Dap Neurological Interpretations

8/12/2019 Dap Neurological Interpretations

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THE DRAW-A-PERSON TEST AND PSYCHONEUROLOGICAL

LEARNING DISABILITY IN CHILDREN

by

CHARLES LOUIS PRATT, B.S.

A THESIS

IN

PSYCHOLOGY

Submitted to the Graduate Faculty

of Texaa Technological College

in Partial Fulfillment of

the Requirementa for

the Degree of

MASTER OF ARTS

Approved

Auguat 1968


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i


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TABLE OF CONTENTS

Page

LIST OF TABLES iv

LIST OF ILLUSTRATIONS v

I. INTRODUCTION 1

Purpose and Scope of the Thesis 1

Review of Pertinent Literature 2

Definitions of Terms 5

Statement of Problem 7

II. EXPLORATORY INVESTIGATION 8

Method and Procedures 8

Scoring System Development 10

Resulta 25

III.

PROCEDURE 25

Problem - 25

Subjecta 25

Procedure 26

IV. RESULTS 29

V. DISCUSSION 34

VI. SUMMARY AND CONCLUSION 58

LIST OP REFERENCES .' 40

APPENDIX 43

1 1 1


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LIST OF TABLES

Table Page

1. Comparison of the 19 Scoring Signa in the

Exploratory Inveatigation 57

2. Experimental Group Data 58

3. Control Group Data 61

4.

Compariaon of the 19 Scoring Signa in the

Major Study 64

5. Compariaon of the I9 Scoring Signa by

Judge A for Three Seta of Drawinga 65

6. Compariaon of the 19 Scoring Signa by

Judge B for Three Seta of Drawinga 66

7.

Reaulta of _t Teat in the Major Study by

Judge A 32

8. Reaulta oft Teat in the Major Study by

Judge B ;... 35

IV


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LIST OF ILLUSTRATIONS

Figure Page

1. Normal Drawing 43

2. Normal Drawing. 44

3

Normal Drawing 45

4.

Normal Drawing 46

5 Normal Drawing 47

6 Handicapped Drawing 48

7. Handicapped Drawing 49



10.

Handicapped Drawing 52

11. Poaitive Handa and Fingera 55

12. Negative Handa and Fingera 54

15. Poaitive Foot Conatruction 55

14. Negative Foot Conatruction 56


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CHAPTER I

INTRODUCTION

Purpoae and Scope of the Theaia

One of the taaka given to clinical paychologiata ia to aid in

the diagnoaia of learning disturbances. A variety of psychological

techniquea have been uaed for this purpoae over the years with varying

degrees of success. A large amount of work has been done using the

drawing of the human figure aa an intelligence teat and as a projective

technique, but the literature containa only a few atudiea where thia

procedure waaydirectly uaed in diagnosing learning disability in

children. Even when drawinga are used in a diagnostic battery, clini

cians occasionally make inferences from them concerning cerebral

dysfunction which are not based on the pictures themselvea but on data

from the caae hiatory, reaulta of other testa, .or from the behavior

and appearance of the child.

^Since the Draw-A-Peraon Test (D-A-P) is a brief and easily

adminiatered teat which requires little material, appeala to moat

children, and yielda both an eatimate of mental age and considerable

projective data, it ia extenaively uaed in paychological evaluation

of children.

>

Some time and effort could be saved if it could be

validly and reliably used as a screening device for learning diaability.

The purpose of this study was to investigate the use of the

D-A-P in the diagnosis of neurologically based learning disability.


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2 2 2 2

It attempted to find any patterns and/or signa in the drawinga of the

human figure which could be ayatematically used to differentiate the

impaired child with a learning handicap from the non-impaired child.

Review of Pertinent Literature

Developmental and intellectual levels are reflected in the human

figure drawings of children and have been standardized as an intelli

gence teat for children between the ages of three and 15 years by

Goodenough(1926). There was also recognition of the projective im-

lications of the drawings by Bender(1948),Goodenough (l950)> Machover

(1949) and others. They based the use of the human drawings as a

projective technique on the assumption that the child will project

his own self-image into his drawings (Bender,1948).

Several authors (Abercrombie & Tyaon,I966; L. Centers & R.

Centers,I963; Silverstein & Robinson, 1956; Wysocki & Whitney,

1965) investigated the possibility of using the human figure drawings

as a measure of an individual's attitude towards his physical disability.

First grade achievement and adjustment have also been examined (Koppitz,

Sullivan, Blyth, Shelton, 1959; Shibb & Loudon,I964; Vane & Eisen,

1962). Relatively few studies refer to the use of human drawings in

the diagnosis of brain dysfunction. Thia literature is summarized

below.

Lauretta Bender (1940) found that children with chronic enceph

alitis were not able to draw the human form at the level which would

be expected of them. She thought the drawings could be used as a

diagnostic measure in doubtful cases of encephalitis or similar organic

brain disturbances in children. She set limits on this technique by

stating that is was not reliable in the non-specific types of


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encephalitis or traumatic conditiona of the brain, due probably to

localization problema. The children performed poorly on the Goodenough

teat,but their productions were not comparable to thoae of children

with a lower mental age. ^ In general, detail waa poorly handled,

motor execution waa poor, and the drawinga expreaaed their uncertainty

aa to hov to accomplish the desired results (Bender, 1940, p. 28 5) .

This may be looked upon as a specific disability. It

does not represent any difficulty in their technical ability

to draw as they can draw other subjects adequately. It

repreaenta an apperception of the postural model andpro

bably arises from perceptual difficulty in relation to

their own body rather than optic perceptual difficulty.

It is probable that the capacity to draw the human form is

not related to a simple optic-Gestalt but a more complicated

Gestalt which is based upon sensory impressions of all types

coming from the surface, as well as the inside of the body.

Besides the sensory impressions of the present, the sensory con

sciousness of the past are integrated into the present con

cepts. However, it is a more important factor that motor

impulses give final shape to the body image, only to motility

do the various impressions of the senses approach the pre-

ceptual world. In these cases the motility disrupts the

body image as it is represented in the Goodenough drawing.

The child aware of his shortcomings, tries again and again

to consociate the picture of the body by renewed contacts.

Here we may find a hint aa to the importance of motility

in the perception of onea own body or the body image (Bender,

1940,p. 286 ).

Another study (Rosenaweig, 1949 p. 4l) auggeated that ...aaymmetry

and diatorted proportional relationahip...auggeat organic brain defect.

Karen Machover (1949) listed indicators often seen in organic

cases: empty, large, poorly proportioned figures; weakly synthe

sized drawings; disproportionately large head; and simple, heavy

line quality.

A study be Vernier (1952),in agreement with Machover, listed

weak synthesis, emptiness, or lack of detail, poor proportions, and

largeness of head and whole figure. In addition she noticed petal

or scribbled fingers, oenter-of-page placement, shrunken arms and


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legs,erasures in arm and hand area, and eyes drawn as slits. She

described the line quality as sketchy and/or broken, rather than

heavy and simple.

In a preliminary study of the drawings of the human figure by

brain injured children, Helen Blanchard (1952) noticed a strong

tendency to draw Orphan Annie Type eyes (composed of blank circlea

without pupila) and difficulty joining linea correctly. She did not

find other cluea to differentiate the drawinga of brain injured

children from thoae of younger normal children.

Michal-Smith (1955) compared the drawings of boya with normal

and abnormal EEGa. He found that H-T-P line quality waa a predictor

of brain damage.

Reznikoff and Tomblen (1956) inveatigated the degree to which

the indicatora auggeated by Machover (1949) and Vernier (1952) were

more characteriatic of the drawinga of adult organic aubjecta over the

drawinga of other groupa, and to what extent the indicatora could re

liably be employed in the differential diagnoaia of organicity. They

found that five of theae indicatora were more prevalent among a

group of organic patienta than among achizophrenic or neurotic groupa.

Theae were: weak ayntheais, parts misplaced, shrunken arms andlegs,

parts,

other than head and extremities, distorted, and petal or

scribbled fingera. However, the groups overlapped to a conaiderable

degree,

limiting the uaefulneaa of thia approach alone for individual

differential diagnoaia.

While not impreaaive, the cited atudiea aeem encouraging and

preaent a challenge to further effort. It ia apparent that neuro

logically impaired individuala give evidence of their diaabilitiea in


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the form of diatortiona, diaplacementa, omiaaiona, and other auch

errors in their drawinga. If aome of theae aigna exiat in the drawings

of neurologically damaged children, then a acoring syatem could be

developed whereby the D-A-P would aid in the diagnoaia of learning

diaorder.

Many of the drawinga in the literature were compared uaing

checkliata of aigns or phyaical meaaurement of the figurea in order

to be aa objective aa poaaible. Thia methodological point of view

appeared to be auperior to any aubjective claaaification method and

waa employed in the preaent atudy. It was utilized with the reali

zation that it is not beyond criticism. It has been said that the

checklist (of signs) violated that holistic, dynamically oriented

approach which competant clinicians use in making drawing analysis

(Brown, 1952, p. 179) .

Definitions of Terms

Following the thinking of Doris Johnson and Helmer Myklebust

(1967),the disorder studied was termed psycho-neurological learning

disability.

In seeking a term that might fulfill our needs, we

encountered psychoneurological (Benton, 1959> Luria,I961).

The root of the term, neurological, clearly discloses that

the basic condition is organic and involves the central

neirvous system. The prefix psycho appropriately emphasizes

that an important concomitant is behavioral. The desig

nation psychoneurological, therefore, indicates that the

disorder is in behavior and the causation is neurological

...in those having a psychoneurological learning disability,

it is the fact of adequate motor ability, average to high

intelligence, adequate hearing and vision, and adequate

emotional adjustment together with a deficiency in learning

that constitutes the basis for homogeneity (Johnson &

Myklebust, 1967, pp. 7-8 ).

The learning process has been altered in these children and the


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modification is due to neurological dysfunction. This results in a

disability in learning, no incapacity. They have the commonly recog

nized deficits in learning that pertain to academic success such as

difficulty in reading, writing, and arithmetic.

The dysfunction causing the learning difficulty is not necessarily

due to structural damage, so the term minimal brain damage is

mis

leading, perhaps even inaccurate. There is also the problem of quanti

fying the term minimal for proper evaluation and study. Measuring

the amount of dysfunction and locating the area of the brain it

influences is also not an easy task. The difficulty encountered in the

classroom by these children can result from perceptual disturbances,

but not necessarily from this alone, so the term perceptually

handicapped is erroneous for many children.

The use of the term psychoneurological learning disability was

applied to this exploration in order to arrive at as definitive and

objective criteria as possible, with the realization that there would

be overlapping between the groups under study. Minor motor incoordi

nations and some degree of emotional disturbance were found with the

children who had a learning disability but they were not incapacitating.

Some multiple involvement occurred, but motor ability, hearing, vision,

intelligence, and emotional adjustment were considered average to

adequate.

The non-verbal aspects of learning were also involved. Teachers'

reports were reviewed by Johnson and Myklebust (I967) with some of the

following difficulties or their equivalent being mentioned about each

child.


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Together with deficits in the learning of arithmetic,defi

ciencies in acquiring spoken, read, and written language

constitute the primary areas under the category of disabilities

in verbal learning. Under the non-verbal are found dia-

turbancea in learning to tell time, direction (east andwest),

body orientation (right and

left),

meaning of facial expressions

(happiness andanger),meaning of the behavior of others (learn

ing to play games such as

cowboy ),

music and rhythm, and

meaning as conveyed in art (Johnson & Myklebust, 1967

p.17).

Children with a learning disability have a discrepancy between

ability and achievement. Their level of learning, when measured by

their achievement teat acorea, ia below anticipated normal performance.^

Statement of Problem

Clinical practice auggeats that children with learning diaabilitiea

manifeat characteriatic modea of drawing human figurea which make it

poaaible to diatinguiah their productiona from thoae who were not ao

handicapped. The purpoae of thia atudy waa to make a preliminary in

veatigation of the ability of a trained individual to differentiate

drawings produced by children with a learning disability from those

made by children without a neurological dysfunction. This was to be

done by developing a scoring system based upon the indicators of

dys

function found in the drawings of human figures.


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CHAPTER II

EXPLORATORY INVESTIGATION

Method and Procedures

The drawings of forty-four male children were selected from

the files of two child guidance centers on the basis of final diagnosis

which folowed the criteria and classifications described in Psycho-

pathological Disorders in Childhood: Theoretical Considerations and

a Proposed Classification, prepared by the Group for the Advancement

of Psychiatry

(1966),

and/or the Diagnostic and Statistical Manual of

Mental Disorders prepared by the American Psychiatric Association (1965)

The children had been diagnosed chronic brain syndrome and were

between the ages of 7 years, 7 months, and 12 years, 1 month, with a

mean age of 9 years, 5 months. All drawings were performed during

routine psychological testing.

Normal potential was a necessary prerequisite in order to

differentiate the neurogenic disorders of learning from mental retarda

tion.

This was difficult to evaluate because mental ability consists

of a number o f factors, making any single measure misleading or faulty.

For the purpose of this study, adequate capacity was established as an

IQ of 85 or above on either a verbal or non-verbal measure of intelli

gence.

The total score on the Wechsler Intelligence Scale for Children

(wise),

for example, was not the determining factor but that the child

Oklahoma State Health Department of Regional Guidance Centers

located in Muskogee and Okmulgee, Oklahoma

8


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acored 85 or above on either the verbal or performance aection. A

total IQ acore of 85 or above waa required on the Stanford-Binet In

telligence Scale, when it waa uaed in the evaluation of a child, as

well as on the Leiter International Performance Scale. This demarca

tion waa not aa atringent aa deaired because of the limited sample

available and may have allowed a moderate degree of mental retarda

tion to be present in some cases.

Sensory capacities were also within the normal range of function

ing and did not cauae a detriment to learning. Defining motor ability,

hearing, and viaion aa adequate waa difficult either becauae of the

lack of well atandardized testa of ability or the different methoda

uaed by each child in manifeating hia aenaory capacitiea. Although

in aome caaea, aenaory and motor deficienciea were preaent, they were

not crippling and evaluated aa within adequate limita according to a

physician'a report or the achool nurae.

A group of 27 third and fourth grade elementary boya completed

81 peraon drawinga for compariaon with the impaired children (llluatra-

tiona 1-5 in theAppendix),theae atudenta had a mean age of 10 yeara,

2 montha and were given the D-A-P in a group aetting. Two teachera

were preaent in order to minimize copying and to aaaiat in identifying

and collecting the data.

Theae atudenta were aufficiently normal in development and

behavior ao that they had not come to the attention of a paychological

or neuro-psychiatric clinic, or, if they had been seen by a clinic,

had not been diagnosed as chronic brain syndrome . They were selected

by their teachers on the basis of average and above average adjustment

and grades so it was assumed they were not psychotic. Their achievement


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test scores were also average or above.

Scoring System Development

Similarities were noticed in many of the drawinga produced by

the impaired children (illustrations 6-10 in theAppendix). The

following observations were made about the drawings.

1. Asymmetry; especially in the neck and shoulder area

2. Features or detail more pronounced in the head with a lack

of detail in the body

3. Limbs hand or are short and stubby

4. Few erasures

5. Lack of angles present

6. Absence of separation of parts

7.

Flaccid bodies

8. Poor directionality of continuous line

9. Blunted or poorly formed hands and feet

, 10. Poor perspective or depth

The following scoring categories resulted from an integration

of personal clinical experience with the observations of dysfunction

mentioned in the literature:

Diagnostic Scoring Outline

I. Line construction

A.

B.

C.

D.

E.

F.

Type

Function;

Function;

Function;

Joining

Erasures

minimal

reasonable

additional

II.

Body Unit: Assembly

A. Arm attachment

B. Hand formation

C. Finger construction

D. Foot construction

III.

Body Unit: Detail

A. Minimal

B. Reasonable

C. Additional


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IV. Symmetry

A. Bilateral division^

B.

Head placement

C. Neck location

V. Body Unit: Proportion

A.,Minimal

B. Reasonable

C. Additional/

These nineteen categories were selected for use in this study

after testing numerous scoring items on the available drawinga. Each

category waa acored aa either plua or minua. In caae of doubt, an

item waa not acored. The categories are defined below with examples

given when necessary.

Type.

A plus score was recorded when short sketchy lines were

used to form the basic portion of the figure. The lines, over most of

the body, had a stroking quality to them with overlapping, somemis

fits,

and occasional breaks where pencil movement stopped and a new

line began. The pressure, often comparatively light, resulted from

good motor control. In some instances the lines appeared to be con

tinuous,

but closer inspection found them to be a reinforcement over

light sketching. The drawing was scored positive when this occurred

in approximately half of the picture with the remainder being sketched.

A minus score was given if the lines were continuous and rather

shaky, as if the child did not wish to remove the pencil from the

paper because he would lose his place and not know where to begin again.

This usually resulted in an inaccurate body outline because the child

would draw slowly from one side of the head all the way around the

figure to the other side without removing the pencil. This often re

sulted in the body being distorted as well as creating blunted, poorly


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formed hands and feet.

A minus score was also recorded if the figure was composed of

extremely jagged, poorly formed lines. The lines seemed more continuous

than skethchy but the quality was very saw-like and uneven frompro

jections and irregularities, as if the child's hand was trembling. The

controlled overlap found in the positive drawing was lacking. The lines

appeared to be the result of poor motor control and not sketched on

purpoae.

Function. Lines have more of a aophiaticated function for the

normal child than for the handicapped child. They begin to have mean

ing for children between 9 to 11 yeara of age (lowenfeld,

1963).

Objecta and the apace between linea become meaningful for children at

theae agea. Linea begin to aid in the creation of perapective. The

plane ia being discovered and ateps undertaken towards the concept of

depth. The child has not developed a conscious visual percept of

depth but automatically begins to employ it in his drawings. Line

pressure is increased or decreased in selected areas, shading or

shadowe are uaed, and by grouping detaila or featurea towards the center

the child demonstrates an understanding of depth. These techniques are

often lacking in the human drawings of the perceptually impaired.

The drawings of the normal children expressed dimension and

spatial relations. There was a purpose to the lines used whereby areas

or features of the figure are emphasized, giving it depth. Parts of

the figure seemed closer to the viewer than others. This impression

was generated by producing heavier or darker lines in the center of

the figure or in body parts than were closer to the viewer while having

lighter lines elsewhere. A concentration of detail in center areas and


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shading also caused depth. Areas near the viewer had more line weight

and emphasis, indicating a growing ability in the perception and repro

duction of depth. Any or all of the above devices were utilized to

provide perspective in the pictures.

The handicapped child's drawings were usually flat and without

adequate depth. The figures were drawn mechanically and simply with

no constructive effort to go beyond a simple two dimensional plane.

He seldom added any creative emphasis to his production and oftenpro

duced it as fast as possible. Few attempts were made to make prominent

features of the figure stand out in perspective and when they were

made there often was confusion and reversal of depth. Shading was

usually minimal or lacking with poor arrangement of details.

Function; minimal. A plus was given for minimal line function

when depth was seen in one area of the figure. This was usually the

head area but could be found in other areas of the figure. The feet

could be more prominent or, in a profile drawing, an arm or shoulder

could be the leading feature. Placement or concentration of the details,

line pressure, shading, and line direction were usually the contributing

factors.

An emphasis for a portion of the figure caused that area to

have perspective while the remainder of the figure was flat.

In a profile drawing the side of the head nearest the viewer had

darker lines in the hair or the ear while the face had lighter lines.

A belt buckle and belt produced in detail or emphasized by shading or

line pressure created roundness to the middle of the body. An arm OP

leg positioned forward in the picture had shading or reworked lines

producing depth in that segment of the body.

A minus score was received for drawings that were flat, simply


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drawn,

without depth. The entire figure was drawn with even line

pressure, either heavy or light, features of the face limited and not

concentrated, and body detail lacking. Occasionally depth reversal

was found with the outline of the head much darker than the facial

features,

creating the impression of a face peeking through a porthole.

This produced a false sense of depth and was scored minus.

Function; reasonable. This item received a plus score when

two areas or segments of the figure produced the impression of depth

in the viewer. This usually included the head and the trunk, but

other areas were involved. The quality of depth was perceived in a

larger area of the figure or in more features than in the preceding

scoring item. Subjectively the figure had more life to it than those

scored in the previous item.

A negative score was given for this item when it did not reach

satisfactory level. In other words, the drawing was limited to only

one area of depth being produced. A drawing was unscored for depth

reversal when two areas of depth were in opposition to each other. For

example, line direction and pressure would create the idea that a body

segment was in a leading position, in respect to the rest of the body,

while the shading placed it in the background.

Function; additional. This category was scored plus only in

the best drawings. The major portion of the figure was viewed in per

spective. Three or more areas were drawn in a manner that produced

depth. Shading line direction, pressure, and arrangement of detail-

combined to produce a drawing that had life and depth to it. A

majority of the lines were drawn with meaning and purpose.

A minus was recorded if the child could not demonstrate the ability


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to create depth or perspective in the major portion of the body. If

the child was unable to go beyond the scoring requirements of the pre

vious item he was scored minus.

Joining. This scoring, adapted from Harris (I965),was plus

when the juncture points met cleanly, without a marked tendency to

cross,or overlap, or leave gaps between theends. A drawing with few

lines was scored more strictly than one with frequent changes in

direction of line. A sketchy drawing was usually credited even though

the juncture of lines seemed uncertain, aince thia waa characteriatic

of a poaitive drawing. Some eraaurea were allowed.

When spacea were left between varioua body parte and linea

overlapped the acoring waa minua. The acoring waa alao negative when

parta of the body auch aa arma or lega did not join correctly to the

trunk. Some eraaurea were allowed and aketchineaa taken into conaidera-

tion.

Eraaurea. Any obaerved eraaurea were acored plua. Thia item

occaaionally required the placement of a white aheet of paper under

neath the drawing being acored ao the eraaure points could be seen

more clearly and to lessen any confusion from other figures showing

through. The picture was scored plus if an erasure was indicated by

roughness on the surface of the paper or where lines could still be seen

from earlier attempts, either from indentation in the paper or because

they were only partially removed.

The scoring was minus if erasures were not found on the paper.

It was anticipated that this minus scoring would handicap some of the

normal subjecta but it was predicted that the majority of them would

make at least one erasure as they attempted to correct perceived errors


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in their drawings.

Arm Attachment. A plua was scored when the arms were connected

to the top of the trunk at the location of the shoulder. When the neck

was missing, they had to be attached to the upper part of the trunk.

Credit was given for botharms,on the basis of the limb that was

shown in a profile drawing.

This category was scored minus when the arms were attached

elsewhere than to the trunk or more than one quarter of the chest length

down from the top (neck towaist). Where the crotch was not shown, as

in some profiles, the belt or waist was considered at about two-thirds

down the total trunk length. The item was not scored if the arms were

omitted from the drawing or if one was plus and the other minus.

Hand Formation. Reasonably formed hands were given a plus

score.

The presence of an area at the end of the arm spreading out to

form the fingers was scored with the length of the hand being approxi

mately equal to the length of the fingers and edge of sleeve or cuff

when fingers were shown. The fingers, even stubby in some cases,

were a continuation of the hand area and not looped on as if they were

an afterthought. A slight broadening of the arm was necessary when the

cuff did not exist to suggest palm or back of hand as distinct from

the wrist . A plus score was also given to hands that were of the

mitten type , but with opposition of thumb shown and lines indicating

the separation of the fingers (illustration II in theAppendix). Credit

was given for both hands in profile drawings on the basis of the one

present and when they appeared clenched if finger separation was

evident by the lines used.

Blunted, poorly formed hands acquired a minus score on this


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item. Sometimes this took the form of a curved stump at the end of

the arm without fingers. The arm line would start from the body and

go to the end of the limb, round the end, and return to the trunk. The

type of handa where the fingers appeared to be merely looped on the

end with no attempt at a hand area was also scored minus. No score was

given if the arms were placed behind the back, keeping the hands from

view, or when they emerged cut off at the end of the arm. A score

was also not given when one hand was positive and the other negative

making the decision difficult. If only one hand was intended in a

profile drawing, credit was given for both on the basis of the one

shown (illustration 12 in the

Appendix).

Finger Construction. The way the fingers were formed was

another scoring item with credit given for both hands on the basis

of the one drawn in a profile picture. Positive scoring waa given to

adequately formed fingera where their length waa approximately equal

to the hand and they were a continuation of the hand area. They were

not added to a blunted or rounded arm but an integral part of the hand

unit.

Well formed mitten handa with linea that indicated aeparation

of fingera were acored plua (llluatration 11 in the

Appendix).

Petal,

acribbled, or atick fingera added to blunted handa or

arma were acored minua. Blunted arma were acored minua as well as

fingers so poorly formed to be indistinguishable. Minus credit was

given for both hands when the only one shown in profile was minus.

No score was given when the fingers were out of view or missing and

when one hand was plus and the other minus (illustration 12 in the Ap

pendix).

Foot Construction. Reasonably drawn feet received a plus score


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(illustration 13 in the

Appendix).

Some attention was given to

detail in most of them. This was sometimes just shoelaces, rivet

holes,

or shoe markings created by reinforced lines or purposeful

shading. Others lacked detail but an effort waa made to go beyond a

rounded stump or club foot. In the case of a profile figure credit

was given for both feet on the basis of the one presented.

Minus credit was recorded when the feet were poorly formed.

They were usually rounded stumps, musical notes, or looked like

badly constructed golf clubs or hockey sticks. Sometimes detail was

present but the shape of the foot dictated a minus score. The level

of production was quite low (illustration I4 in theAppendix). This

was scored for both feet in profile drawings on the basis of the foot

shown. No score was given for feet that were missing or when one foot

scored plus and the other minus.

Minimal Detail. A plus score was assigned for minimal body

detail if the drawing had indications of hair,eyes,nose, mouth,

lines across the body at the waist dividing the upper part of the trunk

from the lower, lines across the wrist where the arm or sleeve and

hand met, lines separating the leg from the foot. On occasion some of

these details were absent andany of the items listed in reasonable

detail were present substituted for the missing details. For examples,

a belt buckle was scored to replace a missing nose, buttons substituted

for missing arm/hand lines, and shoelaces replaced hair that was lack

ing.

A total of seven scoring items was necessary for a plus score.

The hem of a skirt on the female drawing was a scoring item when the

dress style did not suggest the need for the middle body line, but

this was usually just a means of closing the bottom of the figure


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19

making the waist line a required scoring item.

Minus scores were given when the drawings had only hair,eyes,

nose,

and mouth or less in the head area and usually no other details

or lines intersecting parts of the body except mediocre attempts at

either arm/hand or leg/foot separation. The female drawing had a

simple line closing the end of the skirt. These pictures did not re

ceive the seven required scoring points even after substitution of

items.

A minus score was also granted for the type of figure that

had the above minimal head detail or less along with stick figure

arms and legs attached to the trunk in a crude manner. The trunk in

this case was generally a poorly formed square or circle with the limbs

merely attached to it.

Reasonable Detail. A plus score was obtained for reasonable

amount of detail when the drawing acquired a positive score on the

previous category plus any three of the following items after substi

tution:

hat, eyebrows, eyelashes, eyeglasses,iris,teeth, beard,

freckles,

collar detail, sleeve detail, elbows, cuff detail, buttons,

pockets, double or shaded lines at the waist for belt, buckle, shading

for shirt or pants, skirt pleats, knees, stockings

(female),

sock

detail, shoelaces or eyelets, heels, jewelry.

If the three things necessary for scoring reasonable detail

was not obtained it was then scored minus. The drawing received just

one point for minimal body unit detail.

Additional Detail. Additional detail was plus when the drawing

pasaed the prior categoriea and had two or more itema beyond what was

needed to pass reasonable detail. Any item not previously listed

was included in arriving at this score for a total of twelve items


25/71

20

such as meaningful shading, articles of clothing that go with a

particular type of costume, and realistic lines or points of expression

in the face, etc.

A minus score was given when the details were limited to the

three received in the previous category. If a total of twelve items

could not be found it was scored minus.

Bilateral Division. A large number of the drawings produced

by the children diagnosed as chronic brain syndrome were asymmetrical.

The bilateral division of the total figure was distorted when a center

line was established along the length of the body. A piece of 10x10

per inch transparent graph paper placed over the drawing was used to

evaluate the amount of distortion. A vertical mid-line was drawn in

ink on the graph paper. The graph paper was then placed over the draw

ings and adjustments made until the left and right sides of the figure

were approximately equal to each other. This base line on a normal

drawing passed up through the middle of the crotch, the center of the

neck and the nose with little differences in body configuration on

either side. It would pass up through the center of the leg, trunk,

and shoulder in profile drawings providing motion was not intended.

This item was scored plus if the bilateral division had reason

able symmetry excluding the outer limits of the arms andlegs. Could

the figure be folded down the middle with the left and right sides

being nearly equal? This scoring was subjective, especially when

the figures were extremely small or in motion, but the picture could

still be adequately judged with the aid of the mid-line.

A minus was scored if a proper mid-line could not be established

in a drawing not in motion, or if the distortion was such that one side


26/71

21

of the body was noticeably different from the other side. Aesthetically

the drawings of the majority of the handicapped children did not reach

the level obtained by the normal child. The drawings were markedly

off-balance. The judgment was aesthetical in nature but could be

made by an intelligent and sensitive person who had experience with

the scoring technique.

Head Placement. Placement of the head used the same center

line employed while determining bilateral division. A plus score was

granted if the outline of the face or head excluding hair style, was

within reasonable deviation right or left from the mid-line of the

trunk.

This item was scored minus if the difference was such that a

distortion was evident. This also was judgmental especially with small

figures and those in motion.

Neck Location. The location of the neck was scored from the

mid-line provided while judging the symmetry of the total figure. A

slight variation to the left or right of the center line was scored

plus. When the neck was not present it was still scored plus when the

head placement was plus and negative when the head placement was nega

tive.

Any pronounced deviation from center placement was scored

minus.

This scoring was also subjective and relied on personal judg

ment when an extremely small figure was encountered.

Body Proportion; minimal. The child was given a plus score

when his drawing resembled a person. The proportional configuration

was that of a human. The figure was not proportionally exact but the

child's effort resulted in a figure that had human qualities.


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22

A minus was received for a drawing that could not be recognized

as a person. The figure was either crudely drawn or looked like a toy,

doll,puppet, cartoon figure, or a mythical character. It was distorted

proportionally to such an extent that it fell below the configuration

expected of a person.

Body Proportion; reasonable. A plus was given when the child

passed the previous item, an attempt to draw a human figure, and the

drawing was a reasonable representation of a person. The basic body

proportions were within acceptable limits. The trunk,arms, legs,and

head were combined into a reasonable facsimile of a human figure.

A negative score was presented when there was a distortion of

the figure great enough to be a distraction to the viewer. The drawing

was reasonable in most aspects of proportion except one or two segments

of the body. There were exaggerations auch aa the head ahaped like a

keyhole, and extremely distorted nose, very large feet and/or hands,

or the trunk shaped like a coke bottle. The picture was recognizable

as a human but minor configural distortions were not within acceptable

limits.

Body Proportion; additional. When the drawing of a man or

woman looked very much like the sex they were intended to be, the

score was plus for this item. The shoulders were usually broader for

the male than for the female. The waist,hips,and arms and legs

were different for the two sexes. All of the body proportions con

tributed to the genuine impression of the sex designated. The draw

ings of a girl or boy also looked their part.

A minus was given when the drawing was a reasonable representa

tion of a person, no unusual distortions, but proportionally the sexual


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23

qualities were missing. Adequate sexual differentiation was lacking.

Resulta

Forty drawinga were acored by the author for each of the 19

categoriea. Twenty were produced by the impaired children and 20 by

the non-impaired children. Each aign waa acored plua, minua, or un-

scorable.

For example, a figure with poorly formed feet received a

minus score for that particular item, a drawing with feet judged to

be adequate was scoredplus,and a picture with the feet cut off was

considered unscorable.

There were two undergraduate psychology students selected to

learn the scoring system. They were instructed in its use and prac

ticed scoring a number of drawings. When they were proficient with

the system, they independently scored the forty pictures completed

earlier by the author. These were arranged in random order.

A correlation coefficient of .960 was obtained on the positive

scores recorded by the two judges. This correlation was significant

beyond the .05 level of confidence (one-tailedtest). This indicated

that 92 percent of the scoring was common to the two judges. Scoring

disagreements were later reso-lved in conference. On the whole, the

obtained scoring reliability was considered acceptable.

Chi square was employed to compare the drawings of the two

subject groups on the 19 signs. For each comparison, the null hypo

thesis was tested against the alternative that the handicapped group

contained a greater proportion of minus scores on a given indicator

(Table 1 in the Appendix presents a summary of the differences found

among the drawingsused). In the 19 comparisons made for the two sets

of drawings the number of differences actually found to be significant


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24

at the .05 level or bette r was 15 for judge A and 15 for judge B.

This suggested that the majority of the 19 signs reliably differentiated

the drawings of the impaired and control subjects.

A t test of the differ ences b etween the mean of Group A and B

was calculated on the positive scores given by the students. Both of

these judge A : 7.437 judge B: 7.225) were significant beyond the

.001 level of confid ence one-tailed

test).

It was clear in this sample

that the drawings of the impaired and control subjects had been reliably

differentiated by the scoring system employed.


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CHAPTER III

PROCEDURE

Problem

It was anticipated that the scoring system could be used to

distinguish the drawings produced by children with a learning disorder

from those of a matched group of normal children. It could perhaps be

used as a screening test.

Subjects

Two groups of children served as subjects in this study. Group

A consisted of 27 male children who were between 8 years, 4 months,

and 12 years, 10 months of age and were enrolled in the classes for

2

perceptually handicapped children in the Tulsa public school system.

The mean age for the group was 10 years, 7 months (See Table 2 in the

Appendix).

All 27 subjects were determined to be in good general health

and to have normal vision, some with corrective glasses.

All subjects in Group A had been diagnosed as neurologically

impaired or perceptually handicapped either by the testing department

of the Tulsa school system or a private psychiatrist or psychologist.

The electoencephalographic findings were abnormal in five cases and 12

subjects were on medication. Results on the Bender Visual Motor Gestalt

Test were strongly indicative of impairment in 18 instances. Achievement

Permission granted by the Research Projects Screening Committee,

Office of the Superintendent, Tulsa, Oklahoma.

25


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26

scores on the Stanford Achievement Test or the Wide Range Achievement

Test averaged 1.6 grades below expected level. Intellectual functioning

on the Wise, Stanford-Binet Scale, or Leiter Performance Scale ranged

from an IQ of 85 to 129 with a mean of 97.6. Variations in sub-scale

performance in the WISC and item difficulties in the other instruments

were also similar to those found in this form of handicap.

A group of 27 male children from an elementary school were

individually matched with the learning disorder group on the basis of

chronological age and intelligence. (See Table 5 in theAppendix).

Their ages were between 8 years, 2 months and 12 years, 5 months with

a mean of 10 years, 6 months. Their intelligence scores ranged from

88 to 119 with a mean of105-6. Achievement levels were adequate or

above in order to control for the statistically known percentage of

children with learning disability in the average classroom. The

achievement scores averaged 1.4 grades above the class placement. An

attempt was made to approximate the socio-economic status of the subjects

by the location of the school. The children were in good general health,

had no physical disability, and possessed normal vision according to the

public school nurse.

Procedure

/

'Three figure drawings, a male, a female, and a self-picture,

were obtained from each child. They were acquired from individual

test administration with Group A and from group administration of no

more than seven students with Group B. The children were tested during

the school day in a quiet room reserved by school officials. All

drawings were made on 8^ by 11 white unlined paper with a No. 2

pencil having an eraser. A ten minute time limit was set for each


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27

drawing: clinical experience has shown that this amount of time was

adequate for subjects to complete the figure. The children werepre

sented with three sheets of paper with the following instructions:

Drawing I - On this paper I would like you to draw a figure of

a whole person.

When the first drawing was completed, it was collected and the child

instructed to draw a figure of the opposite sex.

Drawing II - If you drew a picture of a girl or woman last time,

draw one of a boy or man this time.

The paper was again collected leaving a third sheet.

Drawing III - Now draw a picture of yourself.

If the child attempted to draw a stick figure on his first

drawing he was allowed to complete it. He was then told that it was

a good picture but not what was really wanted. He was then asked to

draw a picture of a whole person and not a stick man. If the child

continued on the next picture without correction he was then allowed

to complete all three pictures in the same manner. If correction was

made,

another piece of paper was presented and he completed a total of

four pictures, one stick man and the three required for the study.

The drawings of all 54 subjects, identifying data removed, were

randomly arranged according to a table of random numbers (Hoel,I96O).

The 162 drawings were scored independently by the two students trained

in the scoring method.

In statistical analysis the two groups were compared and the

three sets of drawings (same sex, opposite sex, and self-figure) were

also treated separately. A correlation coeficient was obtained on all

the positive scored given by the two students and on the scores received


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28

on the three seta of drawings. For both judges, Chi square waa employed

to compare the drawinga of the two aubject groupa on the 19 aigna and

a Jb test waa uaed to compare the total poaitive acorea of both groupa

(Ferguaon,

1959).

Chi aquare and a ;t teat were alao used to compare

each of the three aeta of drawinga. Chi aquare waa utilized to compare

the 19 indicatora in each aet, and a jt teat waa employed to compare the

total poaitive acorea. For each compariaon, the null hypotheaia waa

teated againat the alternative that the impaired group contained a

greater proportion of subjecta receiving minua acorea on their drawinga.


34/71

CHAPTER IV

RESULTS

The correlation between the poaitive acorea of Judge A and Judge

B waa .9099. Thia waa aignificant beyond the .01 level of confidence

(one-tailedteat). Thia poaitive coefficient waa anticipated from

the reaulta of the exploratory inveatigation and indicated that 85

percent of the acoring variance waa common to the two judgea. Good

agreement waa alao obtained on the three aeta of drawinga (aame sex,

opposite sex, andself-figure). A correlation of .9288 was received

on the same-sex drawing, .9064 was calculated on the opposite sex

drawing, and the self-figure received a coefficient of.8998. This

indicates that the common variance accounted for was 86, 82 and 81 per

cent respectively. The judges thus demonstrated adequate reliability

of scoring.

Table 4 in the appendix shows that a number of the 19 indicators

were found to differentiate the two groups. The number of comparisons

found to be significantly different by Judge A was 19, and 17 by Judge

B. For Judge A, in 15 of the comparisons, the difference between the

two groups was significant beyond the .001 level. In four comparisons,

the difference was significant at the .01 level. The difference between

the two groups for Judge B was significant beyond the .001 level in 15

of the comparisons while two were significant at the .01 level. The

remaining indicators occurred with approximately equal frequency in

29


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50

both groups, with any discrepancies attributable to chance factor.

These resulta constitute evidence for the rejection of the null hypo

thesis.

A comparison of the 19 signs for each of the 5 sets is shown in

Tables 5 and 6 in the appendix. For the same sex drawing. Judge A

had 15 comparisons scored different at or beyond the .05 significance

level while Judge B had 10. For the opposite sex drawing Judge A had

15 significant comparisons and Judge B had 16. Both judges had 14

comparisons at or beyond the .05 level of confidence on the self-figure.

There was 100 per cent agreement between the judges on the

following scoring items in the threesets: Line Type, Minimal Line

Function, Hand Formation, Finger Construction, Foot Construction,

Minimal Detail, Minimal Proportion, and Reasonable Proportion. These

categories were significant and lower scores on them were indeed more

characteristic of impaired children. The judges had 85 per cent agree

ment on Joining, Erasures, Head Placement, and Neck Location. Sixty-

seven per cent agreement was found on Reasonable Line Function, and

Reasonable Body Detail. Only 34 per cent agreement was obtained in

Additional Line Function, Arm Attachment, Additional Detail, and Bi

lateral Division. Additional Body Proportion failed completely as a

diagnostic indicator.

The ^ test was applied between the means of the two groups.

Results of the comparisons are shown in Tables 7 and 8. It can be

seen that the scores of the psychoneurologically impaired differed

from those of the normal children at the .0005 level of confidence

for each judge on each drawing.

This is a highly significant differential and suggests that the


36/71

31

total score obtained from any one of the three types of drawings can

be used reliably to differentiate neurologically impaired and normal

children. If a cut-off score of 10 is used, the results in the proper

categorization of 20 out of 27 normal children, and 14 out of 27 impaired

children, using the 81 drawings.


37/71

TABLE 7

GROUP COMPARISONS OF DRAWING SCORES

OF HANDICAPPED AND NORMAL

CHILDREN FOR JUDGE A

Comparison df

32

Same-Sex Drawing

Opposite-Sex Drawing

Self-Figure Drawing

Total Drawings

52

52

52

160

5.15

6.10

4.77

4.95

.0005

.0005

.0005

.0005

*One-Tailed test.


38/71

55

TABLE 8

GROUP COMPARISONS OF DRAWING SCORES

OF HANDICAPPED AND NORMAL

CHILDREN FOR JUDGE B

Comparison df

Same-Sex Drawing

Opposite-Sex Drawing

Self-Figure Drawing

Total Drawings

52

52

52

160

4.78

6.45

4.66

4.10

.0005

.0005

.0005

.0005

*One-Tailed Test.


39/71

CHAPTER V

DISCUSSION

From the results of the tests cited in Tables 7 and 8 which

yielded significant results, it is evident that the psychoneurologically

handicapped child does characteristically draw poorer figures than the

normal child. The correlation results suggest good agreement between

the judges in their ability to learn the scoring system and reliably

use it. It could possibly be used as a screening technique by other

trained persons providing it is modified. The combined judgments

were adequate.

It is suggested that Additional Body Proportion failed as a

diagnostic indicator because it was too refined for the developmental

level of the children involved. Apparently it required perception

and drawing skills beyond the capability of the subjects studied. This

required level of refinement could also explain the poor results found

with Additional Line Function, Additional Body Detail, and Bilateral

Division. The scoring criterion was set too high and therefore was

unreliable. Reasonable Body Detail and Reasonable Line Function were

also slightly too selective.

The original 19 scoring categories should be reduced to a final

scoring system which includes only the 12 significant categories agreed

upon by the judges. A composite score should then be computed for each

subject by adding all his scoring points. The highest composite score

34


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35

a subject could get would be 12. This final scoring system should

once more be tested with a final cross-validation of the scoring

system being carried out on a larger group of subjects. There is good

indication that a high degree of confidence can be obtained in the use

of this system as a screening device to differentiate between groups of

children with learning problems and those with satisfactory school

achievement.

Some limitations and observations regarding the study are in

order. The desire for direct applicability dictated the use of the

Chi square and ^ test over matched pairs design. The use of the latter

would have been a more precise comparison because of the age range of

the subjects relative to the size of the entire sample. The matched

pairs design, however, was considered so foreign to most clinical

settings that it would prevent direct application of the results. This

limitation would be alleviated when sufficient data are available to

permit the establishment of adequate age norms.

The outcome of the study has been influenced, positively or

negatively, by the definition and structure of the scoring categories.

The number, definitions, and the unexpected amount of overlap between

categories have created a bias through loading. The categories were

not as independent as desired. Adjustments should be made in any

future study such as an increase in the number of categories in order

to refine the system's ability to differentiate between groups. The

overlap and description of the categories should also be investigated

for the same purpose.

A thorough review of the data revealed that some of the handicapped

children who had relatively high scores on the drawings had very high


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36

intellectual levels. This intellectual functioning apparently helped

them compensate for their handicap, while several of the normal children

lost scoring points because thearms,hands, or feet were either hidden

or missing from their figures. A difference in the time used to draw

the figure was also noticed. The handicapped children rushed to com

plete their drawings apparently without noticing that the detail was

missing. The normal child took longer and evidenced more concentration

and effort. The results of having the three sheets of paper at one

time was also noticed. Strong pencil pressure on the top piece of

paper caused an indentation in the following piece of paper making

erasures difficult to judge, plus giving some of the children a guide

to follow in drawing their next picture. Single sheets of paper should

be presented to each child for each picture.

Group testing would not be advisable in any future study unless

strict controls could be established, such as individualized booths

and absolutely no talking. In the present study several children in

the control group saw what their neighbors were drawing and may have

copied. Occasionally, one child would make a spontaneous comment such

as I'm going to make a clown , creating a set that the others followed.

One comical leader, by word or gesture, would cause the emergence of a

playful attitude that distracted the others from their task. Group

pressure concerning who finished first or last also influenced the

results. Some children rushed to complete their drawing before the

others,

or the slower child, on finding he was the last to finish,

would leave his drawing incomplete to prevent embarassment. The

teacher's personality, method of teaching, and/or instructions con

cerning the drawing test appeared to be an influence. The group


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37

differed in behavior and production depending upon their particular

teacher.

Difficulties and inadequacies in present day diagnosis of psy

choneurological learning disorders may have influenced the purity of

the experimental sample. Drawings produced by some of the impaired

children created concern about questionable diagnosis and placement.

Some pictures were more representative of emotional problems than per

ceptual difficulty. This could explain why some of the handicapped

children did not score as anticipated. It is suggested that any

pro

posed follow-up study should be based on recent individual testing and

more exacting diagnostic standards.

The effect of remedial techniques on the figures drawn by the

handicapped children must also be considered in any follow-up study.

This was not controlled in the present study. Some of the impaired

children had two or more years of specialized education while others

were just finishing their first year. This uncontrolled factor possibly

had a negative effect on the results. It is recommended that any further

study have the child draw the figures as part of his initial testing

before remedial techniques have intervened.

The findings of this study must be regarded as preliminary ones.

Specifically, it has not yet been possible to compare sufficiently

large groups of children with learning disabilities to permit experi

mental control over such components as lesion type, locus, severity,

and cause of dysfunction. It also remains to be determined how effec

tively these indicators can be utilized in individual diagnosis even

if they can distinguish between groups.


43/71

CHAPTER VI

SUMMARY AND CONCLUSIONS

This study attempted to evaluate and apply a number of drawing

indicators, cited in the literature as characteristic of organic

patienta, to the picture productiona of neurologically impaired children,

Thia waa accompliahed through the conatruction of a acoring ayatem that

utilized the child'a figure drawinga. Nineteen acoring categoriea were

developed in order to differentiate the drawinga of neurologically

impaired children from the drawinga of normal children. It was found

that the groupa could be aignificantly differentiated from each other

by the acorea the children received. Eight of the signs were very

reliably judged and significantly more prevalent among a group of

handicapped children than among a group of normal children. These

were poor production of Line Type, Minimal Line Function, Hand Forma

tion, Finger Construction, Foot Construction, Minimal Body Detail,

Minimal Body Proportion, and Reasonable Body Proportion. Four other

scoring categories were significantly important and produced a reason

able amount of agreement between the judges. These were Joining,

Erasures, Head Placement, and Neck Location. The remaining 7 signs

did not differentiate between the two groups.

It was found that the handicapped children had significantly

lower total scores than the normal children on each of the drawings.

This suggests that this scoring system for drawings would be useful

38


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39

as a screening devise for detecting learning disabilities in children.

The limitations and observations regarding the study were discussed.

Some suggestions for further research were also made .


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40

REFERENCES

1. Abercrombie, M. L. J., & Tyson, M. C. Body image and Draw-A-Man

Test in cerebral palsy. Develop. Med. Child Neurol.. I966, 8, 9-15.

2.

Bender, Lauretta, The Goodenough Test in chronic encephalitis.

J. Nerv. Ment. Dis., I94O, 91, 277-286.

3. Bender, Lauretta, & Silver, A. Body image problems of the brain

injured children. J. Soc. Issues. 1948, 4, 84-89.

4.

Blanchard, Helen M. A preliminary study of the drawing of the

human figure by brain injured children. Unpublished Master's

Thesis, Univ. of Denver, 1952.

5. Brown, F. House-Tree Person and human figure drawings, in D.

Brower & L. E. Abt(Eds.),Progr. in Clin. Psych. Vol. 1, Sec. 1,

New York: Grune & Stratton, 1952.

6. Centers, Louise, & Centers, R. A. Comparison of the body images

of amputee and non-amputee children as revealed in figure drawings.

J. Proj.Tech., 1963, 27, 158-165.

7. Diagnostic and Statistical Manual of Mental Disorders. Washington,

D. C : American Psychiatric Association, I965.

8. Ferguson, G. A. Statistical Analysis in Psychology and Education.

New York: McGraw-Hill, 1959.

9. French, Viola. How to Draw and Paint Children. Tustin, Calif.:

(430 West Sixth Street) Walter T. Foster, No. 31.

10. Goodenough, Florence L. Measurement of Intelligence by Drawings.

Yonkers,New York: World, 1926.


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41

11. Goodenough, Florence L., & Harris, D. D. Studies in the psychology

of children's drawings. Psychol. Bull., I95O, 47, 569-455.

12. Harris, D. B. Children's Drawings as Measures of Intellectual

Maturity. New York: Harcourt, Brace & World, I965.

15. Hoel, P. G. Elementary Statistics. New York: John Wiley & Sons,

i960.

14. Johnson, Doris, & Myklebust, H. Learning Disabilities: Educational

Principles and Practices. New York: Grune & Stratton, 1967.

15.

Koppitz, Elizabeth M., Sullivan, J., Blyth, D. D., & Shelton, J.

Prediction of first grade school achievement with the Bender Gestalt

Test and human figure drawings. . Clin. Psychol., 1959, 15, I64-I68.

16. Lowenfeld, V. Creative and Mental Growth. New York: Macmillan,

1965.

17. Machover, Karen. Personality Projection in the Drawing of the

Human Figure. Springfield, 111.: Charles C. Thomas, 1949.

18.

Michal-Smith, H. The identification of pathological cerebral

function through the H-T-P technique. J,. Clin. Psychol., 1955, 9,

293-295.

19. Psychopathological Disorders in Childhood: Theoretical Considera

tions and Proposed Classification. New York: Group for the

Advancement of Psychiatry, I966.

20. Reznikoff, M.,ScTomblen, D. The use of human figure drawings in

the diagnosis of organic pathology. J.. Consult. Psychol.. 1956,

20(6),467-470.

21. Rozensweig, Z. Psychodiagnosis. New York: Grune & Stratton, 1949.

22. Shibb, D. E., & Loudon, Mary L. The Draw-A-Man Test and

achievement in the first grade. Educ. Res.,I964,57,(10)518-521.


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42

23.

Silverstein, A. B., & Robinson, H. A. The representation of

orthopedic disability in children's figure drawings. . Consult.

Psychol.. 1956, 20(5),555-541.

24.

Vane, Julis R., & Eisen, Virginia W. The Goodenough Draw-A-Man

Test and signs of maladjustment in kindergarten children. .

Clin.

Psychol.. 1962, 18, 276-279*

25. Vernier, Claire M. Projective test productions: 1. Projective

Drawings. New York: Grune & Stratton, 1952.

26.

Wysocki, B. A.,

,

Whitney, Eleanor. Body image of crippled

children as seen in Draw-A-Person Test behavior. Percept. Mot.

Skills,

1965, 21, 499-504.


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4

Fig. 1. Normal Drawing


49/71

F ig . 2 . Normal Drawing


50/71

45

F ig . 5 Normal Drawing


51/71

46

Fig. 4 Normal Drawing


52/71

F ig . 5. . Normal Drawing


53/71

Fig. 6. Handicapped Drawing


54/71

Fig. 7. Handicapped Drawing


55/71

50

F ig . 8 . Handicapped Drawing


56/71


57/71

52

F ig . 10 . Handicapped Drawing


58/71

53

: ^

c ^

tti ^

\

^ ^

Pig. 11 . Positive Hands and Fingers


59/71

54

k

>

^ ^

^

: =

^ \ ^

Fig. 12. Negative Hands and Fingers


60/71

55

d7

W

lui \

s a

/

M \ C *

Fig. 13. Positive Foot Construction

C(.


61/71

56

i lA

b^

U

e)

Fig. 14. Negative Foot Construction


62/71

TABLE1

COMPARISON OF THE 19SIGNSBYJUDGESA AND B

BETWEEN CONTROLAN DHANDICAPPED SUBJECTS

IN

TH E

EXPLORATORY INVESTIGATION

57

Sign

I.

II.

III.

IV.

V.

Line

A.

B.

C.

D.

E.

F.

Type

Function;

minimal

Function;

reasonable

Function;

additional

Joining

Erasures

Assembly

A.

B.

C.

D.

Arm

attachment

Hand

formation

Finger

construction

Foot

construction

Detail

A.

B.

C.

Minimal

Reasonable

Additional

Symmetry

A.

B.

C.

Bilateral

division

Head

placement

Neck

location

Proportion

A.

B.

C.

Minimal

Reasonable

Additional

Chi

square

2.58

18.05

15.00

1.97

17.14

17.14

11.84

21.05

21.05

17.47

17.14

12.58

9.72

8.69

1.81

5.58

24.00

8.15

0.00

JudgeA

P

.20

.001

.001

.20

.001

.001

.001

.001

.001

.001

.001

.001

.01

.01

.10

.02

.001

.01

..

Chi

square

10.42

22.56

6.89

5.58

15.00

19.26

6.15

19.05

19.05

15.14

18.05

19.26

5.91

0.00

0.00

0.00

14.00

11.90

1 97

JudgeB

P

.01

.001

.01

.02

.001

.001

.02

.001

.001

.001

.001

.001

.05

.001

.001

.20


63/71

58

TABLE2

DATA:

GROUPA

No.

1.

2.

5.

4.

5.

6.

7.

8.

9.

10.

11.

12.

15.

14.

15.

16.

17.

18.

19.

20.

21.

22.

25.

24.

25.

26.

27.

Mean

Code

BC2

FMO

FGO

MCO

RGO

CWO

EKO

MKO

MPO

TKO

NMO

AMO

CMI

LNO

YPO

PRO

CKO

BJ5

JCO

DRO

SM5

MTO

PBO

ERO

HDO

MSO

LCO

CA

8-4

8-6

8-10

9-10

9-2

9-11

10-0

10-0

10-2

10-2

10-5

10-7

10-8

10-8

10-9

10-11

11-0

11-1

11-5

11-5

11-7

11-10

11-11

12-4

12-4

12-10

12-10

10-7

IQ

111

94

104

115

102

90

90

95

111

89

107

87

129

87

97

88

92

102-

91

86

99

97

104

94

96

85

95

97.6

Estimated

Grade

2nd

2nd

5rd

3rd

3rd

4

th

4

th

4th

4 th

4

th

4 th

5 th

5 th

5 th

5 th

5 th

5

th

5th

5th

5th

5

th

6 th

6 th

6

th

6th

6th

6th

4.6

(Table continued

on

next page)


64/71


65/71

60

No.

1.

2.

3.

5.

6.

7.

8.

9.

10.

11.

12.

15.

14.

15.

16.

17.

18.

19.

20.

21.

22.

25.

24.

25.

26.

27.

Mean

Hand

Used

RH

RH

LH

LH

RH

RH

RH

RH

RH

RH

RH

RH

LH

RH

LH

RH

LH

RH

RH

RH

RH

RH

RH

RH

RH

RH

22RH

5LH

TABLE2

Time

I

59

315

26

218

96

150

80

230

115

110

68

270

138

126

68

115

550

116

105

186

220

77

266

55

196

80

142.3

Continued

Time

II

55

180

58

140

129

105

160

263

124

105

78

216

208

157

95

55

196

165

27

165

258

70

175

50

140

68

127.5

Time

III

58

170

42

165

116

64

170

278

120

110

120

155

170

138

65

88

172

270

. 68

220

212

105

239

45

155

115

155.5

Average

Time

44

222

55

174

114

100

157

257

120

108

89

214

172

154

76

85

255

185

67

190

223

84

226

50

163

88

135.2


66/71

TABLE

5

DATA: GROUP

B

^1

N o .

1.

2.

5.

4.

5.

6.

7.

8.

9.

10.

11.

12.

15.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

Mean

Code

DMI

ESO

MWO

MJO

SM2

PTO

WPO

RMO

e o

MRO

MTO

RPO

WDO

PHO

MGO

HJ2

CJO

BD2

WJ2

CBO

MD2

DDO

SWO

CM2

LRO

FJO

DBO

CA

8-2

8-6

8-10

9-1

9-4

0-6

10-5

9-6

10-5

10-1

10-6

10-6

10-10

10-4

10-8

11-5

11-1

11-5

11-6

11-6

11-6

11-10

11-7

11-10

12-1

12-4

12-5

10-6

IQ

110

88

101

120

105

96

94

97

108

100

105

101

116

107

109

96

105

104

105'

96

112

116

100

118

118

119

110

105.6

Grade

2nd

2nd

5rd

3rd

3rd

5rd

4 th

3rd

4th

4 th

4 th

4 th

5th

4th

5 th

5 th

5 th

5 th

5 th

5 th

5 th

6th

5 th

6th

6th

6th

6th

4.4

Tablecontinued onnext page)


67/71

TABLE 3 Continued

62

No.

Total Reading

Arith.

Lang,

1 .

2 .

5 .

4 .

5 .

6 .

7 .

8 .

9 .

10 .

11 .

12.

1 3 .

14 .

15 .

16 .

17 .

18.

19 .

20 .

21 .

22.

25 .

24 .

25 .

26 .

27.

2 .4

2 .6

4 . 4

4 . 1

4 . 1

5 .9

5 .6

5 .8

6 .0

5 .2

6 .1

6 .5

7 .5

6 .9

7 . 9

7 .5

7 .2

6 .7

7 .7

7 .9

8 .1

7 .2

6 . 8

7 . 8

6 .9

7 .9

7 .5

2 .4

2 .4

2 .4

4 .6

4 . 4

4 .0

5 7

4 .2

5 .7

5 .4

6 .7

7 .2

7 .4

6 .5

7 .0

7 .6

7 .4

6 . 3

7 .2

7 .2

8 .7

5 .9

6 .5

8 .3

7 .2

8 .5

8 .1

2 .3

2 .2

5 .4

4 .0

4 .1

5 .8

4 .6

5 .5

4 .7

4 .5

5 .6

5 .8

6 .1

5 .1

6 .9

5 .6

6 .5

5.7

6 .5

6 .5

7 .4

6 .0

7 .1

7 .2

7 .1

7 .6

7 .0

2 .8

2 .2

5 .5

4 .2

4 .0

5 .8

6 .1

5 .9

5 .2

5 .5

6 .1

6 .7

5 .9

6 .5

6 .9

6 .9

6 .9

5.7

6 .5

6 .5

7 .9

6 .1

6 .7

8 .9

6 .6

8 .1

7 .2

Mean

6.1

6.2

5.5

^California Achievement Test

(Table continued on next page)

5.8


68/71

63

T BLE 3 Continued

No.

1.

2.

5.

4.

5.

6.

7.

8.

9,

10.

11.

12.

15.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

Mean

and

Used

LH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

RH

26RH

ILH

Time

I

128

126

240

308

115

165

180

150

280

260

420

165

188

255

510

540

450

405

265

255

200

545

285

300

278-

201

345

272.5

Time

II

160

95

225

250

240

296

205

146

140

558

270

170

540

140

595

570

519

425

380

305

295

465

150

450

270

260

560

290.5

Time

III

. 165

90

200

290

210

165

150

170

122

290

405

255

450

215

504

400

410

585

450

505

415

580

105

480

550

278

550

286.4

Average

Time

151

105

221

276

188

209

178

155

181

515

565

183

386

205

556

570

593

405

556

516

505

597

160

405

295

246

545


69/71

TABLE4

COMPARISON

OF THE 19

SIGNS

BY

JUDGES

A AND B

BETWEEN CONTROLAN DHANDICAPPED SUBJECTS

64

Sign

I.

II.

III.

IV.

V.

Line

A.

B.

C.

D.

E.

P.

Type

Function;

minimal

Function;

reasonable

Function;

additional

Joining

Erasures

Assembly

A.

B.

C.

D.

Arm

attachment

Hand

formation

Finger

construction

Foot

construction

Detail

A.

B.

C.

Minimal

Reasonable

Additional

Symmetry

A.

B.

C.

Bilateral

division

Head

placement

Neck

location

Proportion

A.

B.

C.

Minimal

Reasonable

Additional

Judge

A

Chi

square

22.50

20.48

10.59

11.18

16.56

55.99

9.71

27.77

27.77

55.85

22.68

15.71

15.16

7

=

51

15.10

14.89

50.55

26.25

9.55

P

.001

.001

.01

.001

.001

.001

.01

.001

.001

.001

.001

.001

.001

.01

.001

.001

.001

.001

.01

JudgeB

Chi

square

20.88

21.86

25.52

15.58

18.85

41.77

14.74

. 51.52

27.46

51.09

23.15

11.84

7.90

14.00

9.51

2.49

25.00

29.88

0.12

P

.001

.001

.001

.001

.001

.001

.001

.001

.001

.001

.001

.001

.01

.001

.01

.20

.001

.001

.80


70/71

65

TABLE5

COMPARISON OF THE 19SIGNSFOR THETHREE

SETSOFDRAWINGS BYJUDGEA BETWEEN

CONTROL

A N D

HANDICAPPED SUBJECTS

o

Sign**

I.

II.

III.

IV.

V.

A .

B.

C.

D.

E.

F.

A .

B.

C.

D.

A .

B.

C.

A .

B.

C.

A .

B.

C.

DAM

Chi

square

6.51

10.80

4.21

0.55

4.42

15.89

2.15

8.80

10.56

8.22

11.44

5.20

2.55

2.82

4.96

4.96

10.71

10.71

2.57

P

.02

.01

.05

.70

.05

.001

.20

.01

.01

.01

.001

.10

.20

.10

.05

.05

.01

.01

.20

DAW

Chi

square

8.96

4.91

1.54

2.57

5.55

15.45e

5.60

10.90

10.90

15.71

6.95

6.17

6.18

2.55

8.21

7.85

5.09

7.52

.58

P

.01

.05

.50

.20

.10

.001

.10

.001

.001

.001

.01

.02

.02

.20

.02

.01

.05

.01

.80

DAS

Chi

square

7.50

5.68

6.03

5.59

9.25

6.17

5.60

7.05

7.05

10.68

4.96

4.91

4.96

1.05

3.00

2.85

13.81

5.09

1.51

P

.01

.01

.02

.02

.01

.02

.10

.01

.01

.01

.05

.05

.05

.50

.10

.20

.001

.05

.30

a

Fordescriptions

of

signsrefer

to

Table

4


71/71

66

TABLE

6

COMPARISON OF THE 19SIGNSFOR THETHREE

SETSOFDRAWINGS BYJUDGEBBETWEEN

CONTROLA NDHANDICAP PED SUBJECTS

o

Sign^

I.

II.

III.

IV.

V.

A.

B.

C.

D.

E.

F.

A.

B.

C.

D.

A.

B.

C.

A.

B.

C.

A.

B.

C.

DAM

Chi

square

6.15

12.00

5.20

2.55

4.96

12.80

2.84

8.71

6.76

9.55

15.17

2.05

0.58

2.50

4.96

1.71

7.94

11.17

0.00

p

.02

.001

.10

.20

.05

.10

.10

.01

.02

.01

.001

.20

.50

.20

.05

.20

.01

.001

.00

DAW

Chi

square

7.42

10.59

15.05

12.27

6.18

22.74

5.94

16.55

14.91

11.10

5.55

4.96

0.55

7.48

4.96

0.85

8.88

9.25

1.51

P

.01

.01

.001

.001

.02

.001

.05

.001

.001

.001

.05

.05

.50

.01

.05

.50

.01

.01

.50

DAS

Chi

square

7.42

9.64

7.50

2.53

6.85

6.55

5.94

6.55

7.08

10.87

5.68

5.55

0.85

5.69

' 0.75

0.47

8.55

9.64

0.00

P

.01

.01

.01

.20

.01

.02

.05

.02

.01

.001

.02

.02

.50

.02

.50

.50

.01

.01

.00

Vor descriptions ofsigns refe r toTable4.

Dap Neurological Interpretations

Documents