Communication Art, Inc.

Dementia Tools

Reality Comprehension Clock Test
Dementia Populations Gift of Purpose Programs

"Focus is on skills that remain, not on those that are lost."


About the Reality Comprehension Clock Test

A dignified, standardized assessment that is easy to administer and easy to score.  The RCCT is designed to evaluate reality comprehension skills and assist in establishing functioning range, functional age, stage of deterioration, potential memory deficits and fall risk of the elderly cognitively impaired.


The RCCT Assesses:

  • Comprehension of task
  • Visual spatial awareness
  • Number recognition
  • Visual task performance
  • Number sequence
  • Orientation to time
  • Shape/line recognition and recall

Patients are directed to view a picture of a clock drawing, then replicate it to the best of their ability.  The results are then scored and interpreted by a trained, certified RCCT administrator.  The data is used to establish appropriate care plans, goals and objectives.  The RCCT manual contains rational of use, clock drawings and scoring examples, normative data, and research tables.

Content validity of the RCCT established by review of the literature and use of experts in the field of reality orientation and cognitive functioning.  Seven experts included Phd's and an MD.  The PhD's represented the fields of nursing, occupational therapy, psychology, and recreational therapy.  All experts had extensive experience with nursing home residents and had published articles, books, and rating scales in the areas of reality orientation and low level cognitive functioning (comprehension).

Interrater reliability established.  RCCT 1999 Brock, B. et al

The RCCT May Be Administered:

  • When score on Mini Mental Status Exam is 23 or below.  Folstein, M.F., et al (1975)
  • When Brief Interview of Mental Status (BIMS) Score is <13 or 99
  • Pre-admission
  • Admission
  • Quarterly
  • Annually
  • Upon Significant Change

RCCT Currently Being Used In:

  • Physicians' offices
  • Long-term care facilities
  • Assisted living facilities
  • Adult daycares
  • Mental health clinics
  • DD workshops
  • Home healthcare agencies
  • Non-Medical Home Care services
  • Adult Protective Services
  • OT Private Practice
  • Geriatric Care Managers Private Practice
  • Physical Therapists
  • Hospital in Beijing, China
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