Spatially lateralised deficits that typically define the hemispatial neglect syndrome have been shown to co-occur with other non-lateralised deficits of attention, memory, and drawing. However even a simple graphic task involves multiple planning components, including the specification of drawing start position and drawing direction. In order to investigate the influence of these factors in neglect we presented patients with a circle-copying task, and specified the drawing start point. The ability to draw from the instructed location was strongly related to tests that measure constructional abilities, but not related to start point laterality. In contrast, the direction in which patients drew the circle was affected by start point laterality: patients with neglect were less likely to draw in a typical direction when the cue was on the affected side of space and this was strongly related to severity of the neglect. Patients with neglect consistently produced circles that were smaller than the model; however, the scaling was not affected by the laterality of the start point, nor was the proportion of drawings correctly started at the cue. These findings demonstrate the complex relationship between neglect and even the simplest test for the syndrome. (c) 2007 Elsevier Inc. All rights reserved.