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BIT – Neglect Assessment — SCE Neurology MCQ

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ModerateNeurorehabilitationBIT – Neglect AssessmentSCE Neurology

A 65-year-old man with a right hemisphere stroke has left visual neglect. His occupational therapist assesses neglect using the Behavioural Inattention Test (BIT). What does the BIT assess?

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Correct answer: D — The BIT is a standardised comprehensive assessment of visual neglect that includes conventional subtests (line crossing, letter cancellation, star cancellation, line bisection, figure copying, drawing) and behavioural subtests (functional tasks like reading a menu, telling the time, setting a table) — it assesses the functional impact of neglect on daily activities

The BIT is the gold standard assessment for visual neglect. It has two components: (1) conventional subtests — paper-based screening tasks (line bisection, cancellation tasks, figure copying), and (2) behavioural subtests — real-world functional tasks (reading a menu — do they miss the left side?; telling the time on a clock; coin sorting; map navigation; article reading). The behavioural subtests are particularly important because they measure the functional impact of neglect on everyday activities, which directly informs rehabilitation goals and discharge planning. A: Visual fields are assessed separately (perimetry). C: Motor function uses different tools. D: Speech uses aphasia assessments. E: Mood uses validated mood scales.

Reference: RCP Stroke Guidelines; BIT (Wilson et al.)