Applied Neuropsychology Copyright 2000 by

2000, Vol. 7, No. 4, 252–258 Lawrence Erlbaum Associates, Inc.

The Corsi Block-Tapping Task: Standardization and Normative Data THE CORSI BLOCK-TAPPING
KESSELS ET
TASK
AL.

Roy P. C. Kessels
Psychological Laboratory, Utrecht University, Utrecht, The Netherlands
Martine J. E. van Zandvoort
Psychological Laboratory, Utrecht University, Utrecht, The Netherlands, and
Department of Neurology, University Medical Center, Utrecht, The Netherlands
Albert Postma
Psychological Laboratory, Utrecht University, Utrecht, The Netherlands
L. Jaap Kappelle
Department of Neurology, University Medical Center Utrecht, The Netherlands
Edward H. F. de Haan
Psychological Laboratory, Utrecht University, Utrecht, The Netherlands

This article describes a standardized administration and scoring procedure for the widely used
Corsi Block-Tapping Task, designed to assess the visual memory span. This method was ap-
plied in a group of healthy participants (n = 70) and a group of patients with cerebral lesions (n
= 70), that were categorized on the basis of lesion location (left or right hemisphere, bilateral
or subcortical). The percentile distribution as well as cutoff points on the basis of the control
data are provided. It was found that 20% of the patients perform in the borderline range on this
task, and over 8% have an impaired performance (“retarded”). In addition, right hemisphere
patients performed worse than left hemisphere patients. These data show that the Corsi
Block-Tapping Task can be effectively used to assess visuospatial short-term memory in pa-
tients with brain damage, and is selective for the side of the lesion.

Key words: spatial span, memory test, Corsi, normative data, lateralization, stroke

The Corsi Block-Tapping Task is widely used for
the assessment of visuospatial short-term memory,
both in clinical practice and in experimental research
settings. Basically, it is a span task and, as such, a
visuospatial analogue to the digit span as an index of
verbal short-term memory (Lezak, 1995). Originally
developed by Corsi (1972), this test entails simple mea-
surements that can be administered quickly and easily,
even with patients who are difficult to test. The task
consists of nine cubes mounted on a board. The exam-
iner taps a sequence of blocks, which the participant
has to repeat subsequently in the correct sequential or-
Requests for reprints should be sent to Roy P. C. Kessels, Psycho-
logical Laboratory, Department of Psychonomics, Heidelberglaan
2, 3584 CS Utrecht, The Netherlands. E-mail: r.kessels@fss.uu.nl
der. By increasing the length of the sequences, the ca-
pacity of the visuospatial short-term memory can be
measured.
The Corsi test has been used in patients with Alzhei-
mer’s disease (Carlesimo, Fadda, Lorusso, &
Caltagirone, 1994), Korsakoff’s syndrome (Haxby,
Lundgren, & Morley, 1983), schizophrenia (Salamé,
Danion, Peretti, & Cuervo, 1998), and focal brain le-
sions following surgery or cerebrovascular disease (De
Renzi, Faglioni, & Previdi, 1977; Hopkins, Kesner, &
Goldstein, 1995; Milner, 1971; Roth & Crosson, 1985).
However, a standardized administration and scoring
procedure for the Corsi Block-Tapping Test is lacking.
Although adapted versions of this test have been made
commercially available, essential differences exist with
the original Corsi task. For example, the Spatial Span
subtest included in the Wechsler Memory Scale–III

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 THE CORSI BLOCK-TAPPING TASK
consists of 10 blue blocks on a white board (Wechsler,
1997), whereas the blocks in the Block-Tapping Test
by Schellig (1997) are considerably smaller than in the
original task (making the test less applicable in patients
with perceptual or motor dysfunction). Moreover, nor-
mative data for the widely used original nine-cube
Corsi task that can be used for clinical assessment pur-
poses are not available (Berch, Krikorian, & Huha,
1998).
This lack of standardization may be the cause of the
substantial variation that has been reported in the scores
of healthy participants (Schellig & Hättig, 1993). Vari-
ous researchers have administered the procedure with a
number of larger or smaller differences. Particularly,
the spatial layout of the blocks and the sequences that
have to be repeated greatly influence test performance
(Kemps, 1999; Smirni, Villardita, & Zappalà, 1983).
Furthermore, the administration and scoring criteria
vary. For example, the number of presented sequences
of equal length varies across studies from one to five
(Berch et al., 1998). A widely used administration pro-
cedure in clinical settings employs two sequences of
equal length. The test is discontinued if the participant
fails to repeat these two sequences correctly, otherwise
the length of the sequences is increased with one. In this
administration procedure, the block span is the length
of the last correctly repeated sequence (Trojano,
Chiacchio, De Luca, Fragassi, & Grossi, 1994).
This study proposes a standardization of the admin-
istration procedure for the original Corsi
Block-Tapping Task, as well as criteria for scoring the
response. Furthermore, a detailed description of the test
materials is given to make this procedure freely avail-
able. The Corsi Block-Tapping Test was administered
to a group of healthy volunteers, whose results can be
used as (preliminary) normative data. Furthermore, the
task was applied in a group of patients with cerebral le-
sions to examine whether it is sensitive to the effects of
brain damage.
Method
Participants
Seventy paid healthy participants without a history
of neurological disease or other diseases known to af-
fect cognitive function were included to collect norma-
tive data within a broad age range. All participants were
selected from a database of volunteers who responded
to an advertisement in the local newspaper. Mean age
was 31.2 years (SD = 14.1, range = 18–72), and the
mean education level was 13.8 years (SD = 3.2, range =
5–19).
Furthermore, a group of 70 patients of the Depart-
ment of Neurology of the University Medical Center in
Utrecht participated, all of them having cerebral le-
sions. Of these, 26 patients suffered from acute
ischemic stroke (< 1 month prior to the study), 33 pa-
tients had a nonacute ischemic stroke (> 1 month prior
to the study), and 11 patients had a cerebral lesion of
other etiology (tumor resection or hemorrhage). Lesion
site was assessed on the basis of CT or MRI data.
Twenty-five patients had left hemisphere lesions, 22
patients had right hemisphere lesions, and 4 patients
had bilateral damage. Furthermore, 19 patients had le-
sions that did not affect the cerebral cortex, but were lo-
calized in subcortical regions, the brain stem, or the
cerebellum (see Table 1 for a more detailed description
of each patient subgroup). Mean age of the patients was
54.0 years (SD = 14.6, range = 19–83), mean education
level in years was 10.1 (SD = 3.1, range = 5–19). At the
time of testing, none of the patients had hemispatial ne-
glect or visual field defects for which they could not
compensate well.
Materials
Figure 1 shows the Corsi Block-Tapping Task used
in this study. The test consisted of nine black cubes (30
× 30 × 30 mm) mounted on a black-colored board (225
× 205 mm). The digits 1 to 9 were printed on one side of
the cubes, visible to the examiner only (for the detailed
layout of the cubes see Appendix A).
Procedure
The participant was seated in front of the examiner,
who subsequently tapped the cubes starting with a se-
quence of two blocks. Two trials were given per block
sequence of the same length. If at least one of these was
repeated correctly, the next two trials of a sequence of
an increased length were administered (see Appendix B
for the details of the block sequences that were used).
The cubes were touched with the index finger at a rate
of approximately 1 cube per sec (with no pauses be-
tween the individual cubes). The participant had to tap
the cube sequences in the same order immediately after
the examiner was finished. The following instruction
was given: “I will tap a block sequence on this board.
When I have finished tapping, I want you to tap these
blocks in the same serial order. After this, I will tap an-
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 KESSELS ET AL.

Table 1. Etiology, Lesion Characteristics, and Demographic Variables for the Patient Group

Acute Ischemia Nonacute Ischemia Nonacute Other Etiology

Site of Lesion (n)

Left Hemisphere 3 15 7
Right Hemisphere 5 13 4
Bilateral 1 3 —
Subcortical 17 2 —
Hand Used to Tap (n)
Right Hand (Preferred) 24 26 10
Left Hand (Preferred) 2 3 1
Right Hand (Nonpreferred) — 1 —
Left Hand (Nonpreferred) — 3 —
Total n 26 33 11
Male:Female 17:9 13:20 5:6
Age
M 60.3 51.3 47.2
SD 13.7 13.0 16.8
Education in Years
M 9.9 9.9 11.2
SD 3.6 2.5 3.7

the product of the Block Span and the number correctly

repeated sequences until the test was discontinued (i.e,
the number of correct trials). This latter score takes into
account the performance on both trials of an equal
length and thus is more reliable than the Block Span
alone. Cutoff scores were calculated on the basis of
these data, which can be applied as a clinical criterion.
That is, following the criteria of Lezak (1995), a perfor-
mance level of more than 1.3 SD below the control
mean is regarded as “borderline,” and a performance
level of more than 2 SD below the control mean is clas-
sified as “retarded” (p. 159). Furthermore, the percen-
tile distribution was calculated for both measures on the
Figure 1. The Corsi Block-Tapping task. basis of the performance of the healthy controls.

other sequence. The sequences will gradually increase

in length.” If a participant started the task while the ex-
aminer was still busy tapping blocks, the following in-
struction was given: “Please wait until I have finished.”
The test was terminated if the participant failed to re-
produce two sequences of equal length. Only a com-
pletely correctly repeated sequence was scored as
correct; self-corrections were permitted here.
Analyses
Two different scores were computed for each partic-
ipant. First, the Block Span equals the length of the last
correctly repeated sequence. Second, the Total Score is
Results
Table 2 shows the data for the healthy controls and
the patients (categorized on the basis of the lesion site)
for the Block Span and the Total Score. Figure 2 dis-
plays the frequency distribution for the Total Score for
the healthy participants and patients together. All pa-
tients were able to perform the task according to the in-
struction. Four patients used their nondominant hand to
tap (3 left hemisphere patients and 1 right hemisphere
patient) as a result of a hemiparesis of the preferred
hand, contralateral to the side of the lesion. The healthy
participants and the overall patient group were subdi-

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 THE CORSI BLOCK-TAPPING TASK

vided into three age groups, and an analysis of variance
(ANOVA) of group (patients vs. healthy participants) ×
age group (three levels) was performed for each perfor-
mance measure separately. For the Block Span, no
main effect of group was found, F(1, 134) = 0.7, but
there was an effect of age group, F(2, 134) = 4.6, p <
.05, as well as a Group × Age Group interaction, F(2,
134) = 3.0, p = .05. Analysis of the Total Score revealed
no significant main effect of group, F(1, 134) = 0.4, but
a significant main effect of age group, F(2, 134) = 15.6,
p < .001, and a significant Group × Age Group interac-
tion, F(2, 134) = 8.1, p < .001, were found.
Although the overall ANOVA did not reveal a main
effect of group for both Block Span and Total Score,
this was probably due to the uneven distribution of the
patients over the three age groups (i.e., a relatively
large proportion of the patients was included in the old-
est age group compared to the younger age groups).
Therefore, post hoc t tests were performed subse-
quently, comparing the patients and controls directly in
each age group. In the youngest age group (≤ 20 years),
the patients (n = 2) performed worse than the healthy
volunteers (n = 21) on the Total Score, t(21) = 2.1, p <
.05, but did not differ on Block Span, t(21) = 1.4. The
patients (n = 12) in the second age group (20–40 years)
performed worse than the healthy participants (n = 27)
on both measures, Block Span: t(37) = 3.3, p < .002;
Total Score: t(37) = 3.2, p < .003. Finally, the patients
(n = 56) in the oldest age group (≥ 40) also performed
worse on the Block Span, t(76) = 3.0, p < .004, and the
Total Score, t(76) = 2.8, p < .006, than the healthy vol-
unteers (n = 22). Overall analysis did not demonstrate
sex differences on both measures, F(1, 138) = 0.91;
F(1, 138) = 0.25.
To study function localization for this task, the pa-
tient groups were analyzed separately with localization
as the between-subject factor (left or right hemisphere,
bilateral or subcortical). Overall, a significant effect of
localization was found both on the Block Span, F(3, 66)
= 2.9, p < .04, and on the Total Score, F(3, 66) = 2.6, p <
.06. Post hoc analyses showed that the right hemisphere
patients performed worse than the left hemisphere pa-
tients on both measures, respectively, t(45) = 2.4, p <
.02; t(45) = 2.4, p < .02; all other post hoc comparisons
were not significant. Also, no significant differences on
the two performance measures were found between the
type of lesion, that is, acute stroke, nonacute stroke, and
other etiology, F(2, 67) = 1.3; F(2, 67) = 1.7.
Applying the aforementioned cutoff criterion on the
Total Score for the individual patients showed that 4
patients (22.0%) performed in the borderline range
(Total Score < 29.3) and 6 patients (8.6%) performed in
the retarded range (Total Score < 15.1). Moreover, in-
dividual data can also be classified using the percentile
distribution for the three age groups (listed in Table 3).
Discussion
The goal of this study was to develop and apply a
standardized administration and scoring procedure for
the original Corsi Block-Tapping Task, as well as to
provide preliminary normative data. The use of two dif-
ferent performance measures was suggested: the clas-
sic Block Span (the longest block sequence that was
repeated correctly) and the Total Score (a product of the
Block Span and the number of correctly repeated tri-
als). It was found that, overall, patients with cerebral le-
sions performed worse than the healthy volunteers both
on the Block Span and on the Total Score. However, the
Block Span appears to be the less sensitive measure,
because the range of possible scores is limited (i.e.,
varying from 2–9). Therefore, determining a firm cut-
off score only on the basis of this measure is not possi-
ble. Moreover, it does not take into account the
performance on both trials within each level, because
only one of the two trials has to be correct. The perfor-
mance on both trials is, however, included in the Total

Table 2. Mean Performance on the Block Span and Total Score and Demographic Characteristics for the Healthy Controls and the Patient
Groups Categorized on the Basis of Lesion Sites

Healthy Controls Left Hemisphere Right Hemisphere Bilateral Subcortical

Measure M SD M SD M SD M SD M SD

Block Span 6.2 1.3 5.3 1.4 4.4 1.2 4.8 0.5 5.3 1.0
Total Score 55.7 20.3 43.5 25.6 28.4 15.1 31.5 10.6 42.0 19.1
Age 31.2 14.1 49.6 17.1 52.8 13.3 53.0 15.2 61.3 10.2
Education (Years) 13.8 3.2 11.0 3.3 10.1 2.6 8.6 2.0 9.4 3.5
n 70 25 22 4 19
Male:Female 43:27 11:14 10:12 1:3 13:6

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 KESSELS ET AL.

We did not find differences in performance between

males and females on this task. Sex differences are of-
ten reported in tasks assessing spatial-memory func-
tions (Postma, Izendoorn, & De Haan, 1998). Only one
study examined sex differences on the Corsi
Block-Tapping Task, and found that males outper-
formed females (Capitani, Laiacona, & Ciceri, 1991).
However, the absolute difference on the equivalent of
our Block Span between the males and females in the
latter study was rather small (0.27 blocks), yet signifi-
cant in a large sample.
Comparing patients with lesions in the left hemi-
sphere to patients with right hemisphere lesions re-
sulted in a worse performance on both measures of the
group of patients with right hemisphere lesions. It is un-
likely that this is primarily the result of impairments in
visual detection, because none of the patients had
hemispatial neglect, or hemianopia for which they did
not compensate well. Additionally, this finding is in
Figure 2. Frequency distribution of the total score (n = 140). agreement with the results of previous studies (De
Renzi et al., 1977; Milner, 1971), and supports the no-
tion that the right hemisphere is more important for the
Table 3. Percentiles for the Total Score of the Corsi processing of visuospatial short-term memory tasks
Block-Tapping Task Based on the Data of 70 Healthy Participants such as the Corsi test. In this light, however, it must be
(Divided Into Three Age Groups) noted that there is also evidence for a left hemisphere
contribution for specific functions in spatial cognition
Age Group (e.g., Laeng, 1994; Mehta, Newcombe, & Damasio,
Percentiles ≤ 20a 20–40b > 40c 1987). Furthermore, it should be mentioned that the
Corsi test might not be a “pure” spatial memory task. It
5 28.7 37.0 16.6 does not only measure visuospatial memory, but it also
10 35.0 40.0 20.0 relies heavily on memory for temporal information, be-
20 37.0 40.0 38.0 cause the block sequences have to be remembered in
30 44.8 44.4 40.0
the correct sequential order (Della Salla, Gray,
40 54.0 54.0 41.6
Baddeley, Allamano, & Wilson, 1999; Ferreira et al.,
50 60.0 54.0 48.0
60 60.6 60.0 52.8
1998). Thus, other brain regions than those specialized
70 65.8 70.0 54.0
in spatial memory per se—for example the frontal lobes
80 74.2 78.2 60.0 (D’Esposito & Postle, 1999)—might also be involved
90 92.2 86.4 68.4 in this task, and lesions in these structures could poten-
95 131.1 100.8 76.3 tially explain a low performance on the Corsi test.
a For future research purposes, it would be interesting
n = 21. bn = 27. cn = 22.
to apply the aforementioned administration and scoring
procedure in patients with other neurological diseases,
Score. Also, the range of scores is much wider here such as Alzheimer’s dementia or Parkinson’s disease.
(with possible scores between 2 and 144), which results Moreover, the group of healthy participants must be ex-
in a more sensitive and statistically reliable measure for panded (e.g., elderly persons or children). In this way, a
analyzing the performance of individual patients in large set of normative data can make the Corsi test more
clinical practice, as shown in the percentile distribu- reliable than it is now and a helpful tool for both clinical
tion. Using the cutoff criteria shows that the perfor- assessment and research purposes.
mance of 20% of the patients can be regarded as In sum, a standardized administration and scoring
borderline on this task. Over 8% can be classified as re- procedure for the original widely used Corsi
tarded, which is indicative for an impaired performance Block-Tapping Task is described in detail. This proce-
on this test. dure was applied to a group of healthy volunteers, as

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Appendix B 3–7–8–2–9–4
Block Sequences 5–9–1–7–4–2–8
5–7–9–2–8–4–6
8–5 5–8–1–9–2–6–4–7
6–4 5–9–3–6–7–2–4–3
4–7–2 5–3–8–7–1–2–4–6–9
8–1–5 4–2–6–8–1–7–9–3–5
3–4–1–7
6–1–5–8
5–2–1–8–6 The sequences with a length of four or greater are re-
4–2–7–3–1 ported in Smirni et al. (1983). The other sequences are
3–9–2–4–8–7 derived from Capitani, Laiacona, and Ciceri (1991).

258