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Assessing children's memory

productions of the Rey-Osterrieth
complex figure
a a
Deborah P. Waber & Jane M. Holmes
a
Children's Hospital , Boston
Published online: 04 Jan 2008.

To cite this article: Deborah P. Waber & Jane M. Holmes (1986) Assessing children's
memory productions of the Rey-Osterrieth complex figure, Journal of Clinical and
Experimental Neuropsychology, 8:5, 563-580, DOI: 10.1080/01688638608405176

To link to this article: http://dx.doi.org/10.1080/01688638608405176

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 Journal of Clinical and Experimental Neuropsychology 0 168-8634/86/0805-0563 $3.00
1986, Vol. 8, NO.5, pp. 563-580 @ Swets h Zeitlinger

Assessing Children’s Memory Productions of the

Rey-Osterrieth Complex Figure”
Deborah P. Waber and Jane M. Holmes
Children’s Hospital, Boston

ABSTRACT
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This report describes (1) developmental changes in children’s memory produc-

tions of the Rey-Osterrieth Complex Figure and in the relation of memory to copy
productions, and (2) a method for evaluating these productions that is sensitive to
parameters relevant to neuropsychological diagnosis. Based on protocols from a
standardization sample of 454 children between the ages of 5 and 14 (Waber &
Homes, 1985), a system was devised for objectively evaluating organization,
production style, and accuracy. Normative findings are described and implica-
tions for the use of this instrument in the neuropsychological assessment of
children discussed.

The Rey-Osterrieth Complex Figure can be exceptionally useful as a diagnostic

instrument in the neuropsychological evaluation of children and adults (Lezak,
1982; Osterrieth, 1944; Rey, 1941). It permits assessment of a variety of cogni-
tive processes, including planning and organizational skills and problem-sol-
ving strategies, as well as perceptual, motor, and memory functions. Moreover,
administration of the task is brief, materials are simple and readily available,
and verbal demands are minimal.
As noted in a previous report (Waber & Holmes, 1985), application of this
instrument by practicing clinicians has been constrained by the absence of (1) a
valid and reliable method for assessing parameters most relevant for neuro-
psychological diagnosis, and (2) detailed developmental descriptive data. In
that report, we described developmental changes in children’s copy productions
of this figure. We also devised a system for quantifying parameters central to the
process of neuropsychological diagnosis - goodness of organization and style
(part-oriented or configurational). This system entails identification of critical
features (24 for organization and 18 for style) on the basis of which productions
are assigned to 1 of 5 levels of organization and then categorized by style within
each organizational level.

* This research was supported by a grant from the Rowland Foundation and by Reseach
Scientist Development Award MH00287 to Deborah P. Waber. We are grateful to James
Merola for assistance in the statistical analysis of the data. Address correspondence to
Deborah P. Waber, Department of Psychiatry, Children’s Hospital, 300 Longwood
Avenue, Boston, MA 021 15, USA.
Accepted for publication: November 13, 1985.
 564 DEBORAH P WABER AND JANE M. HOLMES

The typical administration of the test entails copying the figure and then
reproducing it from memory, either immediately after copying it or following a
delay period of up to 1 hour. Evaluating the copy and memory productions in
tandem provides diagnostic information that cannot be obtained from the copy
production alone. First, the kind of information lost or preserved in memory
can be a significant indicator. Some individuals retain the configuration but
omit the details, while others preserve isolated details but lose the configuration.
Some systematically delete information from the right side of the design, while
others leave out material from the left. Second, the design can undergo
significant distortion or transformation in the transition from copy to memory.
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The productions of some individuals show marked deterioration when repro-

duced from memory, while those of others improve. Some are characterized by
perseveration of specific elements, while others entail rotation of part of the
design or the whole structure. The design may be copied in a part-oriented
manner but reproduced configurationally or vice versa. In each of these cases,
similarities and differences between copy and memory productions can be
diagnostically significant.
In children, the developmental dimension renders interpretation of these
transformations even more complex. Since the process by which information is
transformed from copy to memory is likely to be age-related (Ornstein, 1978),
evaluation of the relation between copy and memory productions in children
necessitates that the clinician have an appreciation of the normal development
of these transformational processes.
It is to this need that the present study is addressed. Its first goal is to provide a
normative description of the development of children’s ability to reproduce this
design from memory. This description includes evaluation not only of the
memory productions themselves, but also of their relation to the copy produc-
tions. The second is to generate a reliable and valid method for quantifying
goodness of organization and style of the memory productions that is compat-
ible with the one derived for copy productions (Waber & Holmes, 1985).

METHOD

Subjects
The participants were the 454 children whose copy productions were described in the
previous report (Waber & Holmes, 1985). These children came from a middle- to
lower-middle-class district and ranged in age from 5 to 14 years. Children were not
screened for learning difficulties, and handedness was ascertained by self-report. Table 1
shows the age, sex, and handedness distribution of the sample. Overall, the group is
divided evenly by sex and, consistent with other estimates (Annett, 1970; Michel, 1981),
approximately 10% of the children report themselves to be left-handed.

Materials
The Rey-Ostemeth Complex Figure (Figure 1) was reproduced so that the base rectangle
I measured 8.0 cm x 5.5 cm. It was mounted on a white card measuring 20 cm x 15 cm, with
 ASSESSING REY-OSTERRIETH MEMORY 565

Table 1

Sample Characteristics
Age n Sex (%) Age in Months Handedness (%)
F M M SD R 1
5 24 62.50 37.50 67.96 2.30 83.30 12.50
6 47 48.90 51.10 78.50 2.98 89.10 10.90
7 47 53.20 46.80 89.00 3.66 91.50 8.50
8 53 47.20 52.80 102.60 3.74 94.30 5.70
9 38 47.40 52.60 113.20 3.40 94.70 5.30
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10 42 45.20 54.80 124.60 3.63 97.60 2.40

11 44 63.60 36.40 137.30 3.73 95.30 4.70
12 59 44.10 55.90 150.70 3.35 87.40 12.10
13 60 46.70 53.30 261.18 3.66 84.70 15.30
14 40 45.00 55.00 170.80 2.93 86.50 13.50
n 454 225 229 -- -- 405 41
5% 100 49.60 50.40 -- __ 90.60 9.20

an additional card of the same dimensions affixed as a cover. Each child was provided
with a piece of white peaper measuring 8% x 11 inches and five colored pencils.

Procedure
Kindergarten children were tested individually. All other children were tested in their
classroom groups. Administration of the copy conditions was as described in the
previous report (Waber & Holmes, 1985).
In order for the effect of delay on reproducing from memory to be examined systema-
tically, classroom groupings were randomly assigned to an immediate or a delay condi-

Figure 1. Rey-Osterrieth Complex Figure (from Osterrieth, 1944).

 566 DEBORAH P. WABER AND JANE M. HOLMES

tion. As a result of this procedure, 57% of the children reproduced the design from
memory immediately after copying it and 43% after a 20-min delay.
In the immediate condition, the stimulus cards and copy productions were collected
and a second piece of white paper immediately distributed. Children were instructed to
draw as much of the design as they could remember in whatever color they liked best. In
the delay condition, the examiners collected the stimulus cards and copy productions and
left the classroom. Teachers were instructed to resume their normal activities. Twenty
minutes later, the examiners returned to the classrooms unannounced and passed out
pieces of white paper. Children were told to draw as much of the design as they could
remember, again using whatever color pencil they preferred.
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Data Reduction
Objective Rating
The goal of the data reduction procedure was to code objectively as much information as
possible from the drawings.' Prior to coding, all identifying information (name, age,
handedness) was removed and a random identification number was assigned to each
protocol.
Accuracy. Accuracy was coded by the same system applied to the copy productions
(Waber k Holmes, 1985). As illustrated in Figure 2, the design was broken down into the
smallest line segments possible and each segment categorized as belonging to one of the

A B

C D

Figure 2. A. Base recta,ng!e,(l2 elements). B. Main substructure (13 elements).

'
C. Outer
configuration (27 eltments). D. Internal detail (13 elenimts).
 ASSESSING REY-OSTERRIETH MEMORY 567

four major components of the structure: base rectangle (BR); main substructure (MS);
outer configuration (OC); and internal detail (ID). Line segments were coded as either
present or absent.
Alignments and Intersections. Analysis of the copy productions (Waber & Holmes,
1985) yielded 24 critical features (intersections or alignments of line segments) on the
basis of which goodness of organization could be reliable specified. These 24 features
were coded as present or absent for the memory productions as well (see Figure 3).
Continuity of Lines. Analysis of the copy productions also revealed 18 critical junctures
on the basis of which style could be specified. For the memory productions, these
junctures were scored present if they were drawn with one continuous line and absent if
they were drawn in separate segments.
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Errors. Four kinds of errors were coded: (1) conflation or use of one line to represent
more than one part; (2) rotation of a part of a figure or of the whole figure; (3)
perseveration; and, (4)misplacement. Both the copy and the memory productions were
scored for frequency of errors according to these categories.
Each drawing was scored by one of two judges. In order to assure reliability, a random
sample of 50 protocols was scored independently by both judges. Agreement exceeded
94% for accuracy, alignments and intersections, style junctures, and errors.

Clinical Rating
As was the procedure for the copy productions, the memory productions were rated
clinically for goodness of organization and style. The organization rating was based on a
5-point scale ranging from poor (1) to excellent (5). The style rating included four
categories: (1) part-oriented; (b) exterior configurationaVinterior part-oriented; (c) exte-
rior part-orientedhterior configurational; and (d) configurational. The ratings were
carried out by two judges (JMH and DPW) who were blind to the identity (e.g., age, sex)
of the children as well as to their organization and style scores on the copy production.
Agreement was reached on all protocols. Protocols were rated in two separate passes,
first for organization and then for style, so that judgments for the two parameters would
be independent.
The clinical organization ratings were systematically related to age ( r=.645,p < .01).
Moreover, as was the case for the copy productions, the predominant style shifted from
part-oriented to configurational as organizational goodness increased (x2=201.24, p <
.01). Table 2 shows the distribution of clinical rating scores for organization and style for
both the copy and memory productions.

RESULTS

Descriptive Findings
Analysis of the descriptive findings was aimed not only at the memory produc-
tions themselves but also at their relation to the copy productions. Four areas
were addressed: accuracy, that is, how much of the design was recalled; errors,
o r distortions; organization (clinical ratings and specific critical features); and
style (clinical ratings and criteria1 features). For purposes of these analyses, the
designs were grouped into five categories according to the organizational level
of the copy production, using the scoring criteria set forth previously (Waber &
 568 DEBORAH P. WABER AND JANE M.HOLMES
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Figure 3. Organizationalcriteria: Intersections(1-13); Alignments (14-24).

Holmes, 1985). Organizational level was deemed preferable to age for this
purpose since the copy productions, which were to serve as a baseline of
comparison for the memory productions, would be grouped most homoge-
neously. For purposes of reference, however, age norms are presented as well.
Accuracy. Accuracy scores (total number of parts reproduced) were derived
for the four subcategories of parts (BR, MS,OC, and ID) and submitted to a 5
(Organizational level-copy) x 2 (ImmediateAIelay) x 2 (Copy/Recall) analysis
 ASSESSING REY-OSTERRIETH MEMORY 569

Table 2

Joint Distribution by Percent of Clinical Organization and Style

Ratings for Memory and Copy (in parentheses) Productions
Level P oc-IP ~
OP-IC C ~~

I 67.0 (66.1) 10.6 (10.2) 4.3(11.9) 18.1 (11.9)

I1 22.8 (47.1) 29.7 (23.1) 0.0 (19.2) 47.5 (10.6)
111 3.7 (40.0) 31.8 (16.3) 0.0 (12.6) 64.5 (31.1)
IV 2.9 (26.7) 25.0 (22.9) 2.9( 8.6) 69.1 (41.9)
V 1.2 (20.7) 15.7 (17.2) 1.2 (5.2) 81.9 (56.9)
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P = Part-oriented
OCAP = Outer configurational-inner part
OPAC = Outer part-inner configurational
C = Configurational

of variance. Means appear in Table 3. Effects reported here are significant at a

probability level of .01 or less.
The accuracy of both the copy and memory productions increased with
organizational level for all categories of parts, most of the increase occurring

Table 3

Mean Number of Parts Reproduced within Each Category in Copy and Recall Condi-
tions for Children Grouped by Copy Organization Level and Immediate (I) or Delay (D)
Memory Condition
I I1 111 IV V
I D I D I D I D I D
Base rectangle (12)
Copy 8.2 9.4 11.5 11.2 11.7 11.9 12.0 12.0 12.0 12.0
Recall 9.2 9.3 11.9 10.9 11.6 11.3 12.1 11.5 11.8 12.0

Main substructure (13)

Copy 9.0 9.2 12.3 11.3 12.7 12.8 12.9 12.9 13.0 13.0
Recall 7.1 6.4 10.4 8.5 10.6 10.5 11.9 11.1 12.0 13.0

Outer configuration (27)

Copy 20.5 21.1 25.7 25.1 26.1 26.0 26.7 26.3 26.9 26.9
Recall 14.5 13.8 20.9 18.5 20.3 22.0 22.0 20.7 21.7 20.6

Internal Detail (13)

Copy 7.1 8.1 11.6 10.2 12.6 12.4 12.4 12.7 12.9 12.8
Recall 4.7 3.6 6.6 4.0 6.6 5.8 8.3 4.9 7.9 7.0
Note: Numbers in paratheses indicate total number of parts in the category.
 570 DEBORAH P. WABER AND JANE M.HOLMES

between Levels I and 11. Children reproduced fewerparts in the memory than in
the copy condition, except for the base rectangle,which was reproduced equally
well in both conditions. The main substructure was less accurately produced
from memory than was copy at the lower levels of organization, but by level V it
too was reproduced equally well in copy and memory. Finally, the 20-min delay
affected recall of internal details only, recall for other parts being equivalent in
the immediate and delay conditions.
Given the significance of lateral asymmetries for neuropsychologicaldiagno-
sis, it was of interest to examine the amount of information recalled from the left
and right sides of the design. For this purpose, a ratio of the proportion of parts
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produced on each side was computed and matched pairs t tests carried out
within each organization group. At Level I (copy organization), more informa-
tion was reproduced from the left than the right side ( r < .05), and at Level IV,
more information was reproduced from the right than the left ( r < .05). There
were no differences at other levels. A similar analysis within age groups revealed
a left-side advantage up to age 8 ( r < .05), but none thereafter (see Table 4),
consistent with the developmental pattern shown in the copy condition.
To summarize, the organizing structures, that is, the base rectangle and main
substructure, are remembered best. Structures incidental to the logic of the
figure, the outer configuration and internal details, tend to be lost in memory.
Delaying recall affects memory for details, but structural elements are preser-
ved. Finally, young children recall more information from the left than the right
sides, but this difference disappears after age 8.
Errors. Differences between the immediate and delayed-recall groups in
committing each type of error were evaluated by Chi-square tests camed out
within each organizational level. Since differences were detected for fewer than

Table 4

Mean Proportion of Parts Recalled from Left and Right Slides by Age
Side
Age Left Paired- ?-Statistic
5 41 31 1.91*
6 61 50 2.32*
7 68 63 2.13*
8 74 69 1.59
9 75 81 -1.90
10 79 80 -.37
11 78 80 -.99
12 79 83 -1.93
13 79 81 -1.05
14 75 78 -1.13
*p<.05
 ASSESSING REY-OSTERRIETH MEMORY 57 1

5% of the possible comparisons, it was concluded that these could be attributed

to chance and, hence, memory delay does not affect the likelihood of commit-
ting errors. For purpose of further analysis comparing copy with memory, the
immediate and delay groups were collapsed.
Total number of errors committed in the copy and recall conditions was
compared by paired t tests within each organizational level. Prior to these
analyses, the frequencies were adjusted for the presence of absence of the
affected part to assure that the child had the opportunity to commit the error.
Thus, the outcome measure was the number of errors committed divided by the
number of parts reproduced for which errors could occur. At every organization-
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al level, errors occurred with greater frequency in the memory than in the copy
condition ( p < .Ol). Analysis of individual error types (according to the part
affected and the nature of the error) was carried out by McNemar tests. These
analyses revealed that the bulk of these errors involved internal details, which
were either perseverated, rotated, or misplaced.

Table 5

Percentile Distribution of Total Number of Errors and Mean Number of Errors by Age
for Copy and Recall Conditions
%-ile

25 50 75 100 Error Score

5 COPY 0 1 2 4 .08
Recall 0 0 1 3 .17
6 COPY 0 1 2 6 .07
Recall 0 1 2 5 .18
7 COPY 0 1 1 6 .04
Recall 0 2 3 7 .17
8 COPY 0 1 2 4 .04
Recall 1 2 2 6 .13
9 COPY 0 0 1 4 .03
Recall 0 1 2 5 .09
10 COPY 0 0 1 4 .02
Recall 1 2 3 5 .12
11 COPY 0 0 1 2 .01
Recall 0 1 3 6 .ll
12 COPY 0 0 0 3 .01
Recall 0 1 2 5 .08
13 COPY 0 0 0 2 .oo
Recall 0 1 2 5 .09
14 COPY 0 0 0 1 .01
Recall 0 2 2 4 .07
Note: Total number of errors is not adjusted for accuracy;mean error score is adjusted
for accuracy.
 572 DEBORAH P.WABER AND JANE M.HOLMES

For descriptivepurposes, Table 5 is presented. It shows the distribution of the

total number of errors committed in the copy and recall condition within each
age group. No adjustment is made for the presence of affected parts. Paired t
tests, with the adjustment for presence of the affected parts within each age
group, revealed differences ( p < .01) between the copy and recall conditions at
every age level.
Organization. Clinical ratings of organization for the memory productions
were closely related to those for the copy productions ( r = .69;p < .O 1): 45% of
the productions received the same rating for both copy and memory, and only
15% were discrepant by more than one level.
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Style. Although the clinical style ratings for copy and memory were strongly
correlated as well ( r = .51; p < .Ol), there was less consistency than had been
observed for the organization ratings: 26% of the productions were discrepant
by more than one level. This was due to a general shift to a more configurational
style in the memory condition. In the copy condition, 30% of the designs were
classified as configural, while 55% were so classified in the memory condition.
Indeed, in the memory condition, part-orientation past Level I1of organization
was exceedinglyrare. Children in the delayed-memorycondition rendered even
more configurational productions than did those in the immediate condition
(X2=2.3,p < .03): 49% of the memory productions were classified as configura-
tional in the immediate group, while 62% were so classified in the delay group.
In order to determine how this shift to a more configurational style in
memory is related to age, comparisons were carried out for groups selected at 5,
7, 10, and 13 years of age. Among 5-year olds, the distribution of style ratings
was equivalent for the copy and memory productions. At each age after 5 ,
however, memory productions were rated as more configurational than copy
productions 0,< .05, Wilcoxon Matched-Pairs Signed Ranks Test). The pro-
portion of children who shifted toward a more configurational memory produc-
tion was equivalent across the three older age groupings (43%, 40%, and 44%),
but only 21% among the 5-year olds. Conversely, the proportion of children
who shifted to a more part-oriented memory production decreased with age,
from 21% among 5-year olds to 7% among 10- and 1Zyear olds.
Examination of the frequency of executing the 18 critical style junctures
indicated that, at each age, the shift from copy to memory was essentially the
same: The base rectangle was consolidated and became the primary organizing
feature of the memory production. The likelihood of drawing the sides of the
base rectangle in continuous strokes increased, .while the likelihood of tracing
around the exterior of all or part of the design decreased. Figure 4 shows
representative examples of the typical transformation from copy to recall.

Development of Scoring Procedures

As was the case for the copy productions (Waber & Holmes, 1985), the major
aims of this portion of the data analysis were (1) to determine which specific
features of the productions were most salient for the judges, and (2) to quantify
 ASSESSING REY-OSTERRIETH MEMORY 573

L
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Figure 4. Representative examples of transformationfrom copy to recall. A. 10 year old

boy. B. 7 year old girl.

and order them in such a way that they could be applied reliably by other
clinicians and researchers in evaluating children’s productions. Further, the
results of this analysis highlight the nature of developmental changes in the
organization and style of the memory productions.
In devising a procedure for scoring the copy productions, we applied discri-
minant function analysis to identify criterial features for scoring the parameters
of interest. Those analyses identified 24 criterial features for organization and
18 for style. In the interest of consistency, only these features were considered in
constructing a system for scoring the memory productions.
Organization. A system for scoring the organization of the memory produc-
tions was derived in a manner similar to that applied to the copy productions.
Discriminant function analyses were carried out on a random sample of 50% of
the protocols. The 24 criterial organization features were entered as discriminat-
ing variables and a function derived that best discriminated each contiguous
pairing of clinically assigned organizational levels (e.g., I vs. 11, I1 vs. 111, etc.).
These analyses were used in a descriptive way, in conjunction with frequency
distributions, to guide the construction of the scoring system.
Based on these analyses, 16 discriminating features were identified. These
included: (a) the four corners of the base rectangle (1-4 Figure 3); (b) alignment
of the four sides of the base rectangle (14, 15, 16,20,21,23,24in Figure 3); (c)
intersection of the main horizontal and vertical (6 in Figure 3); and (d) intersec-
tion of the main diagonals with the main horizontal and vertical (5,7 in Figure
3). As would be predicted from the descriptive data, alignment of the base
rectangle with structures incidental to the logic of the figure (outer configura-
 574 DEBORAH P. WABER AND JANE M. HOLMES

tional structures, interior box) did not discriminate organization for the
memory productions.
Since different subsets of features discriminated different pairs of organiza-
tional levels, the scoring system was structured in a hierarchical fashion. If a
protocol had all the features required for Level I, the rater could then go on to
determine whether it had the features required for Level 11, and so forth until a
basal level was obtained. Criteria1features achieved above the basal level were
treated as extra points and used to assign the protocols to one of three sub-levels
within each of the major levels (except V). The criteria for each level are
described in detail in Table 6 and illustrative examples shown in Figure 5.
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Using this system, devised on the basis of the random sample, scores were
generated by computer for the full sample and compared with the clinical
ratings. Agreement was achieved for 51% of the caases; discrepanciesexceeded
more than one level for only 11.8% (see Table 7). The correlation between the
objective and clinical ratings was .77 ( p < .OOOOl). This level of agreement
compares favorably with that achieved for the copy productions (Waber &
Holmes, 1985), for which the overall level of agreement was 52% and the
correlation between objective and clinical ratings was .82.

Table 6

Criteria for Levels of Organization

Level I: Any design that does not satisfy criteria for Level 11.
Level 11: (1) Upper and lower left comer of base rectangle;
(2) Left side of base rectangle aligned;
(3) Lower horizontal of base rectangle aligned at the middle;
(4) Lower horizontal aligned at lower left box or middle horizontal aligned
at left center box or upper horizontal aligned;
Level 111: (1) Upper and lower left corner of base rectangle;
(2) Lower right corner of base rectangle;
(3) Four sides of base rectangle-aligned;
(4) Middle vertical aligned at center or middle horizontal aligned at left cen-
ter box or main horizontal and vertical intersect or main diagonals
intersect
Level IV: (1) Upper and lower left corner of base rectangle;
(2) Lower right corner of base rectangle;
(3) Four sides of base rectangle aligned;
(4) Diagonals of base rectangle intersect;
( 5 ) Main horizontal and vertical intersect or middle vertical aligned at cen-
ter or middle horizontal aligned at left center box
Level V: (1) Four corners of base rectangle aligned;
(2) Four sides of base rectangle aligned;
(3) Main horizontal and vertical aligned;
(4) Diagonals aligned;
(5) Horizontal, vertical, and diagonals intersect.
 ASSESSING REY-OSTERRIETH MEMORY 575

LEVEL I LEVEL I I 1 LEVEL 111

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LEVEL I V LEVEL V

Figure 5. Representative examples of figures scored at 5 levels of organization.

As was the case for the copy productions, inclusion of sublevels made it
possible to assign to each protocol a score based on a 13-point scale (3 sublevels
at each level from I through IV, plus level V). Mean values of these scores for
each of the age groups appear in Table 8. These mean values increase as a
monotonic function of age, and variability within age levels is fairly uniform
across age groups. Moreover, correlation of these schores with the analogous
scores for the copy productions, with age partialled out, revealed a systematic
association between them ( r = .29, p < .01).
Table 7

Concordance (by Percentage) of Clinical and Objective Organization Ratings for

Memory Productions
Objective

I I1 I1 IV V
Clinical
I 80.2 16.5 2.2 1.1 0.0
I1 39.3 37.1 21.3 2.2 0 .o
I11 15.3 26.3 27.3 29.3 2.0
IV 11.8 19.1 14.7 35.3 19.1
V 3.6 2.4 2.4 14.5 77.1
 576 DEBORAH P.WABER AND JANE M. HOLMES

Table 8

Means and Standard Deviations of Organization Scores by Age Groups

M SD
5 1.72 1.08
6 3.82 2.76
7 4.79 3.7 1
8 4.82 3.43
9 7.20 4.10
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10 8.61 3.99
11 8.62 4.01
12 8.07 4.25
13 9.19 4.07
14 9.51 3.93

A random sample of 50 protocols was scored independently by two raters.

Interrater reliability for scoring organization was .94. The same protocols were
also scored according to the Osterrieth system, revealing a high correlation
between it and the organization score ( r = .@).
Style. The system for scoring style, unlike the one devised for scoring organi-
zation, required a different approach from the one that had been applied to the
copy productions. Because a significant amount of information could be mis-
sing from the memory productions, especially at the lower levels of organiza-
tion, the style score had to be derived on the basis of those parts that were
remembered rather than the whole figure as presented to the subject. The
style-scoring system was based on those structures which had been determined
to be critical for scoring organization. Accordingly, four structural units were
used for this purpose: (1) the horizontal sides of the base rectangle; (2) the
vertical sides of the base rectangle; (3) the diagonals; (4) the main horizontal and
vertical. A line was scored as present if all or part of it were present. A line was
scored as present if all or part of it were present. A ratio score was then
computed to indicate what proportion of the lines present had been drawn in a
continuous fashion. For example, if both diagonals were present and drawn
continuously across the midline, the score would be 2/20r 1.O. If only a segment
of one diagonal were present, the score would be 0/1 or 0. These ratios were
computed for each of the four structures listed above.
Within each organizational level (as determined by the objectivescoring), the
clinical style ratings were regressed on these four ratios. Since the outer part-
inner configurational style category was rare for the memory productions
(Table 2), this category was dropped, leaving three categories, part-oriented,
intermediate, and configurational.
A style score was devised based on the proportion of variance accounted for
by each of the predictor variables. The formulas thus derived are shown in Table
 ASSESSING REY-OSTERRIETH MEMORY 577
Table 9

Formula for Computing Style Score

A Horizontal sides of base rectangle (# continuous/# present)
B Main horizontal-vertical (# continuous/# present)
C Main diagonals (# continuous/# present)
D +
A B (# continuous/# present)

Criteria1Values of Style Score

Part Configurational
Level I: D 0.0 x.5
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Level 11: A + (IOxC) 0.5 >6.0

Level 111: B + (1OxC) 0.5 >5.5
Level IV: B + (3xC) 0.5 >3.0
Level V C 0.0 1.o
Note: Intermediate style values are those that fall between part and configurationa1.

9. Cut-off points were then chosen within each organizational level so that the
distribution of these objectively derived scores would best approximate the
clinical ratings. On this basis, 74% of the designs were classified in accordance
with clinical ratings, with less than 5% deviating by more than one classification
(Table 10). Again a random sample of 50 protocols was scored by two indepen-
dent raters. Agreement was achieved for 87% of the protocols.

DISCUSSION

As was the case for the examination of the copy productions, the first goal of the
present study was to describe developmental changes in children’s productions
Table 10

Concordance (by Percentage) of Clinical and Objective Style Rations for Memory
Productions
Objective

P I C
Clinical
P 57 32 11
I 14 57 28
C 4 6 90
P = part-oriented
I = intermediate
C = configurational
 578 DEBORAH P. WABER AND JANE M. HOLMES

from memory of the Rey-Osterrieth Complex Figure. Total accuracy, in terms

of the number of parts recalled, was not achieved for the memory productions,
even by the oldest children. More significantly, certain categories of parts were
recalled better than others. The base rectangle and main substructure were
recalled almost perfectly from age 9 onwards, while structures more incidental
to the logic of the figure were remembered far less well, even among the oldest
children. Material on the left side of the design was recalled better than that on
the right up to age 8, at which point recall for the two sides was equivalent.
Delaying recall resulted in further loss of internal details, but other parts of the
design were recalled equally well with the delay and without it.
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Errors and distortions, which were rare on the copy productions, occurred
with far greater frequencyin recall, even in well-organizedproductions. internal
details were most vulnerable to errors, primarily perseveration and misplace-
ment. The organizing structures (base rectangle and main substructure) were
vulnerable to conflation, that is, using one line to represent two parts, and
rotation.
Examination of the clinical ratings for the style parameter reveals the same
developmental progression from part-oriented to configurational seen for the
copy productions. Indeed, at the lowest organizational level, the distribution of
style ratings for the copy and memory productions are nearly identical. At Level
11, however, a marked shift toward more configurational memory productions
is seen so that, by Level 111, part-orientation in the memory productions is
exceedingly rare.
To summarize the normative findings, (1) the organizing structures are
remembered better than incidental details at all ages; (2) material on the left side
of the design is remembered better than that on the right until age 8; (3) errors
and distortions are more frequent on the memory than the copy productions at
every age but are not affected by memory delay; (4) memory productions are
produced more conf"gurational1y than copy productions except among the
youngest children; and ( 5 ) delaying the memory production results in further
loss of details and a more marked shift to a configural approach.
A second goal of the study was to develop a valid and reliable method for
evaluating children's memory productions in terms of organizational goodness
and style. Using criteria comparable to those used for the copy production, a
scoring system was devised whose level of agreement with clinical ratings
equalled that achieved for the copy productions (Waber & Holmes, 1985). In
addition, interrater reliability was very high.
The features determined to be critical for the scoring system provide insight
into the development of the organizational process. In general, organization of
the design centered on the base rectangle and main substructures. Structures
external to the base rectangle, which were important determinants of organiza-
tional goodness for the copy productions, were not criteria1 for the memory
productions. The left side of the design was organizedfirst, followed by the main
horizontal and vertical, and then the diagonals. This sequence, which was seen
 ASSESSING REY-OSTERRIETH MEMORY 579

in the copy productions as well, is in keeping with accounts of the developmen-

tal course of the perception of structure in mid-childhood (Chipman & Mendel-
son, 1979; Mendelson, 1984), which indicate that perception of the horizontal
and vertical in complex visual arrays precedes perception of diagonals. In
contrast with the copy productions, however, for which the whole base rect-
angle was a salient organizing structure at Levels IV and V only, the base
rectangle emerges as the primary organizing structure at a much earlier level for
the memory productions. This is consistent with the more configural approach
seen in memory, as noted above.
Examination of the criterial features for rating style indicate that the main
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diagonals are criterial determinants of style at every level of organization. At the

lower levels, the sides of the base rectangle are criterial as well, but disappear as
determinants at Level 111, presumably because most children draw the base
rectangle in a continuous fashion by that point. At Levels I11 and IV, the main.
horizontal and vertical and the diagonals are criterial. By Level V, the diagonals
alone are criterial. It is important to bear in mind in using the system that,
since it was derived on the basis of discriminant function analysis, the criteria
yield a classification that is relative rather than absolute. That is, features are
chosen that yield the best discrimination of categories from one another. At an
absolute level, therefore, idiosyncrasies of individual productions may lead to
apparent misclassifications because of the heavy weight assigned to particular
features (generally the diagonals) in order to achieve the best discrimination for
the total sample.
From a clinical standpoint, the normative findings have a number of impor-
tant implications for users of this instrument.' First, part-orientation in the
memory productions is very rare after age 9 and therefore should be viewed as
significant in an older child or adult (see also Visser,1973). Second, errors or
distortions are fairly common in the memory condition but rare in the copy
condition. Errors in the copy condition and an excessive number of errors in
recall are therefore likely to indicate pathology. Given the potential significance
of these findings, clinical use of the instrument should not rely solely on the
organization and style ratings; other parameters, such as accuracy (overall and
of subcategories), errors, and asymmetries, all of which may be equally
significant diagnostically, should be considered as well.
Finally, the findings provide insight into the development of memory for
complex visual material, about which little is known. The predominance of the
gestalt in memory is of particular interest. Further work is currently underway
in our laboratory to ascertain whether this transformation occurs in the encod-
ing or retrieval phase of the memory process. Determining the nature of the
memory process will be of significance in interpreting clinical data from cases
where this shift fails to occur.

A manual based on the results described in this paper and in Waber and Holmes
(19851, which provides detailed instructionsfor using the scoring system, is currently
in preparation by the authors.
 580 DEBORAH P. WABER AND JANE M. HOLMES

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