries.
The selection of what is now called the Global Scoring System
resulted from the interaction of experts in a variety of fields (e.g.,
psychology, medicine, statistics), trial and error, and pilot studies.
The Global Scoring System evaluates the representation of each
design on the basis of its overall quality using a 5-point (0 to 4)
rating scale. The scoring system yields an individual score for each
design and total scores for the Copy and Recall phases of the test.
Initially, several objective and subjective scoring systems were
used to score the standardization data and protocols from numer-
ous clinical samples. The scoring systems were compared on a
number of criteria, including reliability, validity, and ease of use.
This research was communicated in newsletters and presentations
to advisors and consultants throughout the revision. After the
evidence was analyzed, it was clear that the Global Scoring System
had advantages over the other systems. It was shown to be reliable,
valid, and especially sensitive to clinical conditions that involved
disturbances in visual-motor functioning.
The acquisition of a large, representative normative sample was
the most significant part of the revision. This normative base was
especially important because such factors as age and development
are crucial to the interpretation of scores. The normative sample
for the Bender-Gestalt II is the largest and most comprehensive in
the history of the test. In addition to its size, it is stratified to
closely match the U.S. 2000 Census.
Validity studies were also conducted on the normative sample as
well as individuals with mental retardation, learning disabilities,
attention-deficit/hyperactivity disorder, autism, Alzheimer’s dis-
ease, and special talents. In addition to these major changes, the
Bender-Gestalt II includes Motor and Perception supplementary
tests to help detect specific problems in these areas separate from
the integration processes that are required for performance on the
Bender-Gestalt II. The information provided by these tests, in
conjunction with the Bender-Gestalt II, should aid differential
diagnosis.
The last enhancement is the addition of an observation form. On
this form, examiners can check lists to determine whether sensory
or motor factors and/or test-taking behaviors might have influ-
enced test performance. They can also record any design-copying
behavior that may have clinical relevance.
 12 BRANNIGAN AND DECKER
Research Directions
Twenty-five years ago, Tolor and Brannigan (1980) stressed the
need for research on the Bender-Gestalt Test to proceed in several
directions. Although some significant advancements have been
made (for examples, see review in Brannigan & Brunner, 2002),
the publication of the Bender-Gestalt II will, we hope, stimulate
further research in the following areas:
1. diagnosing organic pathology,
2. predicting school learning problems, and
3. assessing personality dynamics and psychopathology.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
With the innovations in the revision, the Bender-Gestalt II has
become a more dynamic assessment tool. Research in these areas
should stress its role in various phases of the assessment process
(i.e., from screening to comprehensive evaluation) and its contri-
butions, along with other tests, to differential diagnosis. We hope
many others will join us in this endeavor.
References
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Brannigan, G. G., & Brunner, N. A. (1996). The Modified Version of the
Bender-Gestalt Test for Preschool and Primary School Children—Re-
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View publication stats
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Received August 12, 2004
Accepted October 20, 2004 䡲