# Constructive Apraxia: An Unexpected Limit of Instructible Vision-Language Models and Analog for Human Cognitive Disorders

arXiv: https://arxiv.org/abs/2410.03551 · HTML: https://mlsanity.com/paper/2410.03551/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Embodied and 3D vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 18 of its 31 references that are in the map.
- First posted on arXiv 17 Sep 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Embodied and 3D vision-language models](https://mlsanity.com/mllm/embodied-and-3d-vision-language-models/)

## Builds on (most cited first, 18 of 18)

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- [Are We on the Right Way for Evaluating Large Vision-Language Models?](https://mlsanity.com/paper/2403.20330/) (2024)
- [When and why vision-language models behave like bags-of-words, and what to do about it?](https://mlsanity.com/paper/2210.01936/) (2022)
- [HallusionBench: An Advanced Diagnostic Suite for Entangled Language Hallucination and Visual Illusion in Large Vision-Language Models](https://mlsanity.com/paper/2310.14566/) (2023)
- [VisionLLM: Large Language Model is also an Open-Ended Decoder for Vision-Centric Tasks](https://mlsanity.com/paper/2305.11175/) (2023)
- [Make-A-Scene: Scene-Based Text-to-Image Generation with Human Priors](https://mlsanity.com/paper/2203.13131/) (2022)
- [A Categorical Archive of ChatGPT Failures](https://mlsanity.com/paper/2302.03494/) (2023)
- [Vision language models are blind: Failing to translate detailed visual features into words](https://mlsanity.com/paper/2407.06581/) (2024)
- [LLMScore: Unveiling the Power of Large Language Models in Text-to-Image Synthesis Evaluation](https://mlsanity.com/paper/2305.11116/) (2023)
- [A Vision Check-up for Language Models](https://mlsanity.com/paper/2401.01862/) (2024)
- [Hidden flaws behind expert-level accuracy of multimodal GPT-4 vision in medicine](https://mlsanity.com/paper/2401.08396/) (2024)
- [Reading Isn't Believing: Adversarial Attacks On Multi-Modal Neurons](https://mlsanity.com/paper/2103.10480/) (2021)
- [Can Vision-Language Models be a Good Guesser? Exploring VLMs for Times and Location Reasoning](https://mlsanity.com/paper/2307.06166/) (2023)
- [Failures Are Fated, But Can Be Faded: Characterizing and Mitigating Unwanted Behaviors in Large-Scale Vision and Language Models](https://mlsanity.com/paper/2406.07145/) (2024)
- [LLMs are Not Just Next Token Predictors](https://mlsanity.com/paper/2408.04666/) (2024)
- [Synthetic Photography Detection: A Visual Guidance for Identifying Synthetic Images Created by AI](https://mlsanity.com/paper/2408.06398/) (2024)
- [GeoPos: A Minimal Positional Encoding for Enhanced Fine-Grained Details in Image Synthesis Using Convolutional Neural Networks](https://mlsanity.com/paper/2401.01951/) (2024)

## Abstract (arXiv)

This study reveals an unexpected parallel between instructible vision-language models (VLMs) and human cognitive disorders, specifically constructive apraxia. We tested 25 state-of-the-art VLMs, including GPT-4 Vision, DALL-E 3, and Midjourney v5, on their ability to generate images of the Ponzo illusion, a task that requires basic spatial reasoning and is often used in clinical assessments of constructive apraxia. Remarkably, 24 out of 25 models failed to correctly render two horizontal lines against a perspective background, mirroring the deficits seen in patients with parietal lobe damage. The models consistently misinterpreted spatial instructions, producing tilted or misaligned lines that followed the perspective of the background rather than remaining horizontal. This behavior is strikingly similar to how apraxia patients struggle to copy or construct simple figures despite intact visual perception and motor skills. Our findings suggest that current VLMs, despite their advanced capabilities in other domains, lack fundamental spatial reasoning abilities akin to those impaired in constructive apraxia. This limitation in AI systems provides a novel computational model for studying spatial cognition deficits and highlights a critical area for improvement in VLM architecture and training methodologies.