THE DRAW-A-PERSON TEST AND PSYCHONEUROLOGICAL LEARNING DISABILITY IN CHILDREN by CHARLES LOUIS PRATT, B.S. 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.
THE DRAW-A-PERSON TEST AND PSYCHONEUROLOGICAL LEARNING DISABILITY IN CHILDREN by CHARLES LOUIS PRATT, B.S. 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.
THE DRAW-A-PERSON TEST AND PSYCHONEUROLOGICAL LEARNING DISABILITY IN CHILDREN by CHARLES LOUIS PRATT, B.S. 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.
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 . " - ) r3 i<ik tio. ' / /6i> Cci). ^ ACKNOWLEDGEMENTS I am deeply indebted to Profeaaor Charlea H. Mahone for hia direction on thia theaia and to Joe D. Garma, Ph.D. and Darrell Canfield, M.S. for their helpful criticiam. In addition, appreciation ia expreaaed to my wife, Carol, for her assistance and encouragement in the preparation and execution of this study. 11 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 43 111 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 of t^ Teat in the Major Study by Judge B ;... 35 IV 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 8. Handicapped Drawing 50 9. Handicapped Drawing 51 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 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. 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 3 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. 285). 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 and pro- 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 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 and legs, 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 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 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. 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 and west), body orientation (right and left), meaning of facial expressions (happiness and anger), 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. 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 of 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 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 the Appendix), 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 10 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 the Appendix). 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 11 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, some mis- 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 12 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 from pro- 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 13 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 often pro- 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 14 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 15 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 the ends. 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 16 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 both arms, 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 to waist). 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 the Appendix). 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 17 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 18 (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 the Appendix). 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 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 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 and legs. 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 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. 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 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 scored plus, 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-tailed test). 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 drawings used). In the 19 comparisons made for the two sets of drawings the number of differences actually found to be significant 24 at the .05 level or better 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 differences between 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 confidence (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. 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 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 the Appendix). 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 of 105-6. 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 27 drawing: clinical experience has shown that this amount of time was adequate for subjects to complete the figure. The children were pre- 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 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. 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-tailed teat). 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, and self-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 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 three sets: 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 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. 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. 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. 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 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 36 intellectual levels. This intellectual functioning apparently helped them compensate for their handicap, while several of the normal children lost scoring points because the arms, 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 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. 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 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. 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. 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., Sc Tomblen, 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. 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. 43 Fig. 1. Normal Drawing Fig. 2. Normal Drawing 45 Fig. 5 Normal Drawing 46 Fig. 4 Normal Drawing Fig. 5. - . Normal Drawing Fig. 6. Handicapped Drawing Fig. 7. Handicapped Drawing 50 Fig. 8. Handicapped Drawing 51 Fig. 9. Handicapped Drawing 52 Fi g. 10. Handicapped Drawing 53 : ^ c>^ tti ^ \ ^ ^ Pig. 11. Positive Hands and Fingers 54 k > " ^ ^ L f ^ I : = % ^ \ ^ Fig. 12. Negative Hands and Fingers 55 d7 W lui \ s a / M\ M H C* Fig. 13. Positive Foot Construction C(. 56 M i lA b^ U e) Fig. 14. Negative Foot Construction TABLE 1 COMPARISON OF THE 19 SIGNS BY JUDGES A AND B BETWEEN CONTROL AND HANDICAPPED SUBJECTS IN THE 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