The Clock Drawing Test: A Quick Cognitive Assessment as an OT

As an occupational therapist in acute care, you often need fast, effective tools to assess cognition—especially when time is limited, and your patient might be fatigued, medically complex, or preparing for discharge. One powerful and simple screening tool? The Clock Drawing Test (CDT).

What Is the Clock Drawing Test?

The Clock Drawing Test is a brief cognitive screening tool that evaluates multiple brain functions, including:

  • Executive functioning

  • Visual-spatial skills

  • Numerical understanding

  • Attention and memory

  • Motor planning

It’s a quick way to flag potential impairments in patients who may otherwise appear alert and oriented.

How to Administer the CDT

Supplies: Paper and pen/pencil - click here for template

Instructions to the Patient:

“Draw a clock. Put in all the numbers, and set the hands to 10 past 11.”

This specific time (11:10) is recommended because it requires the patient to distinguish two different hand lengths and mentally organize spatial and numerical layout.

What You’re Observing

You’re not just looking at whether they can draw a clock — you're analyzing how they organize information, plan, and execute the task.

Look for:

  • Are all 12 numbers present and spaced appropriately?

  • Are the numbers in the correct sequence?

  • Do the hands clearly represent the time?

  • Are the hands pointing in the right direction, and is the minute hand longer?

  • Does the clock resemble a circle?

Why It’s Useful in Acute Care

In acute care, your patient might:

  • Be recovering from a stroke, delirium, or TBI

  • Have underlying dementia or neurological changes

  • Be medically stable but showing subtle signs of confusion or poor safety awareness

How to document

“Clock Drawing Test completed per verbal instructions. Patient placed numbers 1–12 in correct order but spacing was uneven. Hands were placed correctly to indicate 11:10. Minor visual-spatial deficits noted. Results suggest mild cognitive impairment; further evaluation recommended.”

OR

“CDT revealed significant cognitive deficits. Only 8 numbers placed; hands not drawn. Indicates poor executive functioning and visual-spatial processing; OT to continue cognitive assessment and monitor safety with ADLs.”

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Diplopia Exercises in OT

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Testing Proprioception in the Hospital Setting as an OT