Kohs described the 1920s version of the test as a series of 17 cards which increase in complexity as the test progressed. Test takers replicated the designs with painted blocks (each side was a single color or two colors divided by a diagonal line). The initial scores were based on completion time and number of moves. Hutt amended the scoring method to only score completion time. The test was given to both children and adults.
The Kohs Block Design Test has been adapted into sections in several current IQ tests. The Kohs Test continues to be used in research extensively to measure executive functioning and learning, consistent with the original design of the test. This has made the Kohs Block Test useful for assessing the effects of aging, drug use, and in brain research, among other areas. In particular, that the Kohs is a relatively non-verbal test lends it to be used effectively in assessment of those with language issues and in multicultural research settings to reduce the impact of language on assessment of functioning.
Patients with damage to the right hemisphere of the brain find successful completion of the task to be extremely difficult, so the test is often used to diagnose right hemisphere damage.
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