|Year : 2019 | Volume
| Issue : 1 | Page : 329-334
Draw-a-person test as a tool for intelligence screening in primary school children
Ali M El-Shafie1, Dalia M El Lahony1, Zein O Abd El Latif1, Mohamed O. A. Khalil2
1 Department of Pediatrics, Faculty of Medicine-Menoufia University, Shebin Elkom, Egypt
2 Department of Pediatrics, Benha Teaching Hospital, Benha, Egypt
|Date of Submission||05-Sep-2017|
|Date of Acceptance||31-Oct-2017|
|Date of Web Publication||17-Apr-2019|
Mohamed O. A. Khalil
Benha Teaching Hospital, Benha
Source of Support: None, Conflict of Interest: None
The aim was to conduct a study for screening intelligence of primary school children using draw-a-person (DAP) test in Meit Ghamr District, Al-Dakahlia Governorate.
The significance of children's drawings has been thought to provide indications of visual motor development, levels of cognitive functioning, and intellectual maturity. One of the earliest drawing tests was the DAP test devised by Goodenough to assess children's creativity, mental age, and visual motor intellectual maturity by coding features of their drawing of a man.
Participants and methods
This study was carried out in 1000 apparently healthy primary school children aged from 6 to 12 years old in Meit Ghamr District, Al-Dakahlia Governorate. All students were subjected to an adequate assessment of history, full clinical examination, socioeconomic level, school achievement, and also DAP test.
The study showed that children with superior intelligence, with high average, with average, with low average, and with below average were 1.5, 9.9, 64.6, 21.1, and 2.9%, respectively. Moreover, positive correlations were found between intelligence quotient (IQ) levels and socioeconomic standards, school achievement, and residence. There was no correlation between IQ levels and children's sex.
There were a positive correlation between IQ levels obtained by DAP test and socioeconomic standards, residence, and school achievement. Moreover, no correlation was found between IQ levels and sex.
Keywords: draw-a-person test, intelligence, intelligence quotient, school achievement, socioeconomic standards
|How to cite this article:|
El-Shafie AM, El Lahony DM, Abd El Latif ZO, Khalil MO. Draw-a-person test as a tool for intelligence screening in primary school children. Menoufia Med J 2019;32:329-34
|How to cite this URL:|
El-Shafie AM, El Lahony DM, Abd El Latif ZO, Khalil MO. Draw-a-person test as a tool for intelligence screening in primary school children. Menoufia Med J [serial online] 2019 [cited 2019 Aug 23];32:329-34. Available from: http://www.mmj.eg.net/text.asp?2019/32/1/329/256131
| Introduction|| |
Intellectual maturity can be considered as 'the ability to form concepts of increasing abstract character', and requirements of intellectual activity or concept formation are the ability to perceive, abstract, and the ability to generalize. Construction techniques require the subject to create something, such as a story or drawing. This response requires more cognitive processing than word associations .
One of the earliest drawing tests was the draw-a-person (DAP) test that allows an examinee to respond to questions through drawings. Projective tests can be applied in various settings such as schools, corporations, and private practices to assess different psychological aspects including personality, family background, intelligence, physical and emotional abuse, depression, etc., .
Harris assumes that changes in the child's drawings of a man or a woman represent the development of cognitive complexity or intellectual maturity expressed by increasingly complex representations of the human figure. He regards the child's concept of a human figure as an index or sample of their concept generally. As Cox  in a comprehensive review noted that in Western cultures 'child's progress from a period of scribbling to the production of tadpole forms and then on to conventional forms, at first composed of segmented body parts, and then later of more contoured and integrated sections'. Our aim of the study was to screen intelligence of primary school children using 'DAP test' in Meit Ghamr District, Al-Dakahlia Governorate, and factors affecting it.
| Participants and Methods|| |
After approval of the Local Institutional Ethical Committee of Menoufia educational affairs, and obtaining written consents from all student parents to participate in our study, this study was carried out on 1000 apparently healthy primary school children aged from 6 to 12 years old in Meit Ghamr District, Al-Dakahlia Governorate, at El Sayed Khalil and El Sayad primary schools from September 2015 to May 2016. This district consists of mixed both rural and urban cultures.
Inclusion criteria were children free from significant disease and having no neurological abnormalities. Exclusion criteria were age less than 6 years and more than 12 years and having associated chronic diseases such as diabetes mellitus, chronic hyper/hypothyroidism, hyper/hypoparathyroidism, chronic kidney disease, rheumatic heart disease, cardiomyopathy, cardiac failure, bronchial asthma, chronic hemolytic anemia, auditory disorders, rheumatoid arthritis, ulcerative colitis, cystic fibrosis, or epilepsy.
Parents were given a questionnaire through the student containing telephone number, full name, date of birth, and any serious medical problems in the past, and it also included degree of education of parents, husband's occupation, family size, and family income, which was questioned to assess socioeconomic level.
All the study children were subjected to complete clinical examination to exclude any chronic clinical problems as mentioned before. Anthropometric measures (weight and height) were also recorded. All measurements were taken using the same type of apparatus and followed the same procedures. School achievement was obtained by the marks of the previous year from participant's school records. Children's marks of junior one class were obtained from the midterm, and grading of school achievement was done using the most common grading scale: grade A (90–100, excellent), grade B (80–89, above average), grade C (70–79, average), grade D (60–69, usually the minimum passing grade), and grade F (0–59).
Draw-a-person test instruction and the test setting
We must ensure a test setting that maximizes the performance of a child and avoids unnecessary distraction. This implies the following: the child must be seated at an individual table with enough space to draw; sufficient lighting must be assured; noise, visitors, and other distractions should be avoided; no objects other than a pencil with soft lead and a sheet of white paper should be on the table; instructions should be given in the local language; and the teacher must make sure that the child understands the instructions and feels comfortable in the test situation.
The teacher should ensure that the child takes his/her time with the drawing and does not work hastily. The teacher should not make comment on the drawing or ask the child to correct certain details, as this is not an art lesson but an attempt to ascertain the child's concept of the human figure.
During testing, the teacher should follow these instructions, which are also reproduced in the Annex C so that they can be photocopied for easier use:
DO Give a piece of white unlined paper and a pencil. The child should neither use a ruler or an eraser. The sheet of paper should have the size of an ordinary exercise book.
SAY 'I'd like you to draw some pictures for me. First, I'd like you to draw a picture of a man. Make the very best picture you can. Take your time and work very carefully and I'll tell you when to stop. Remember: be sure to draw the whole man. Please begin'.
DO After five minutes ask the child to finish and give another sheet of white, unlined paper.
SAY 'This time I want you to draw a picture of a woman. Make the very best picture you can. Take your time and work very carefully and I'll tell you when to stop. Be sure to draw the whole woman. Please begin'.
DO Give the child about five minutes to complete the drawing and tell him not to use an eraser or a ruler. Observe if the child has any difficulties understanding (hearing or seeing) while drawing.
After completion, use the DAP scoring system to rate the drawing. In adding the scores for the 14 criteria, you arrive at the total raw score (maximum = 64). This individual score can then be compared with the child's age group to find out at what percentile he or she is performing.
Raw scores were obtained from participant's drawings, and then converted to intelligence quotient (IQ) by modified Harris scoring guide  which includes the following:
GROSS DETAIL: head present, legs present, arms present, trunk present, length of trunk greater than breadth, and shoulders indicated (abrupt broadening of the trunk below the neck).
ATTACHMENTS: both arms and legs attached to the trunk, arms and legs attached to the trunk at the correct points, neck present, and outline of neck continuous with that of head, trunk, or both.
HEAD DETAIL: eyes present (one or two), nose present, mouth present, nose and mouth in two dimensions, two lips shown, and nostril shown.
Hair shown: hair on more than circumference of head and nontransparent – better than a scribble.
CLOTHING: clothing presents (any clear representation of clothing), two articles of clothing nontransparent (e.g., hat and trousers), the entire drawing free from transparencies – sleeves and trousers must be shown, four articles of clothing definitely indicated (should include 4 – hat, shoes, coat, shirt, necktie, belt, and trousers), and costume complete with incongruities (business suit, soldier's costume and hat, sleeves trousers, and shoes must be shown).
HAND DETAIL: fingers present (any indication), correct number of fingers shown, fingers in two dimensions – length greater than breadth and the angle subtended not greater than 180 degrees, opposition of thumb clearly defined, and hand shown distinct from fingers and arm.
JOINTS: arm joint shown – elbow, shoulder, or both; leg joint shown – knee, hip, or both.
PROPORTION: head not more than 1/2 or less than 1/10 of trunk arms equal to trunk but not reaching knee, legs not less than trunk not more than twice trunk size, feet in 2 dimensions – not more than 1/3 or less than 1/10 of leg, and both arms and legs in two dimensions.
MOTOR COORDINATION: lines firm without marked tendency to cross, gap, or overlap; all lines firm with correct joining; outline of head without obvious irregularities, developed beyond the first crude circle; conscious control apparent; trunk outline, score same as #3; arms and legs without irregularities, dimensions, and no tendency to narrow at the point of junction with trunk; and features symmetrical (more likely to credit in profile drawings).
FINE HEAD DETAIL: ears present (2 in full face, 1 in profile), ears present in correct position and proportion, eye details – brow or lashes shown, eye detail – pupil shown, eye detail – proportion. Length greater than width, eye detail – glance – only plus in profile, chin and forehead shown.
PROFILE: projection of chin shown; heel clearly shown; body profile – head, trunk, and feet without error; and the figure shown in true profile without error or transparency.
The results were statistically analyzed by SPSS version 20 (SPSS Inc., Chicago, Illinois, USA). Two types of statistics were done: descriptive, e.g., percentage, mean, and SD, and analytical, e.g., Student's t-test, which is a single test used to collectively indicate the presence of any significant difference between two groups for a normally distributed quantitative variable; one-way analysis of variance (F-test), which is a single test used to collectively indicate the presence of any significant difference between several groups for a normally distributed quantitative variable; and post-hoc test, which is used after one-way analysis of variance (F-test) or Kruskal–Wallis test to show any significant difference between the individual groups. P value is considered significant if less than or equal to 0.05.
| Results|| |
Results are shown in [Figure 1]. The mean ± SD age was 8.49 ± 1.68 years. There were 45.7% of female and 54.3% of male children. Regarding residence, 53.2% lived in rural and 46.8% in urban areas. Regarding socioeconomic standard (SES), 15.6% were of low, 48.4% of average, and 36% of high economic status. The school achievements were noted as follows: 7.3% had acceptable, 36.3% had good, 51.2% had very good, and 5.2% had excellent grades.
|Figure 1: Distribution of the studied children regarding their characteristics|
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Regarding IQ results, this study revealed some points: first, 1.5% of the children had superior intelligence, 9.9% had high average intelligence, 64.6% had average intelligence, 21.1% had low average intelligence, and 2.9% with below average intelligence, as shown in [Table 1]. On analyzing sex differences, there was no significant difference in IQ levels between male and female, as shown in [Table 2].
|Table 1: Distribution of the studied children regarding their characteristics|
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|Table 2: Distribution of the studied children regarding intelligence quotient level|
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Regarding residency of children, those who lived in an urban residence had higher IQ levels (mean ± SD: 102.66 ± 8.95) in comparison with those who lived in rural areas (mean ± SD: 91.89 ± 8.0) [Table 3]. In our study, we also found a strong positive correlation between SESs and IQ levels, as those with higher SES had a higher IQ scores (mean ± SD: 105.04 ± 8.30) in comparison with those with average (mean ± SD: 94.74 ± 6.64) and low (mean ± SD: 85.02 ± 6.30) SES [Table 4].
|Table 4: Distribution of residence regarding intelligence quotient level|
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The last finding was the positive correlation between IQ levels and school achievement; children with higher school achievement 'excellent' (grade A) had the highest DAP test score (mean ± SD: 112.25 ± 5.46) and IQ level among the whole studied sample, and vice versa [Table 5] and [Table 6].
|Table 5: Distribution of socioeconomic standard regarding intelligence quotient level|
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|Table 6: Distribution of school achievement regarding intelligence quotient level|
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| Discussion|| |
The drawing of the human figure is an early, if not the earliest, activity of children when they begin to use a pencil. The human figure drawing test was found to correlate moderately to highly with IQ and cognitive development until adolescence .
Many studies have been conducted all over the world to find the effect of many risk factors affecting child cognition. The education, occupation, and income of parents – indices of the families' SES – have been found to moderate the heritability of their children's intelligence . These results are the same as our results, as we found a strong positive correlation between SESs and IQ levels; those with higher SES had a higher IQ score (mean ± SD: 105.04 ± 8.30) in comparison with those with average (mean ± SD: 94.74 ± 6.64) and low (mean ± SD: 85.02 ± 6.30) SES. However, some investigators such as Golomb  in his study and Willcock et al.  stated that socioeconomic differences in children's background were found to be not relevant in the human figure drawing test.
Regarding the distribution of overall intelligence, percentage of children with superior intelligence was 1.5%, those with high average intelligence was 9.9%, with average was 64.6%, low average was 21.1%, and with below average was 2.9%., There was no significant difference in IQ levels between male and female. This correlates with a study conducted by Flynn et al.  who found that male and female achieved roughly equal IQ scores on Raven's Progressive Matrices after reviewing recent standardization samples in five modernized nations. Moreover, Lynn  contended that there is virtually no sex difference in average intelligence between the ages of 5 and 15 years. On the contrary, several authors confirmed that human figure drawings produced by girls were more advanced than those produced by boys regarding their type of figure (tadpole vs. intermediate), details (including eyes, clothes, and hair), or use of double lines to depict arms and legs ,.
In our study, we found a strong positive correlation between cognitive function and residency. Children who lived in an urban residence had higher IQ levels (mean ± SD: 102.66 ± 8.95) in comparison with those lived in rural areas (mean ± SD: 91.89 ± 8.0). Children who lived in an urban residence had higher IQ levels in comparison with those who lived in rural areas. This goes with the results of the study conducted by Emmett  that showed rural school children obtained lower scores than urban children, and that the spread in intelligence among them was also smaller. However, it did not match with the conclusion of Naomi et al.  that IQ was lower among children living in urban areas than those of rural residence. So, we need further study directed to investigate the relation between children IQ and residence, which may be helpful in recognizing the residence-related causes that may affect IQ levels, such as nutritional status, quality of education, genetic admixture, and pollution.
We also found a positive correlation between IQ levels and school achievement, as those children with higher school achievement (grade A) had the highest DAP test scores and IQ levels among the whole studied sample and vice versa. These results are similar to the findings of a study conducted in UK schools to relate scores on statewide standardized achievement tests to measures of cognitive skills in a large and representative sample of students in a city that includes traditional district, examination, and charter public schools. They found substantial positive correlations between cognitive skills and achievement test scores, especially in mathematics. These correlations are consistent with prior studies relating working memory to academic performance (grades) in UK schools , and according to Laidra et al. , who reported that students' achievement relies most strongly on their cognitive abilities through all grade levels.
| Conclusion|| |
There were a positive correlation between IQ levels obtained by DAP test and SESs, residence, and school achievement. Moreover, no correlation was found between IQ levels and sex.
The DAP test can provide pediatricians with a useful developmental screening device and alert them to the possibility of developmental disorders. Further studies could be done on those with a low IQ to investigate and treat causes, and then follow-up on the IQ levels by the test later. DAP test could also be performed by teachers routinely to discover any intellectual delay early among their students.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]