Neuropsychological tests allow us to evaluate people to determine cognitive status and other higher functions.

The Benton Visual Retention Test is a test used to determine whether a patient has impaired visual perception and memory, as well as other motor skills involving copying and reproduction of shapes and drawings.

Below we explain in more detail what the Benton Visual Retention Test consists of and what it assesses, what its main characteristics are, how it is applied and corrected, and the uses to which it is put in clinical practice.

What is the Benton Visual Retention Test and what does it evaluate?

The Benton Visual Retention Test is a neuropsychological test originally developed by A.L. Benton and designed to assess cognitive impairment in three main areas: visual perception, visual memory and visoconstructive skills.

Visual perception is a concept that involves the interpretation that our brain makes of the different stimuli received through the sense of sight. This perception encompasses a whole set of processes by which a person organizes, selects and interprets, in a meaningful way and through his or her previous experience, visual information. It is an active process in which not only information is captured, but also transformed and given meaning and coherence.

As far as visual memory is concerned, it allows us to identify a stimulus, examine it and assign a meaning to it. This type of memory involves a process of perception, coding, storage and retrieval of stored knowledge and representations arising from cognitive processing. Visual memory uses information to evaluate, compare and locate objects, places and people, through the construction of a mental image.

On the other hand, visoconstructive skills refer to the capacity we have to plan and execute the movements necessary to organize a series of elements in space and form two or three-dimensional drawings and structures.

Characteristics

The Benton Visual Retention Test has demonstrated its sensitivity to literacy problems, non-verbal learning problems, traumatic brain injury, attention deficit disorder , Alzheimer’s disease and other forms of dementia.

This test has been validated as effective in the evaluation of difficulties in the perception of spatial relationships and in the memory of newly acquired visual stimuli, as well as for the diagnosis of brain damage, both in children and adults.

Studies confirm that the test is reliable and there is a correlation between the different forms of the test, although there is evidence that administration A in form C seems slightly simpler than forms D and E.

The validity of the Benton Visual Retention Test has also been confirmed , using other neuropsychological tests, such as the King’s complex figure test or the WAIS cube test, and also through the comparison between different groups of patients (with cognitive impairment and alterations) and healthy subjects.

However, this neuropsychological test does not appear to have specific sensitivity to lesions in the right hemisphere hippocampus, unlike other tests such as the Warrington Face Memory Test or the Wechsler Face Memory Subtest (WSM-III).

Application and interpretation mode

The Benton Visual Retention Test has 3 alternative, yet equivalent, forms (C, D, and E) that can be administered under different conditions. During the test, the patient is presented with 10 cards (most contain 3 figures, two large and one small) for several seconds, with unique designs on each one.

After each administration’s time has elapsed, the person is asked to make an immediate reproduction of the design of each card (in a visual memory exercise).

In the second phase, you are asked to copy from each of the 10 card designs , with the cards in view. The results of each task are evaluated and transcribed into six categories: omissions, distortions, conservations, rotations, misplacements and size errors.

The final score varies from 0, if many mistakes are made, to 10, if everything is correct. The test should be corrected taking into account the patient’s age and IQ.

The following are the four possible types of test administration :

  • Exposure for 10 seconds and immediate playback of the memory.
  • Exposure for 5 seconds and immediate reproduction of the memory.
  • Copy of the drawings (no time limit). For older adults with advanced cognitive impairment.
  • Exposure for 10 seconds and deferred playback of the memory (after 15 seconds).

Clinical uses of the test

The Benton Visual Retention Test is sensitive to cognitive impairment, brain injury, and various mental illnesses, although it is difficult to diagnose a particular disorder using this test.

Regarding the test results, it has been shown that a large number of perseverations could suggest frontal lobe damage, while many omissions in peripheral designs would suggest possible brain trauma, especially in the right parietal lobe.

On the other hand, the overall performance in the test does not seem to distinguish between people with unilateral damage in the left or right hemisphere . However, it seems that clinicians are able to distinguish between motor, perceptual or memory impairments, depending on the analysis of the test results.

The diseases that have been shown to greatly reduce an individual’s test score are dementias, brain injuries, thalamic stroke and Alzheimer’s disease .

Both the copy and recall versions appear to be particularly sensitive to the detection of dementias, and may help identify subjects at risk of developing Alzheimer’s disease in the future. The test has also been able to detect children with learning difficulties.

Finally, it should be noted that the Benton Visual Retention Test was one of the tests included in the World Health Organization’s NCTB battery more than 30 years ago, with the aim of being able to identify the effects caused by chemical exposure on the human nervous system; since then, it has continued to be used to assess such exposure in the workplace, showing high sensitivity to various chemical components, such as mercury, lead or pesticides.

Bibliographic references:

  • Benton, A. L., Abigail, B., Sivan, A. B., Hamsher, K. D., Varney, N. R., & Spreen, O. (1994). Contributions to neuropsychological assessment: A clinical manual. Oxford University Press, USA.
  • Benton, A. L., Varney, N. R., & Hamsher, K. S. (1978). Visuospatial judgment: A clinical
  • test. Archives of Neurology, 25, 364-367.
  • Vidal, J. L. B., & Campos, E. R. (2009). Benton’s visual retention test in adult brain injured. Quaderns de Psicología, (18), 19-35