Head injury, Alzheimer's disease, and stroke can severely reduce the performance of an individual on the block design test.
[3] Additional evidence suggests impairment in block design performance among schizophrenic and bipolar disorder patient populations, though this represents only preliminary findings.
[6] The block design test is considered one of the best measures of spatial ability, although it is subject to certain problems of administration, such as anxiety or over-cautious responding.
Uta Frith, in her book Autism: Explaining the Enigma,[8] addresses the superior performance of autistic individuals on the block design test.
Felder, at North Carolina State University, has developed a learning style questionnaire that attempts to assess spatial ability in an educational context.