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Since two groups of well-adjusted boys were included Harris raw score is then scaled for age it is not possible
in that study, one matched for chronological and the to remove items as this would decrease the scores
other for mental age, it was possible to conclude that the arti®cially and make the scaled score inappropriate. The
greater number of emotional indicators in the drawings solution adopted was to remove the confounding items
of the clinical group was not simply a function of these from the emotional indicator list. These were tiny head,
boys drawing according to their mental age. Their scores short arms, long arms, hands cut o, no eyes, no nose,
were higher than the scores of both groups of well- no mouth, no body, no arms, no legs, no feet and no
adjusted children. There is a potential problem, how- neck. In this list, `short arms' has already been found to
ever, in the way that the groups were matched in that be invalid according to the new UK norms and `no neck'
study. Four subtests from the WISC-III were used ± two is no longer a valid item for boys (2). Other items found
performance (block design and object assembly) and two to be not valid in the new norms are shading of face,
verbal (vocabulary and similarities) ± but none of these shading of body/limbs, big ®gure, teeth (boys only) and
tests is speci®cally based on children's drawing skills. It legs pressed together. This leaves 13 emotional indica-
is possible that a lack of drawing skill may account for tors which were used as the dependent variable in this
the greater number of emotional indicators in the study: poor integration of parts, shading of hands/neck,
disturbed children's ®gures. It is important therefore gross asymmetry of limbs, slanting ®gure, tiny ®gure,
that the comparison groups should be matched more transparency, crossed eyes, arms clinging to body, big
closely on their drawing ability. hands, genitals, monster/grotesque ®gure, three or more
The Goodenough±Harris Draw-a-Man test (7) pur- ®gures spontaneously drawn, and clouds.
ports to measure intellectual maturity or, as Harris
preferred to call it, conceptual maturity. From the
evidence in the literature Harris believed that the child's Study 1
drawing is an index of his or her conception of that
object, and that the concept of an object, in this case the Method
human ®gure, undergoes elaborate dierentiation with
increasing age. As well as awarding scores for the The participants
number of items included in the ®gure the scoring system
also awards scores for the proportions of the ®gure, the The clinical group consisted of 44 boys who were full-
skill with which the parts are joined together and the time pupils at special schools for children with emotion-
quality of the line. Scores on this test correlate al±behavioural diculties. These boys were aged from 7
reasonably well with scores on other IQ tests. Harris to 11 years 8 months (mean 9 years 10 months). Their
(7), for example, gives signi®cant correlations of 0.26 to mean IQ was 83.11 (s.d. 11.37). All had attention de®cit
0.92 for the Stanford±Binet and 0.38 to 0.77 for the and disruptive behaviour disorders as de®ned by DSM-
Wechsler tests. Since the scores are based directly on the IV (6), including attention de®cit/hyperactivity disorder
child's drawing this might be a better means of matching (three sub-types), attention de®cit/hyperactivity disorder
contrasting groups of participants in order to compare (not otherwise speci®ed), conduct disorder, oppositional
their emotional indicator scores. de®ant disorder and disruptive behaviour disorder (not
The present study was designed to ascertain whether otherwise speci®ed). Just under half the sample was
the signi®cant dierence in emotional indicators between in foster-care or children's homes; all other children were
emotionally disturbed and well-adjusted children would in their own homes although approximately half were in
remain if the groups were matched on the Goodenough± single-parent households. A psychiatrist or social work-
Harris scoring system. If the emotional indicators are er had been allocated to each child in the sample.
sensitive to disturbance which is independent of chil- The comparison group consisted of 44 boys aged 6±11
dren's mental age and drawing level then the dierence years (mean 9 years 2 months). These children attended
should remain. If, however, the higher indicator scores of mainstream schools and were deemed by their teachers
the clinical children are simply indications of their poorer to be well-adjusted (i.e. with no apparent emotional
drawing ability then the previously observed dierence in problems). A number of boys were tested until a suitable
emotional indicator scores should disappear. match was found for each child in the clinical group on
There is some overlap between Koppitz's emotional the basis of their Goodenough±Harris scores and, as
indicators and the Goodenough±Harris scale. For closely as possible, chronological age.
example, points are gained on the Goodenough±Harris
scale for including hands, whereas `hand cut o ' is
credited on the indicator list; the Goodenough±Harris Materials
scale credits points for good proportions whereas `poor
proportions', such as short or long arm length, is Each child was provided with a pencil, an eraser and a
credited on the indicator list. Since the Goodenough± sheet of plain white A4 paper (297 ´ 210 mm).
M. V. Cox and M. Catte 303
Severely disturbed children's drawings
pile; in the `paired format' the judges identi®ed the Group format. ``This is a set of drawings from British
clinical drawing from a pair consisting of the clinical children. All the children were boys. The children were
drawing and its comparison group match. It was all asked to draw a `whole person'. Some of the children
expected that this paired format would lead to a higher are considered to have emotional/behavioural dicul-
number of pictures being correctly identi®ed. The judges ties, some of the children are considered normally
were required to perform these tasks both with and adjusted. Your task is to discriminate between the
without knowledge of the children's ages. It was children's drawings and to identify the disturbed chil-
expected that accuracy would improve when the chil- dren's pictures. This task involves judging each drawing
dren's ages were available. in turn, deciding whether the drawing came from a
The use of experts and trained professionals as judges disturbed child or a normally adjusted one. You must
is common in the clinical use of drawings. There is, record your decisions on the answer sheet supplied by
however, much evidence that expert judges perform no putting a mark in the column to which you think each
better than novices (1, 8, 14, 17, 20). It is not clear why. drawing belongs.''
One reason may be that the clinicians may not in fact
have had a great deal of experience of children's Paired format. ``This task involves judging a pair of
drawings; another is that the drawings of normal and drawings, where one is a disturbed child's and one is
disturbed children may not be signi®cantly dierent. from a normally adjusted child. You must record your
Whatever the reason, in the light of this evidence non- decisions on the answer sheet supplied by choosing
experts were used as judges in the current study. which of the pair is the disturbed child's drawing and
writing it in the column provided.''
Method In the `no ages' condition the judges were told that
the children were all aged between 6 and 12 years. In the
The participants `with ages' condition the ages of the children were
supplied.
Twenty undergraduate students, all over 18 years of age,
were used as judges. There were 13 females and 7 males.
Results
Materials
The number of drawings correctly identi®ed was calcu-
lated for each judge in each task. In the group format
The ®gures used in Study 1 were presented in four
tasks the total possible score was 88; in the paired
dierent tasks:
format tasks it was 44. A series of binomial tests was
1. Clinical and comparison group drawings, group performed in order to ascertain the number of judges
format, no ages. who were able to identify the drawings at better than
2. Clinical and comparison group drawings, group chance level. In order to avoid the possibility of a Type I
format, with ages. error (i.e. ®nding a signi®cant eect in error) the family-
3. Clinical and comparison group drawings, paired wise error rate was applied (p < 0.05/10 = 0.005).
format, no ages. When this criterion was adopted only one judge was
4. Clinical and comparison group drawings, paired found to be able to perform better than chance, correctly
format, with ages. identifying 68% of the drawings in task 2 (group format,
with ages). There is no obvious reason why this judge
In the group format, the 88 drawings were randomly
was so successful. The mean percentage correct score of
mixed within a pile. In the paired format, each clinical
the 10 judges in each task was as follows: 49% in task 1
child's drawing was paired with its partner in the
(group format, no ages), 58% in task 2 (group format,
comparison group, so there were 44 pairs presented. In
with ages), 49% in task 3 (paired format, no ages) and
the `no ages' condition, no information at all was
59% in task 4 (paired format, with ages). This highest
available regarding the age of the drawers. In the `with
mean of 59% (26 out of 44 correctly identi®ed) is not
ages' condition the ages of the drawers were available.
signi®cantly above chance level.
A repeated measures analysis of variance showed a
Procedure signi®cant eect of `with ages' vs. `no ages'
(F(1,18) 37.34, p < 0.001) but no signi®cant eect of
Ten judges completed task 1 and then task 2; the other 10 format and no signi®cant interaction. Although the
judges completed task 3 and then task 4. The following mean scores were higher when the ages of the children
written instructions were given. The form of the instruc- were available it is important to emphasise that the
tions changed to allow for the dierent formats used. scores were still not above chance levels.
M. V. Cox and M. Catte 305
Severely disturbed children's drawings
Summary and discussion time, nor when the ages of the children were available.
The drawings of the children in the clinical group were
Previous research (2) replicated Koppitz's (10) ®nding not reliably distinguished from those of children
that there are dierences between the human ®gure matched for drawing ability. It might be objected that
drawings of severely emotionally disturbed and normally these judges were non-experts and that professionals
adjusted children. In particular, signi®cantly more trained in the use of drawings for diagnostic purposes
emotionally disturbed children draw more than one might have had more success. There is much evidence
emotional indicator from Koppitz's list as compared from previous research (e.g. 1, 8, 14, 17, 20), however,
with normal children. Even when a revised list of which shows that in fact experts are no more successful
indicators was used, based on new normative data, the than novices.
dierence was still signi®cant and was shown to be the It appears, then, that severely emotionally disturbed
case not only for children matched for chronological age children do not draw ®gures which are dierent from
but also for those matched for mental age. These those drawn by normal children with the same level of
®ndings suggest, then, that emotionally disturbed chil- drawing ability. We conclude that dierences noted in
dren are not merely drawing in a similar way to younger previous research, in particular the greater number of
children. emotional indicators, are likely to have been due to the
There are doubts, however, about the way in which poorer drawing ability of the emotionally disturbed
the clinical and comparison groups were matched in this children. This conclusion is important because it casts
previous research, since none of the WISC-III subtests doubt on the view that the Draw-a-Person test is
was based on children's drawing ability. It remains clinically useful for assessing emotional disturbance or
possible that the emotionally disturbed children may indeed that it is possible to identify the human ®gure
have had poorer drawing ability and it was this which drawings of emotionally disturbed children simply by
marked their drawings as dierent from those drawn by visual inspection. It is not only the Draw-a-Person test
normal children. In Study 1 of the research reported here within a clinical setting which is under scrutiny. There
each ®gure drawn by a child in the clinical group was are also long-standing worries about the use of this kind
matched with one drawn by a normally adjusted child of test to assess children's intellectual levels. Despite
according to its score on the Goodenough±Harris some reasonably high and signi®cant correlations cited
scoring system. Since some items on the Goodenough± in the literature (7) some studies have found much lower
Harris scale are the same as those on the emotional correlations. On this basis, Motta et al. (14) concluded
indicator list it was necessary to remove these items that human ®gure drawings should not be used to assess
when assessing the number of emotional indicators in intellectual level or indeed in clinical assessment.
the drawings. This conclusion does not mean that human ®gure
After this matching was achieved in Study 1, the drawings are of no use at all in the clinical context.
groups did not dier signi®cantly in the number of Indeed, a number of authors (e.g. 4, 19) have advocated
children who scored more than one emotional indicator, their use as a means of establishing rapport with children
the criterion of importance identi®ed by Koppitz. who may be reluctant to talk about their problems and
Furthermore, in Study 2, only one out of the 20 judges feelings. Drawing is a relatively non-threatening activity
was able to dierentiate successfully, above chance level, which most children enjoy; it can engage their attention
between the ®gures drawn by the children in the clinical and provide a focus for discussion. It is for this purpose,
group and those drawn by the normally adjusted then, rather than as a diagnostic aid that we would
children. It did not appear to help the judges when the recommend the use of the Draw-a-Person task in the
drawings were presented in pairs, rather than one at a clinical context.
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