DRAWINGS OF KIDS WITH ASPERGER

7/28/2019 DRAWINGS OF KIDS WITH ASPERGER

1/7

B R I E F R E P O R T

Brief Report: Human Figure Drawings by Childrenwith Aspergers Syndrome

Hui Keow Lim Virginia Slaughter

Published online: 9 October 2007

Springer Science+Business Media, LLC 2007

Abstract Twenty-nine children with Aspergers syn-

drome and 28 typically developing children, matched ongender, chronological age and nonverbal IQ, were asked to

produce a free drawing, then requested to draw a person, a

house and a tree. The drawings were scored using stan-

dardized procedures for assessing accuracy, detail and

complexity. There were no differences between the diag-

nostic groups on the tree or house drawing scores. The

human figure drawing scores of children with Aspergers

syndrome were significantly lower than those of the

typically developing children, and there was a positive

correlation between human figure drawing scores and

communication sub-scores on the Vineland Adaptive

Behaviour Scales, for the Aspergers group. These results

suggest that the selective deficit in generating human figure

representations may derive from a relative lack of interest

in the social world, and/or limited practice in drawing

people.

Keywords Aspergers syndrome

Human figure drawing Pictorial representation

Draw-a-person test Vineland adaptive behaviour scales

Introduction

Childrens drawings, especially those of the human figure,

have been the focus of attention for decades because they

are believed to reflect a number of psychological variables

including the drawers intellectual maturity, personality,thought and emotion (Goodenough 1926; Koppitz 1968;

Machover 1949). There is a good deal of debate about the

reliability and validity of drawings as clinical assessment

tools (see Motta et al. 1993). There is less controversy

about the value of childrens drawings as measures of

intellectual maturity. Several standardized and externally

validated systems for scoring childrens drawings are in

existence. The majority of these focus, partly or exclu-

sively, on childrens drawings of the human figure.

Human figure drawings are first produced in the toddler

period, and then follow a reasonably consistent develop-

mental trajectory, increasing in accuracy, detail and

sophistication with age (Cox 1993). The developmental

progression of childrens human figure drawings is suffi-

ciently standard to allow estimates of IQ based on human

figure drawings alone (Goodenough 1926; Harris 1963;

Koppitz 1968; Naglieri 1988). Researchers debate the

extent to which the developmental progression in chil-

drens human figure drawings reflects changes in childrens

knowledge of the human form, as opposed to the acquisi-

tion of drawing skill and accumulated practice in

generating human figures (Cox 1993; Freeman 1987; Motta

et al. 1993). However most agree that childrens drawings,

particularly those of the human figure, reflect develop-

mental stages that are likely to be linked to both cognitive

and socialization processes.

Human figure drawings by children with developmental

disorders typically reveal delays that are concomitant with

any intellectual impairment (Cox and Maynard 1998; Dy-

kens et al. 2000; Golomb and Barr-Grossman 1977). In

addition, human figure drawings of children with devel-

opmental disorders may reflect elements consistent with

their specific diagnosis. For instance Dykens et al. (2000)

H. K. Lim V. Slaughter (&)

School of Psychology, University of Queensland, Brisbane,

QLD 4072, Australia

e-mail: [email protected]

123

J Autism Dev Disord (2008) 38:988994

DOI 10.1007/s10803-007-0468-z


2/7

investigated human figure drawings by children with Wil-

liams syndrome and found that those childrens

standardized scores on the Draw-a-person test (Koppitz

1968) were higher than their scores on a comparable

developmental test of visual and motor integration. Dykens

et al. (2000) interpreted this selective difference across

drawing topics as reflecting the interest in people, and

relative strength in reading facial expressions and remem-bering faces, that are typically exhibited by children with

Williams syndrome (Tager-Flusberg et al. 1998) . I n a

similar vein, Lewis and Boucher (1991) hypothesized that

children with autism would possess less mature represen-

tations of people compared to typically developing children

and this would be reflected in their drawings. They scored

the spontaneous human figure drawings generated by

children in both diagnostic groups using Harriss (1963)

system. The children with autism did receive lower human

figure drawing scores than the comparison group, but the

difference was not statistically significant. Their findings

were based on only 11 children with autism, which maymean that their analyses lacked sufficient power to detect

differences between the groups.

Lee and Hobson (2006) investigated the distinctiveness

of human figure drawings by 14 children with autism,

compared to a matched group of children with learning

difficulties but not autism. They asked children to draw

three different human figures and three different houses.

Like Lewis and Boucher (1991) they reported slightly

lower global scores for human figure drawings by the

children with autism compared to the control group,

although the difference was not statistically significant. The

human figure drawings of the children with autism were

significantly less individually distinctive than the human

figure drawings of children without autism, whereas the

drawings of houses produced did not differ in distinctive-

ness across diagnostic groups.

There is some indication, therefore, that the human

figure drawings of children with autism may be generally

less sophisticated and detailed than those of nonautistic

children, but previous studies addressing this specific

question have lacked sufficient power to reveal reliable

group differences. In the current study we tested a rela-

tively large sample of children with Aspergers syndrome

(N = 29) and a matched group of typically developing

children. We systematically compared the drawings of

human figures, houses and trees across the two groups.

Two hypotheses were investigated, based on the fact that

children with Aspergers syndrome are relatively disinter-

ested in the social world: (a) the human figure drawings of

children with Aspergers syndrome may be selectively less

sophisticated than those of the typical children but the

drawings of other topics will be equivalent, and (b) in the

Aspergers syndrome group, the level of sophistication of

human figure drawings may correlate positively with

communication and social functioning scores on the

Vineland Adaptive Behaviour Scales (Sparrow et al. 1984),

reflecting individual differences in engagement with, and

knowledge of, other people.

Methods

Participants

The sample consisted of 29 children with Aspergers syn-

drome (25 boys and 5 girls) and 28 typically developing

children (24 boys and 5 girls). The mean chronological age

of children with Aspergers syndrome was 9.6 years

(range = 4.913.6 years). The mean chronological age of

typically developing children was 9.4 years (range = 5.3

13.6 years). The groups were matched on nonverbal IQ as

assessed by the Standard Progressive Matrices (de Lemos

1989): The mean IQ of the typically developing children

was 114.4 (range = 85137) and the mean IQ of the chil-

dren with Aspergers syndrome was 109.5 (range = 78

139). The participants were primarily Caucasian.

The children with Aspergers syndrome were diagnosed

either by a psychologist or by a psychiatrist prior to

acceptance into the study. Two of the children with As-

pergers syndrome were home schooled while the rest

attended mainstream schools in Brisbane, Australia. One

child in the Aspergers syndrome group attended art les-

sons outside school curriculum and none of the typical

children did so. Parents and children gave written consentfor participation in the study.

Measures

IQ

The Standard Progressive Matrices (de Lemos 1989), using

Australian norms, was administered to estimate nonverbal

intelligence. This test was chosen for this study because it

is not a language-based assessment and the focus of this

study was on a nonverbal drawing task.

Vineland Adaptive Behaviour Scales

The parents or the main caregivers of all children in the

study were interviewed on the communication and social-

ization sub-domains of this instrument, as these were

considered the most relevant to childrens engagement with

and knowledge about other people.

J Autism Dev Disord (2008) 38:988994 989

123


3/7

Drawing Materials

For the drawing task children were provided with a few

pencils, a pencil sharpener, an eraser and four pieces of

paper (37.5 27.7 cm and presented in landscape orien-

tation). Large paper was chosen to alleviate any constraints

that smaller paper may place on drawing strategy (Cle-

ments and Barrett 1994).

Procedure

Children were visited in their homes and tested individu-

ally without time limit imposed for the completion of tasks.

All children were first asked to draw a picture of anything

they liked, as a warm up task. Then they were asked to

draw a house, a tree and a person. The order of the house,

tree and person requests was randomized across partici-

pants. Next, the children were assessed on the Standard

Progressive Matrices. Finally, the parents or caregivers ofthe children were interviewed.

Most of the children completed all the tasks in one

session. Three children with Aspergers syndrome were

tested over two sessions on different days.

Scoring

The free drawings were not scored. The directed drawings

were scored using two different standardized systems. The

first generated scores for all three of the directed drawings

(house, tree and person) and the second generated detailed

scores for the person drawings only.

Bucks House-tree-person Scoring System

Evaluations of the house, tree and person drawings were

based on the presence and absence of features, details,

proportions and perspectives (Buck 1948). Two scores

were generated: A good score that represented positive

inclusions, and a flaw score that represented omissions

and errors. Examples of good features include a house with

wall material shown in any recognizable way, a tree with

two-dimensional roots tapering into the ground, and a

person with recognizable digits on the hand. Examples of

flawed aspects presented in the drawings were a house

without a roof, a tree with one-dimensional branches and a

person with a circular two-dimensional trunk.

A global score for each drawing was computed by

subtracting the total flaw score from total good score. In

order to compare the relative performance of two groups of

children across the three directed drawings, the total flaw

scores, total good scores and global scores of house, tree

and person drawings were transformed into standardized

(z) scores.

Koppitzs Human Figure Drawing Scoring System

The human figure drawings alone were scored using anindependent technique developed by Koppitz (1968). This

provided a convergent measure for the childrens human

figure drawings. Koppitzs (1968) system includes both

developmental and emotional indicators. For the purpose of

this study, only the developmental indicators were used as

they reflect the accuracy, detail and complexity of the

human figures portrayed. The presence of each develop-

mental indicator (e.g. digits on the hand) gained one point

from a checklist of 30 developmental indicators.

Inter-rater Reliability

The drawings were scored by the first author, who was not

blind to the diagnostic status of the children. The complete

set (100%) was then re-scored by a second rater who was

blind to the age, IQ, gender and diagnosis of the children.

For Bucks scoring system, inter-rater reliability across all

three drawing topics achieved 91.1% agreement, with a

Cohens Kappa of 0.83. For Koppitzs scoring system, both

raters agreed on 95.3% of the developmental indicators.

Inter-rater disagreements were resolved by discussion.

Results

Comparing Diagnostic Groups on Drawings of House,

Tree and Person

To evaluate the relative quality of the directed drawings

across diagnostic groups, a 2 3 mixed model ANOVA

was computed with diagnostic group (children with As-

pergers syndrome versus typically developing children) as

the between-groups variable and drawing topic (house

versus tree versus person) as the within-groups variable.

The dependent variable was Bucks standardized global

drawing score. There was a main effect for drawing topic,

F(2, 54) = 3.96, p\ 0.05, partial g2 = 0.13, subsumed by a

significant interaction of drawing topic and diagnostic

group, F(2, 54) = 4.67, p\ 0.05, partial g2 = 0.15.

Table 1 provides the standardized global scores for

house, tree and person drawings by the two groups of

children.

Independent samples t-tests comparing the mean stan-

dardized global scores of the drawings by the two groups of

990 J Autism Dev Disord (2008) 38:988994

123


4/7


5/7

same correlations between human figure drawing scores

and both Vineland sub-domain scores for the typically

developing children. No significant correlations were

observed.

Discussion

In this study we found some systematic differences

between the human figure drawings of typically developing

children and those diagnosed with Aspergers syndrome.

As a group, the children with Aspergers syndrome pro-

duced less sophisticated human figure drawings than

typically developing children, in contrast to their house and

tree drawings which were as good as those by the typically

developing children. This pattern indicates that the children

with Aspergers syndrome were not deficient in their

general drawing skill, but rather selectively less likely to

produce a developmentally advanced, high-scoring human

figure drawing. This finding contrasts with both Lewis andBoucher (1991) and Lee and Hobson (2006). As noted

above, sample sizes in those two studies were relatively

small compared to that of the current study, and since the

group difference, while statistically significant, is a fairly

weak effect, it is perhaps not surprising that this group

difference in human figure drawing was not reliable when

the sample sizes were smaller. The uneven profile in

drawing ability seen in our sample of children with As-

pergers syndrome is consistent with previous

observational studies of drawing in children with autism

(Kellman 2001) and also with the fact that IQ profiles of

individuals with Aspergers syndrome are often charac-

terized by peaks and troughs (Goldstein et al. 2001).

Several factors may account for this selective deficit in

human figure drawings by children with Aspergers syn-

drome. First, because children on the autism spectrum

spend less time looking at people (Swettenham et al. 1998)

they may as a result possess less detailed representations of

human beings (as suggested by Lewis and Boucher 1991).

Second, compared to typically developing children, those

with Aspergers syndrome may be less motivated to gen-

erate accurate and detailed drawings when given the

instruction to draw a person. That is, if children with As-

pergers syndrome are more interested in inanimate objects

and/or their special interests, then they may put relatively

little effort into producing a human figure drawing. Indeed,

in the current study several children with Aspergers syn-

drome drew perfunctory humans in the context of their

special interests (e.g. a human stick figure being squashed

under a realistically portrayed elephants foot; see Fig. 2).

Third, children with Aspergers syndrome may be less

likely to practice drawing humans than their typical peers,

and this may result in developmentally less mature

drawings of people. In support of this interpretation, we

noted informally during our testing that more than one

child with Aspergers syndrome stated that they were poor

at drawing people. We also observed that a number of

children in the Aspergers group began their human figure

drawings at a location other than the head, which is dif-

ferent from the norm for typical children (Koppitz 1983).

This difference in drawing procedure could reflect group

differences in local versus global processing strategies

Children with Aspergers syndrome Typically developing children

8.33 years old; Female 7.33 years old; Female

IQ 127 (special interest is ) IQ 127

8.25 years old; Male 8.17 years old; Male

IQ 118 IQ 127


IQ 115 IQ 108


IQ 104 (special interest is Egyptian myths) IQ 110


I Q 111 ( special interest is elephants) IQ 110

Fig. 2 Examples of human figure drawings by diagnostic group


123


6/7

(Frith 1989) or else may reflect lack of practice in human

figure drawing by the children with Aspergers syndrome.

Finally, it is possible that the request to draw a human

figure may have selectively increased the cognitive load for

the Aspergers-diagnosed children, exacerbating any fine

motor problems and thereby causing them to produce

developmentally less advanced, relatively low scoring

human figure drawings.Our second hypothesis was that children with Asper-

gers syndrome who were reported to have relatively good

communication and socialization skills, would draw more

accurate and detailed human figures than those whose

communication and socialization skills were weaker. This

hypothesis was partially supported. We found a significant

partial correlation between Vineland communication sub-

scores and person drawing scores derived from Koppitzs

scoring system (1968). There was however no correlation

between socialization sub-scores on the Vineland and the

quality of human figure drawings. The fact that scores on

person drawing correlated with communicative function-ing, rather than socialization, may reflect a link between

the Aspergers-diagnosed childrens capacity to understand

and follow the direction to draw a human, and to put his or

her ideas accurately to paper. However, it is worth noting

that there was no correlation between Vineland commu-

nication scores and childrens drawings of the house or

tree, in either group, so this explanation holds only for the

production of human figure drawings.

We observed no correlation between Vineland scores

and the typically developing childrens drawings, which

goes against the idea that there is a general relation

between individual childrens communication or sociali-

zation skills and their ability to draw human figures. It

may be that this study lacked the power to reliably detect

those correlations because although the sample size

represents an improvement over previous studies, there

were fewer than 30 children per diagnostic group. A

replication study that includes more children would be

valuable, both to replicate the main finding of differences

in the sophistication of human figure drawings, and to

further explore how these relate to childrens socialization

and communication skills.

Mention must be made of another limitation associated

with the present study. We followed Bucks standard pro-

cedure and asked the children to draw a person in the

house-tree-person drawing task. It is possible that children

with Aspergers syndrome interpreted this instruction dif-

ferently from the typically developing children. For

example, the drawings of Marge Simpson and the Egyp-

tians by children with Aspergers syndrome were quite

accurate in the context of those themes (see Fig. 2), but

were penalized in both scoring systems because of the

built-in expectation that children would draw a human

form that closely resembled a real person. This potential

misinterpretation of the instruction by some children with

Aspergers syndrome might also account for the correlation

between communication sub-scores and person drawing

scores discussed above. In future, researchers may want to

alter the standard instruction for children on the autism

spectrum, and ask them to draw a real person, when

eliciting human figure drawings.

Acknowledgments This study was carried out by the first author in

partial fulfilment of the degree of Doctor of Psychology at the Uni-

versity of Queensland, Australia. We are grateful to the children and

parents who participated. We also thank Philippa Neary for coding

assistance, and two anonymous reviewers for their constructive

feedback on an earlier version of the manuscript.

References

Buck, J. N. (1948). The H-T-P technique: A qualitative and

quantitative scoring manual. Journal of Clinical Psychology,

4(4), 317396.Clements, W., & Barrett, M. (1994). The drawings of children and

young people with Downs syndrome: A case of delay or

difference? British Journal of Educational Psychology, 64, 441

452.

Cox, M. (1993). Childrens drawings of the human figure. Hove:

Erlbaum.

Cox, M. V., & Maynard, S. (1998). The human figure drawings of

children with Down syndrome. British Journal of Developmental

Psychology, 16, 133137.

de Lemos, M. M. (1989). Standard progressive matrices Australian

manual. VIC, Australia: The Australian Council for Educational

Research Ltd.

Dykens, E. M., Rosner, B. A., & Tran, M. L. (2000). Drawings by

individuals with Williams syndrome: Are people different from

shapes? American Journal on Mental Retardation, 106(1), 94107.

Freeman, N. (1987). Current problems in the development of

representational picture-production. Archives de Psychologie,

55, 127152.

Frith, U. (1989). Autism: Explaining the enigma. London: Blackwell.

Goldstein, G., Beers, S. R., Siegel, D. J., & Minshew, N. J. (2001). A

comparison of WAIS-R profiles in adults with high-functioning

autism or differing subtypes of learning disability. Applied

Neuropsychology, 8, 148154.

Golomb, C., & Barr-Grossman, T. (1977). Representational develop-

ment of the human figure in familial retardates. Genetic

Psychology Monographs, 95, 247266.

Goodenough, F. L. (1926). The measurement of intelligence by

drawings. New York: World Books.

Harris, D. B. (1963). Childrens drawings as measures of intellectual

maturity: A revision and extension of the Goodenough Draw-a-

Man test. New York: Harcourt, Brace and World.

Kellman, J. (2001). Autism, art, and children. Westport, CT: Bergin

& Garvey.

Koppitz, E. M. (1968). Psychological evaluation of childrens human

figure drawings. London: Grune & Stratton.

Koppitz, E. M. (1983). Projective drawings with children and

adolescents. School Psychology Review, 12, 421427.

Lee, A., & Hobson, R. P. (2006). Drawing self and others: How do

children with autism differ from those with learning difficulties?

British Journal of Developmental Psychology, 24, 547565.

J Autism Dev Disord (2008) 38:988994 993

123


7/7

Lewis, V., & Boucher, J. (1991). Skill, content and generative

strategies in autistic childrens drawings. British Journal of

Developmental Psychology, 9, 393416.

Machover, K. (1949). Personality projection in the drawing of the

human figure. Springfield: C.C. Thomas.

Motta, R., Little, S., & Tobin, M. (1993). The use and abuse of human

figure drawings. School Psychology Quarterly, 8, 162169.

Naglieri, J. (1988). Draw a person: A quantitative scoring system. San

Antonio, TX: The Psychological Corporation.

Sparrow, S., Balla, D., & Cicchetti, D. (1984). The vineland adaptive

behavior scalesInterview edition, survey form manual. Circle

Pines, MN: American Guidance Service.

Swettenham, J., Baron-Cohen, S., Charman, T., Cox, A., Baird, G., &

Drew, A. (1998). The frequency and distribution of spontaneous

attention shifts between social and nonsocial stimuli in autistic,

typically developing, and nonautistic developmentally delayed

infants. Journal of Child Psychology and Psychiatry, 39(5), 747

753.

Tager-Flusberg, H., Boshat, J., & Baron-Cohen, S. (1998). Reading

the windows to the soul: Evidence of domain-specific sparing in

Williams syndrome. Journal of Cognitive Neuroscience, 10,

631639.


123

Documents

DRAWINGS OF KIDS WITH ASPERGER