The Usefulness of The Draw-A-Person: Screening Procedure for measuring

Emotional Disturbance (DAP: SPED) in South African Children

by
Francoise Kubierske

MINI DISSERTATION
submitted in partial fulfillment of the requirements for the degree of

MASTER OF ARTS IN PSYCHOLOGY

in the
FACULTY OF HUMANITIES
at

THE UNIVERSITY OF JOHANNESBURG

Supervisor: Dr N. Coetzee

2008
 Acknowledgements

I would like to express my sincere gratitude to the following people for their
ongoing contribution and support:

 Dr Coetzee, my supervisor. Thank you for your patience and guidance.

 Anneli Harding and Statkon. Thank you for the ongoing effort and work in
support of this research.

 To my research assistants, Natasha and Fikile. Thank you for the

perseverance.

 The schools, teachers and pupils who participated with enthusiasm. Thank
you for the opportunity to conduct the research with your help, and for all
the hard work.

 To my editor, Neil Jacobson. Thank you.

 To Liezel Gericke. Thank you for your unwavering support and

understanding, and particularly for the flexible working hours.

 To my family, especially my husband and son. Thank you for your

encouragement and patience.

ii
 TABLE OF CONTENTS
Page no

ABSTRACT.......................................................................................... xi

CHAPTER 1
INTRODUCTION TO RESEARCH

1.1 Introduction ................................................................................. 1

1.2 Problem Statement ..................................................................... 4

1.3 Research Aims …….................................................................... 5

1.4 Proposed Structure of the Study............................................... 7

1.5 Conclusion................................................................................... 7

CHAPTER 2
LITERATURE REVIEW: EMOTIONAL DISTURBANCE

2.1 Introduction ................................................................................. 8

2.2 Emotional Disturbance ............................................................... 9

2.2.1 The Relationship between Emotional Disturbance and
Emotional Well-being ............................................................ 10
2.2.1.1 Emotional Development as a Factor in Emotional

iii
 Status...................................................................................... 10
2.2.2 Indicators of Emotional Disturbance ....................... 14
2.2.3 The relationship between Emotional Disturbance and
Emotional Disorders ........................................................... 17

2.3 Contributing Factors to Emotional Disturbance in the South

African Context ................................................................................ 19
2.3.1 Poverty ......................................................................... 20
2.3.2 Crime and Violence ..................................................... 22
2.3.3 AIDS .............................................................................. 27

2.4 Conclusion ................................................................................. 29

CHAPTER 3
LITERATURE REVIEW: DRAW-A-PERSON

3.1 Introduction ............................................................................... 31

3.2 Historical Background of the Draw-A-Person Test ................ 31

3.2.1 The DAP as a Cognitive Measure ............................... 34
3.2.2 The Projective use of the DAP ................................... 39
3.2.2.1 Qualitative Interpretation of the DAP as a
Projective Technique ................................................ 41
3.2.2.2 Quantitative Interpretation of the DAP as a
Projective Technique ................................................ 45

3.3 The Draw-A-Person: Screening Procedure for Emotional

Disturbance (DAP: SPED) .............................................................. 46

iv
3.4 Conclusion ................................................................................ 48

CHAPTER 4
RESEARCH METHODOLOGY

4.1 Introduction .................….......................................................... 50

4.2 Research Aims ……................................................................... 50

4.3 Research Approach ...............…................................................. 52

4.4 Sampling ........................................................................................ 52

4.4.1 Selection Criteria ............................................................. 53
4.4.2 Realised Sample .............................................................. 54

4.5 Measurement Instruments ........................................................... 56

4.5.1 The Draw-A-Person: Screening Procedure for
Emotional Disturbance (DAP: SPED) ..................................... 56
4.5.1.1 Limitations of the DAP: SPED .......................... 57
4.5.2 The Beck Youth Inventory of Emotional and Social
Impairment (second edition) (BYI-II) ...................................... 58
4.5.2.1 Results of the BYI-II in a South African
Context .......................................................................... 60
4.5.2.2 Limitations of the BYI-II ................................... 62
4.5.3 Qualitative Questionnaire for Observed Behaviour
in the Classroom (QQOBC) .................................................... 63

4.6 Data Collection Procedure .......................................................... 64

v
4.7 Scoring of Instruments ............................................................... 66
4.7.1 Scoring of the DAP: SPED ............................................ 67
4.7.2 Scoring of the BYI-II ...................................................... 73
4.7.3 Scoring of the QQOBC ................................................. 73

4.8 Statistical Analysis ..................................................................... 74

4.9 Ethical Considerations ............................................................... 74

4.9.1 Consent for Participation ............................................. 74
4.9.2 Debriefing....................................................................... 74
4.9.3 Feedback to Parents about Emotional Disturbance..... 75

4.10 Conclusion .................................................................................. 76

CHAPTER 5
RESULTS

5.1 Introduction................................................................................... 77

5.2 The Usefulness of the Draw-A-Person: Screening Procedure

for Emotional Disturbance (DAP: SPED) .......................................... 77
5.2.1 Descriptive Statistics of the DAP: SPED and the BYI-II 77
5.2.1.1 Descriptive statistics for the DAP: SPED ........ 78
5.2.1.2 Descriptive Statistics for the BYI-II .................. 78
5.2.2 Results of the Correlational Analysis between the
DAP: SPED and the BYI-II ....................................................... 79
5.2.3 Results of the Correlational Analysis between the DAP:
SPED and the BYI-II for Emotional Disturbance Present and
Absent Groups ……………………………………………………. 80

vi
 5.2.4 Results of the Mann-Whitney U Test ……………………. 82

5.3 The Reliability of the Scores of Emotional Disturbance in the

DAP: SPED .......................................................................................... 85

5.4 The Credibility of Inter-rater Scores ........................................... 88

5.5 The Occurrence of Emotional Disturbance ................................. 90

5.5.1 Occurrence of Emotional Disturbance measured by the

DAP: SPED ............................................................................. 90
5.5.2 Occurrence of Emotional Disturbance measured by the
BYI-II ....................................................................................... 91
5.5.3 Results of the Questionnaire for Observed Behaviour
in the Classroom (QQOBC) .................................................... 94

5.6 Conclusion .................................................................................... 96

CHAPTER 6
DISCUSSION OF FINDINGS, LIMITATIONS AND RECOMMENDATIONS

6.1 Introduction ................................................................................. 97

6.2 The Usefulness of the DAP: SPED ........................................... 97

6.2.1 Findings from Related Research ................................. 101

6.3 Reliability of Scores for Emotional Disturbance on the

DAP: SPED ....................................................................................... 113

vii
6.4 Credibility of Inter-rater Scores ............................................... 111

6.5 The Occurrence of Emotional Disturbance in the Target

Group ................................................................................................ 117

6.6 Limitations of the Study and Recommendations for Future

Research ..................................…………………………………......... 120

6.7 Conclusion ................................................................................ 122

REFERENCE LIST ........................................................................... 124

APPENDICES …………………………………………………………… 133

viii
LIST OF TABLES
Page no

Table 2.1 Milestones in Emotional Development......................... 12

Table 2.2 Eight Syndromes common to Childhood Emotional

Disturbance..................................................................................... 15

Table 3.1 Developmental Stages in Drawing ............................. 35

Table 4.1 Reliability Coefficients of the Individual Subscales of

the BYI-II ........................................................................................ 60

Table 4.2 Pearson’s Correlation Coefficients between

Subscales of the BYI-II .................................................................. 61

Table 4.3 Discrepancies in the Scoring System ........................ 69

Table 5.1 Descriptive Statistics of the DAP: SPED ................... 78

Table 5.2 Descriptive Statistics for the BYI-II ............................ 79

Table 5.3 Spearman’s Rho Correlation between the DAP: SPED

and the BYI-II Subtests ................................................................. 80

Table 5.4 Spearman’s Rho Correlations between the DAP: SPED

and the BYI Subtests for emotional disturbance Present and
Absent Groups ............................................................................... 81

ix
Table 5.5 Mann-Whitney U Test for Present and Absent
Emotional Disturbance (ED) Groups ............................................ 83

Table 5.6 internal Reliability of the DAP: SPED........................... 86

Table 5.7 Internal Reliability Coefficients for Different Ages .... 86

Table 5.8 Internal Reliability for the Three Drawings of the

DAP: SPED ..................................................................................... 87

Table 5.9 Spearman’s Rho Correlation between Drawings of the

DAP: SPED..................................................................................... 88

Table 5.10 Spearman’s Rho Correlation Coefficients for

Inter-rater Reliability ................................................................... 89

Table 5.11 Frequency distribution of Emotional Disturbance

Scores measured by the DAP: SPED ........................................ 91

Table 5.12 Frequency distribution for Emotional Disturbance

Scores measured by the four subscales of the BYI-II ............. 92

Table 5.13 Behavioural Clusters of Emotional Disturbance in

Target Group ............................................................................... 93

Table 5.14 Teachers’ Ratings of the Prevalence of Emotionally

Disturbed Behaviour in Learners ............................................. 94

x
LIST OF FIGURES
Page no

Figure 2.1 Continuum of Emotional Status …………………….. 10

Figure 2.2 The Relationship between Emotional Disturbance

and Emotional Disorders .............................................................. 18

Figure 3.1 The Development of the DAP .................................... 33

Figure 4.1 Gender Composition of Sample ................................ 55

Figure 4.2 Age Composition of Sample ...................................... 55

xi
LIST OF APPENDICES
Page no

APPENDIX A
Qualitative Quesionnaire for Observed Behaviour in the
Classroom (QQOBC) ..................................................................... 134

APPENDIX B
Permission to Partake in Research ............................................. 136

APPENDIX C
Feedback for Participants Regarding the Presence of
Emotional Disturbance ................................................................ 138

APPENDIX D
Feedback for Children Excluded from the Sample ................... 139

APPENDIX E
Example of Qualitative Analysis Spreadsheet ………………… 141

xii
 ABSTRACT

South Africa is perceived as a country with many economic and social problems.
These are stressors that put individuals at risk of developing emotional
disturbance. Children, as the most vulnerable sector of society, have the least
access to resources such as psychological intervention. A measurement
instrument that can identify emotional disturbance within this high-risk group; that
minimises the effects of formal learning, cultural and language barriers; and
utilises the minimum of resources is needed. The Draw A Person: Screening
Procedure for Emotional Disturbance (DAP: SPED) (Naglieri, McNeish & Bardos,
1991) is a screening test for emotional disturbance that seems to fulfil these
criteria.

The present study aimed to explore how useful the DAP: SPED is to identify
children with emotional disturbance in South Africa. This involved comparing the
scores of the DAP: SPED with those of an independent measure for emotional
disturbance, the Beck Youth Inventory (BYI-II). To further explore the usefulness
of the DAP: SPED, internal reliability and inter-rater reliability were examined.
The DAP: SPED and the BYI-II were administered to a group of English-literate
Grade 4 learners from two mainstream schools.

The emotional status of the children was unknown, and scores from the BYI-II
were used to provide this information. As the BYI-II was used as a control
measure, the internal reliability coefficients of its subscales were investigated
within the context of the present research. Internal reliability coefficients were
good (r=.823 to r=.929, p<.01). A third measure, the Qualitative Questionnaire for
Observed Behaviour in the Classroom (QQOBC) was completed by the teachers
of participating learners. This measure was used to provide depth to the results
as well as independently rate the children’s behaviour.

xiii
Results showed that the DAP: SPED achieved low correlations with the BYI-II
(rho=.024 to rho= .76, p<.01), thereby supporting the null hypothesis. The DAP:
SPED was also unable to distinguish between emotional disturbance Present
and Absent groups, created post facto according to scores on the BYI-II. A
statistical analysis of the internal reliability showed that the DAP: SPED had low
internal reliability (α=.448), and that the omission of the measurement items
increased the internal reliability (α=.525). Inter-rater reliability was significantly
high (rho=.687 to rho=. 816, p<.01), thereby rejecting the null hypothesis. Despite
the good inter-rater reliability, certain scoring problems were encountered that
showed that a margin for scoring bias could influence the usefulness of the
measure.

High levels of emotional disturbance were present, indicating that psychological

intervention is urgent for South African children. The findings of the current
research suggest that the DAP: SPED is not as useful as initially theorised in
terms of identifying emotional disturbance in South African children. False
positive (16.8%) and false negative (26.4%) results indicated that children were
identified incorrectly. Decisions based on the DAP: SPED would therefore lead to
disturbed children remaining unidentified and thus wasted resources. The BYI-II
had more success in identifying emotional disturbance in learners, although it is
limited in its use to English literate children. Furthermore, comparisons with the
QQOBC showed that social desirability influenced scores on the Disruptive
Behaviour scale of the BYI-II, and that the results could therefore underestimate
the intensity of behavioural problems. It is therefore important to include ratings
from independent sources such as teachers or parents when trying to investigate
emotional disturbance in children.

Subsequent research could focus on finding a suitable measure for identifying

emotional disturbance in South African children. A study into how universal
emotional indicators are would provide information about the cross-cultural use of
drawings for emotional assessments.

xiv
 CHAPTER 1
INTRODUCTION TO RESEARCH

1.1 Introduction

South Africa faces many social and economic problems (Shell, 2000). These
are pervasive and the most vulnerable sectors of society, namely children and
the poor, are the worst affected (Strydom & Strydom, 2006). Their
vulnerability is heightened by the fact that they have limited access to
resources such as health care. Children are particularly vulnerable because
they depend on adults to connect them to necessary resources, such as
psychological care (Dawes & Donald, 1994). The South African Government
has recognised the dire need for the resources mentioned, but service
delivery is difficult in the face of vast geographical areas and the limited
availability of health care workers (White Paper for the Transformation of the
Health System in South Africa, 1997). The result is that the most vulnerable
sector of society has the least access to resources and consequently
becomes increasingly exposed (Shell, 2000).

Children are vulnerable when exposed to neglect or different forms of abuse,

malnutrition and poor or absent schooling (Shell, 2000). Children exposed to
neglect or abuse show symptoms such as depression, anxiety and
behavioural problems (Rudenberg, Jansen & Fridjohn, 1998). One of the
important disciplines that are important in addressing social problems
experienced by children is psychology. Psychological assessment and
treatment can address and alleviate these symptoms of distress. There is,
however, a shortage of psychologists and culture-free psychological
measures to address these abovementioned issues (Seedat, 1998).

Psychological assessment provides the means to identify children in distress.

One form of psychological measurement that could be useful in South Africa,
where a vast variety of cultures and eleven official languages prevail, is non-
verbal assessment (Foxcroft & Roodt, 2004; Richter, Griesel & Wortley,

1
1989). Language forms a barrier in psychological service delivery especially
when a client and psychologist cannot communicate in each other’s
language. Language also forms a barrier when psychologists work with
children. Even if the child and psychologist do communicate in the same
language and thus understand each other, children are still developing their
verbal vocabulary and cannot always successfully express themselves
(Siegler, Deloache & Eisenberg, 2003). A non-verbal measure eliminates the
need for spoken language as a means of communication and is consequently
beneficial amongst a diverse group of clients (Foxcroft & Roodt, 2004).

Drawings are believed to be universal communication tools and are one

example of non-verbal measurement (Golomb, 2000). Many authors reason
that drawings can be analysed to find underlying messages, such as feelings
or indications of interpersonal relationships (Di Leo, 1973; Koppitz, 1968;
Machover, 1980; Naglieri, McNeish & Bardos, 1991). Representations of the
human figure in particular are popular as a non-verbal communication tool (La
Roche, 1994). For more than a century representations of the human figure
have been studied and found to be useful in cognitive and emotional
assessment (Naglieri, McNeish & Bardos, 1991). Studies from around the
world indicate that the human figure is also universally one of the most
popular subjects in children’s drawings (Golomb, 2000; Kellogg, 1970).

Over the years, many different versions of how to study human drawings
have emerged. Each version differed slightly in relation to the emphasis
placed on administration and the purpose thereof. The most recent version of
using a human figure as an assessment tool is the Draw-A-Person: Screening
Procedure for Emotional Disturbance (DAP: SPED) (Naglieri, McNeish &
Bardos, 1991).

The DAP: SPED assures a quick form of assessment to determine the need
for further therapeutic intervention (Naglieri, McNeish & Bardos, 1991). The
non-verbal nature of the screening measure minimises the effects of formal
learning and language barriers and is therefore more suitable for cross-
cultural use than static verbal measures (Foxcroft & Roodt, 2004). Research

2
has shown that this measure is useful across cultures within the American
context and that it can accurately identify children with emotional problems
(Matto, 2002; Naglieri, McNeish & Bardos, 1991). The effectiveness of this
measure for children of various backgrounds in America suggests that it
would be valuable in the South African context.

Although the DAP: SPED has been available for more than a decade, no
literature revealed its local application. The necessity to determine the utility
of the DAP: SPED in the South African context originates from different
factors. Although the DAP: SPED has been reported valid within an American
context, it must be kept in mind that South Africa is a developing country that
faces different social and economical problems.

One of the areas where South Africa differs form America is the high
incidence of violent crime. Violence in South Africa has been likened to war-
torn countries such as Palestine (Neser, 2006; Ward, Martin, Theron &
Distiller, 2007). Violent crime has an escalating negative impact on the
emotional well-being of individuals and as a result, the need for psychological
services will increase (Harris & Radaelli, 2007). Masango (2004) noted that
prolonged exposure to violent crime has detrimental effects on cognitive and
emotional functioning. Children in particular become increasingly vulnerable
to the psychological impact of violence, since they are still developing as
individuals and have not yet developed a wide range of coping skills (Wicks-
Nelson & Israel, 2003).

Within the limited scope of the current research, it was decided not to
replicate previous validation studies. Instead the usefulness of the DAP:
SPED as a screening measure was investigated within a small sample of
South African learners. Usefulness is an aspect of validity. The usefulness of
a measure relates to how effective the measure is within a given application
(Murphy & Davidshofer, 2001). It is specifically concerned with functionality in
terms of how well it serves its intended purpose (Cronbach, 1988).

3
In order to ascertain how well the DAP: SPED may screen for emotional
disturbance in South African children, it was compared with an independent
measure. This is different from the original standardisation process or
subsequent validation studies, where no equivalent measure was employed
(Naglieri, McNeish & Bardos, 1991). Another reason why the current research
did not replicate previous studies, is that information was needed regarding
the DAP: SPED’s ability to distinguish between emotionally disturbed and
non-disturbed children when their emotional status was unknown.

Another reason why it was decided not to do a validation study is that

projective measures such as the DAP: SPED generally achieve low reliability
and validity scores in research (Field, 2005). In this regard, Murphy and
Davidshofer (2001) stated that validity coefficients alone provide little
information, as they are relative to the intended context and importance of
decision-making. Because of this, progressive thinkers in research emphasise
the usefulness of a measure in terms of decision-making, rather than a
measure’s validity (Cronbach, 1988). Focus is therefore directed to the kind of
decisions that would be made based on the measure, and whether using the
measure facilitates more effective decision-making. The DAP: SPED could
therefore be considered useful if it is able to identify most cases of emotional
disturbance in learners correctly. If the DAP: SPED is useful in the South
African context, it would provide a good reason for schools and other
organisations to incur the costs of acquiring the manual and answering sheets
of the DAP: SPED.

1.2 Problem Statement

A tentative assumption about the DAP: SPED is that it should be functional

for the South African population because of the psychometric properties
displayed within the American context. Since it is a non-verbal instrument, it is
theorised that the DAP: SPED will not only be a cost-effective form of
psychological measurement, but that it will also be adequate for use with
clients, such as children, who have trouble communicating with therapists.

4
As explained in 1.1, South African children are particularly vulnerable to the
social problems facing the country. Due to a shortcoming in the provision of
psychological services, children’s limited range of coping skills and their
frequent inability to communicate their needs, children are at risk of
developing emotional disturbance (Wicks-Nelson & Israel, 200). The DAP:
SPED has the potential to identify emotionally disturbed children who might
otherwise go unnoticed. This would be the first step in connecting affected
children with appropriate help. Professional caregivers can then help schools
by instituting relevant programs to assist children to cope with adversity.

The DAP: SPED, however, has not yet been used in the South African
context, and it is unclear if it will be useful as a screening measure for
emotional disturbance in children. The usefulness of the DAP: SPED
therefore needs to be examined within the envisioned application thereof.

1.3 Research Aims

The primary aim of this study is to determine whether the DAP: SPED could
be a useful instrument for use with South African children to identify those
with emotional disturbance.

From the primary aim, the following secondary aims were identified:

1. To determine the efficacy of the DAP: SPED by comparing it with

another measure, the Beck Youth Inventory (BYI-II). An independent
measure such as the BYI-II, which statistically demonstrated the
effective measurement of emotional disturbance (Beck, Beck, Hammer
& Jolles, 2005), would provide information about how useful the DAP:
SPED is in identifying children with emotional disturbance. In order to
measure the objectives stated above, the following hypotheses were
formulated:

5
 H o : There is no correlation between the scores of the DAP: SPED and
the BYI-II in a sample of Grade 4 South African learners.
H 1 : There is a significant correlation between the scores of the DAP:
SPED and the BYI-II in a sample of Grade 4 South African
learners.

2. To determine the reliability scores for the measurement of emotional

disturbance in children by the DAP: SPED. If obtained scores are
reliable, it provides information about the usefulness of the measure.

3. To determine the credibility of the scoring process of the DAP: SPED.

The DAP: SPED is considered psychometrically advanced due to its
standardised scoring procedure (Matto, 2002; Trevisan, 1996). By
studying the inter-rater reliability, it would provide information about the
credibility of the scoring system. The following hypotheses were
formulated to measure this objective:

H o : There is no correlation between the scores given by different raters

when the DAP: SPED is scored.
H 1 : There is a significant correlation between the scores given by
different raters the DAP: SPED when the DAP: SPED is scored.

4. To obtain more information about the incidence of emotional

disturbance within the target group.

The results of the attainment of these aims and the measurement of these
hypotheses will be presented during the course of this study. Before the
results are reported, however, certain issues will be discussed to demarcate
the study field. The study will therefore be presented according to a specific
structure, which is as follows:

6
1.4 Proposed structure of the study

Chapter 2: Literature Review: Emotional disturbance

Chapter 3: Literature Review: Draw-A-Person
Chapter 4: Research Methodology
Chapter 5: Results
Chapter 6: Discussion of findings, Limitations, Recommendations and
Conclusion of the Study

1.4 Conclusion

The high levels of crime and the nature of violence in the South African
society potentially negatively affect the emotional and cognitive development
of children (Masango, 2004; Shell, 2000; Williams, Xintolo & Nombaca, 2001).
Widespread poverty and reduced access to resources makes help-seeking
behaviour difficult. This is particularly true for children who are dependent on
adults for information about services and access to those services. As a
result, the effects of poverty and violence are not easily mediated (Shell,
2000). Furthermore, South Africa has great diversity in terms of culture and
language, which further complicates psychological service provision. It could
be beneficial for both professionals and help-seeking children if a measure
were available that is minimally influenced by cultural and language issues
and is widely available and easy to administer. The DAP: SPED has the
potential to fill this void, but its usefulness in the South African context should
be examined.

In the following chapter, the discussion will focus on emotional disturbance as

a construct to outline the scope of the current research. The extent of
emotional disturbance within the South African context will be discussed to
demonstrate the necessity of identifying and helping emotionally disturbed
children. Chapter 3 will deal with the background and development of the
DAP: SPED, and describe why the measure is potentially valuable for use in
South Africa.

7
 CHAPTER 2
LITERATURE REVIEW: EMOTIONAL DISTURBANCE

2.1 Introduction

In Chapter 1, a synopsis was presented of the need for a measure like the
Draw-A-Person: Screening Procedure for Emotional Disturbance (DAP:
SPED) in the South African context. The primary objective of the research
was to establish whether this measure could be used locally. The next two
chapters will focus on a detailed look at important concepts such as emotional
disturbance, specifically in the South African context, as well as the
development of the Human Figure Drawings (HFD) as a screening tool for
emotional disturbance, and the theory upon which this measure is based .

Emotional disturbance is a term often used in the literature concerning

impaired functioning in an individual, although the meaning of the concept is
seldom described (Naglieri, McNeish & Bardos, 1991). The developers of the
DAP: SPED, Naglieri, McNeish and Bardos (1991) do not endeavour to clarify
the term in the title of their measure. The benefit for the test user of such an
explanation would be to set parameters for its usefulness (Jooste, 2004). For
example, the developers of the DAP: SPED do not clarify what intensity of
emotional experience is required for classification as emotional disturbance,
and depending on subjective interpretation could refer to anything from
distress to disorder. Because of the vagueness surrounding emotional
disturbance as a construct, an in-depth literature review was conducted to
determine its meaning. A discussion of the findings of the literature review
concerning the meaning of the term emotional disturbance will follow. This
discussion will include an overview of emotional development and well-being
in children to contextualise emotional disturbance within the present study.

8
2.2 Emotional Disturbance

To formulate an understanding of emotional disturbance, it is necessary to

build upon groundwork of several decades ago. Although recent literature
studies seldom use the term, it was discovered that Murphy (1963) attempted
to describe the concept extensively. According to him, emotional disturbance
would occur when a person was unable to cope with the range or intensity of
the emotions experienced. This subsequently led to rigid behavioural patterns
that in turn lead to further distress (Murphy, 1963). Therefore, poor emotional
regulatory skills reduced the person’s ability to manage intense or enduring
emotions towards external factors (e.g. stressful circumstances) and limit his
or her ability to generate alternative outcomes (Murphy,1963).

When using this definition of emotional disturbance, it becomes clear that the
concept relates to other concepts such as emotional distress. Pert (1997)
described emotional distress in terms of a system overload - when emotions
are experienced too fast and too intensely in the face of overwhelming
circumstances, and to such an extent that it leads to impaired functioning. It is
apparent that this definition is analogous with that of Murphy’s (1963), and it
is thus postulated that these terms are interchangeable. Because emotional
disturbance (distress) is closely associated with emotional well-being
(Brannon & Feist, 2004; Murphy, 1963), it is important to explore the
relationship between the two concepts.

2.2.1 The Relationship between Emotional Disturbance and Emotional

Well-being

Emotional well-being is described as the ability to cope or adapt to changing

circumstances that are stressful (Wicks-Nelson & Israel, 2003). However,
Brannon and Feist (2004) describe health, including psychological well-being,
not merely as an absence of disease, but as a positive state with a subjective
feeling of well-being. This definition signifies that the subjective experience of
well-being is an important consideration. Murphy (1963) seemingly would
have agreed with this when he noted that it is normal for everyone to

9
experience difficult circumstances as it drives personal development. He
suggested that the successful negotiation of such crises could actually
enhance a feeling of emotional well-being (Murphy, 1963).

Keeping in mind that emotional disturbance is the result of an inability to cope

with stressful events (see 2.2), while emotional well-being constitutes an
ability to cope with such circumstances, it is argued that emotional
disturbance, when placed on a continuum will be the opposite of emotional
well-being. Consequently, emotional disturbance could be conceptualised as
being located at one end of a continuum of emotional status, with emotional
well-being at the polar opposite, as shown in Figure 2.1.

Continuum of emotional status

Emotional X-------------------------------------------------------X Emotional

Disturbance Well-being

Figure 2.1 Emotional Status

2.2.1.1 Emotional Development as a Factor in Emotional Status

Based on the discussions presented thus far, it is theorised that individuals

are capable of responding realistically to stressful situations and have the
ability to change their response once the threat has passed (Murphy, 1963).

The same can be said about children. However, when working with children it
is important to remember that their level of development will influence their
ability to cope with, and learn from, stressful situations. New coping skills are
only learnt when a child successfully adapts to the situation. In turn,

10
adaptation and coping lead to the building of resilience, which means that the
child is better equipped when confronted with other stressful situations
(Wicks-Nelson & Israel, 2003). Conversely, when the child is overwhelmed by
the intensity or duration of the stress, the risk for developing emotional
disturbance increases (Wicks-Nelson & Israel, 2003).

Children universally meet common milestones in emotional development, and

this is observable across cultures. Table 2.1 gives an outline of the main
developmental milestones during emotional development.

11
Table 2.1 Milestones in emotional development
Sources: Louw (1990), Sadock and Sadock (2003), and Senior (2002).

Stage Milestones in emotional development

Infancy • A range of emotions, such as disgust, pleasure, surprise and distress

can be identified in infancy, and are paired with familiar facial
expressions.
• As development takes place other emotions emerge in the following
order: joy, anger, sadness and fear.
• Infants are not capable of regulating their emotions, and rely on their
caregivers to be responsive to their needs in order to regulate
emotional states. A responsive caregiver provides a greater sense of
security in a child, and allows the child to temporarily tolerate negative
affect.
• For young children negative affect is a means of communication when
they have experienced responsive caregivers, and the feeling is
therefore not necessarily perceived as threatening.

Toddlerhood • By the age of 18 months, tender affection and shame are observable.
• By 24 months, the child can experience pride.
• Toddlers will look to their parents and other people for cues about how
to respond emotionally to an event and this is referred to as social
referencing. For example, when a toddler falls he might look at his
parent’s reaction before crying or laughing about it.
• Toddlers are increasingly able to organise their demonstrations of love
by combining several behaviours to express an emotion. For example,
a toddler might smilingly run to a caregiver to hug and kiss that person.
• It is also during this time that children seem to be more comfortable
with familiar adults, while being more apprehensive with strangers.

• Increasingly complex emotions such as guilt and envy emerge, and

shortly afterwards insecurity, humility and confidence are observable.
Pre-school
• Emotions are still easily influenced by factors such as tiredness or
hunger.

12
 Pre-school • The ability to be less egocentric emerges in sharing, and in empathic
and cooperative behaviours.
(continued)
• It is also at this age that children are able to turn parental restriction into
self-guidance.
• Towards the end of this period the conscience becomes established.

School- • Children prefer to interact with the same sex, as there is shyness about
the opposite sex.
going
• Once children start school, and the environment becomes more
Age
structured and demanding, fear is likely to take the form of a social fear
or a fear of academic failure.
• A toddler might use aggression to get a toy, but by school going age, a
child might use aggression for the purpose of hurting someone else.
• As cognition develops, it influences the expression and use of
emotions.

Table 2.1 clearly shows that emotional development involves coping with
increasingly complex emotions as the child grows older. Emotional
development seems to involve a process of monitoring, evaluating and then
modifying the intensity and timing of emotions (Wicks-Nelson & Israel, 2003).
This is a gradual process, and is more easily mastered by some. The mastery
of emotional development is dependent on factors such as temperament and
circumstance (Wicks-Nelson & Israel, 2003). The successful outcome of
emotional development would contribute to a subjective feeling of emotional
well-being, as the child grows into an individual who is able to cope with
stressful situations and who can negotiate the expression of emotion within a
social context (Goleman, 1996).

Another aspect that comes to the fore when studying Table 2.1 is the fact that
emotions, such as anger, potentially facilitate communication when the infant
can speak his or her discomfort to others. Responsiveness by the caretaker
could contribute to a feeling of well-being in the child. Over time, such
responsiveness could also lead to the development of sympathy for others

13
and the development of a conscience (Wicks-Nelson & Israel, 2003).
However, if the caretaker is uncomfortable with the expression of anger then
this basic emotion becomes confusing and the child might then restrict the
display of such negative emotions, or internalise his or her feelings.
Externalising behaviour might also take shape in the form of acting out in
tantrum-like behaviour (Wicks-Nelson & Israel, 2003).

Experiencing unacceptable feelings and not knowing how to express them in

socially acceptable ways could in turn lead to the experience of increased
negativity or aggression (Senior, 2002). For the child, the pressure to conform
to societal values of how to express discomfort becomes a process of
negotiation between inner experiences and external demands. Children who
are unable to successfully negotiate emotional reactions to stressful
circumstances, feel overwhelmed and confused and experience the
subjective feeling of being emotionally disturbed. This inability to cope is likely
to manifest as certain behaviours that will affect daily functioning. When these
behaviours are displayed, one could conclude that emotional disturbance is
present (Murphy & Davidshofer, 2001).

2.2.2 Indicators of Emotional Disturbance

Wicks-Nelson and Israel (2003) state that emotions play a role in most
behavioural difficulties, and children displaying strong emotions associated
with poor coping skills that endure over time, require professional assistance.
From the literature, three clusters of behaviour are identifiable, and
classification is based upon where this behaviour is directed. The three
clusters are known as internalising behaviour, externalising behaviour and
mixed symptoms (Wicks-Nelson & Israel, 2003). These clusters are further
related to eight syndromes commonly used to identify whether a child
experiences emotional disturbance. A summary of the behavioural clusters
and related syndromes is presented in Table 2.2.

14
Table 2.2 Eight Syndromes common to childhood measures of
emotional disturbance
Source: Wicks-Nelson and Israel (2003)

INTERNALISING MIXED EXTERNALISING

Anxious/ Depressed Social Problems Rule-breaking

Behaviour
Cries a lot Lonely
Lacks Guilt
Fearful/ anxious Gets Teased Bad friends
Feels worthless Not liked Steals at home

Withdrawal/ Depressed Thought Problems Aggressive Behaviour

Rather be alone Hears Things Mean to others

Shy, timid Sees Things Destroys others’ things

Withdrawn Strange ideas Gets in fights

Somatic Complaints Attention Problems

Overtired Difficulty concentrating
N/A
Aches, pains Difficulty sitting still

Stomachaches Impulsive

Internalising behaviour, or acting in, includes depression, anxiety,

somatisation, and withdrawal (Cross, 2004; Wicks-Nelson & Israel, 2003).
Externalising behaviour or acting out, includes defiance and conduct
disorders as well as aggression and violence towards the self and others
(Cross, 2004; Winkley, 1996). Mixed symptoms include social problems in
which children find it difficult to trust others, have low self-esteem and
struggle to fit in with peers (Murphy, 1963). Low frustration tolerance, a lack of
resilience and low impulse control, as well as difficulty in accepting limits is
noticeable in all of these clusters (Murphy, 1963). In general, physical

15
changes such as weight loss- or gain are also observed in children
experiencing emotional disturbance (Lewis, 1999).

From the above discussion, it is clear that so-called negative feelings,

including hate and resentment, fear and longing, or guilt, become
unmanageable for emotionally distressed children (Lewis, 1999). Over time,
the impulsive acting out or withdrawal could become ingrained when the child
is unable to cope for extended periods. Ingrained behavioural patterns could
have enduring effects on personality (Lewis, 1999).

Emotional disturbance is simpler to recognise when externalising behaviour is

present, since such behaviours are generally those that society rejects
(Murphy, 1963). In contrast, caretakers might welcome undemonstrative
behaviour, and therefore overlook emotional disturbance in the form of
withdrawal. In this regard children might change in seemingly positive ways
such as being too brave or too cheerful (Murphy, 1963). It therefore becomes
important when investigating whether emotional disturbance is present in a
child to not rely only on psychological measures, but in addition to compare
current behaviour to previously observed behaviour.

Using Table 2.2 as a guideline to identify whether a child is experiencing

emotional disturbance is highly logical, especially since the way in which it is
structured is similar to the diagnostic categories of the Diagnostic and
Statistical Manual for Mental Disorders (DSM IV-TR) (American Psychiatric
Association, 2000). The three clusters of behaviour, and the related
syndromes, are similar to disorders in the DSM IV-TR, such as depression,
anxiety, conduct disorder and attention deficit disorder (American Psychiatric
Association, 2000). Accordingly, symptoms of emotional disturbance are
related to emotional disorders. It therefore seems that the construct that
Naglieri, McNeish and Bardos (1991) call emotional disturbance relates to
these disorders.

16
2.2.3 The Relationship between Emotional Disturbance and Emotional
Disorders

Emotional disturbance was described in relation to emotional well-being (see

2.2.1), and for this purpose these two concepts were placed at opposite ends
of a continuum (see Figure 2.1). It has been shown that emotional
disturbance is related to impaired functioning, and that this is observable in
certain behaviours that are known as indicators of emotional disturbance.
These indicators correlate with diagnostic categories in the DSM IV-TR
(2000). It therefore appears that there is a relationship between emotional
disturbance and emotional disorders and that the nature of this relationship
relates to intensity.

The DSM IV-TR (2000) addresses the matter of intensity from two directions.
When making a diagnosis on the fifth axis of the DSM IV-TR, it is necessary
to rate the individual’s functioning on the Global Assessment of Functioning
scale (GAF). The GAF is a sliding scale from zero to one hundred. A score of
zero indicates severely impaired functioning to the point of being life
threatening; and a score of one hundred signifies that the person has superior
coping skills without any symptoms (Sadock & Sadock, 2003). The second
requirement in making a diagnosis with the DSM IV-TR (2000) is that the
disorder should be classified as being mild, moderate or severe. A DSM IV-
TR classification can therefore be made on varying levels of emotional
disturbance, with the most severe being an emotional disorder. Concerning
intensity, it therefore seems that emotional disorders can be viewed as
severe forms of emotional disturbance. Severe emotional disturbance is
present in only a small percentage of the population (Davidson & Neale,
2001).

The purpose of the DAP: SPED, as a screening measure, would require the
identification of a spectrum of emotional disturbance, including clinically
diagnosable features of emotional disorders. Although the DAP: SPED should
be able to identify most cases of emotional disturbance (including the
disorders), it should not necessarily be able to classify the intensity of

17
emotional disturbance. This would be the function of a diagnostic tool
(Murphy & Davidshofer, 2001). A diagnostic tool, such as the Beck Youth
Inventory (BYI-II), is based on the criteria of the DSM IV-TR (2000) and
measures the intensity of emotional disturbance.

A visual representation of the relationship between emotional disturbance,

emotional disorder and emotional well-being is presented in Figure 2.2 below.
It also shows the researcher’s conceptualisation of the extent to which a
useful screening measure would be able to identify emotional disturbance.

Continuum of emotional status

Emotional disorders

↓
X----------------------------------------------------------------------X
Emotional Disturbance Emotional Well-being

Useful Screening Measure identifies

Emotional disturbance

Figure 2.2 The relationship between Emotional Disturbance and Emotional

Disorders

18
2.3 Contributing Factors to Emotional Disturbance in the South African
Context

An extensive discussion on emotional disturbance has shown that it is the

inability to cope in stressful circumstances and involves behaviours that
characterise impaired functioning. Many of the potential stressful
circumstances are normative, such as starting school, and provide the
challenges that encourage emotional development (Murphy, 1963). However,
non-normative life-events also occur and the timing and intensity of these
events could put a child at risk of becoming emotionally disturbed (Wicks-
Nelson & Israel, 2003). Some of the non-normative life-events that increase
the risk for developing emotional disturbance include crises and traumas
(Lewis, 1999).

Lewis (1999) described three different kinds of stressful events that could
potentially lead to emotional disturbance. The first is stressful situations.
Stressful situations tend to be short lived and include exams, being fetched
late from school or pressure to perform well. Children are generally able to
cope with stressful events in small measures, but this becomes increasingly
difficult when the stress is continuous and intense. Crises, the second type of
stressful event, are more intense and more difficult to cope with, although
these are not necessarily negative experiences. This type of event often
offers new opportunities for growth and development. Crises include events
like starting school, parental divorce or even the transition into adolescence.
Lewis (1999) stated that because every child is different, what would be a
crisis for one could merely be a stressor for another.

The third type of stressful event is trauma. Trauma differs from the other two
types of stressful events in that it is experienced as horrifying and unexpected
(Lewis, 1999). Trauma victims might also experience intense feelings of being
out of control as well as a fear for personal safety or the safety of a loved one.
Examples of trauma include natural disasters, human-caused disasters as
well as intentional or unintentional violence (Lewis, 1999). Although trauma

19
places severe stress on the coping skills of individuals, continuous or multiple
crises could have the same effect and lead to emotional disturbance.

At present, the three types of stressful events are occurring with varying
frequency and intensity all over the world. In South Africa, however, the social
and economic problems currently experienced are of such a nature that
increasingly strains adults and children. Add to this the alarming increase in
violent crime and its associated trauma, and the inference is that South
Africans are at high risk of experiencing emotional disturbance.

According to Conradie (2003), children are currently the most vulnerable

group in South Africa. More than half of the population is below the age of 18
years. Between 60 and 70% of these children live in extreme poverty, and
one in five suffer from malnutrition (Conradie, 2003). Williams, Xintolo and
Nombaca (2001) in turn found that there are generally elevated levels of
emotional disturbance in South African children. This implies that the children
are not merely at risk like the remainder of the populace, but are already
suffering the consequences of living in an extremely stressful environment.
The following discussion aims to highlight some of the risk factors associated
with emotional disturbance. It will illustrate how these factors contribute to
emotional disturbance in South African children.

2.3.1 Poverty

Poverty in itself does not necessarily cause emotional disturbance, although a

lower socio-economic status is a risk factor (Sadock & Sadock, 2003). The
effect of poverty is that access to resources is limited, and this places
continuous stress on the underprivileged. For example, high transport costs
limit physical access to medical care, while the high cost of medical care is
restrictive to those without medical aid (Seedat, 1998). Poorer areas are often
more difficult to reach logistically, and trained professionals do not prefer to
settle in such areas (White Paper, 1997). Furthermore, the members of these
communities might have limited knowledge of the benefit of health and
psychological services, as well as where to obtain such assistance.

20
Another way in which poverty contributes to emotional disturbance is that it
negatively affects families’ ability to sustain their basic needs like food and
shelter. Malnutrition and hunger influence children’s ability to concentrate in
school and this in turn impacts on school performance (Phillips, 2002).
Malnutrition has the long-term effect of making children more prone to illness,
which weakens cognitive functioning as well as impairs physical, social and
psychological development (Phillips, 2002).

Inadequate housing results in exposure to elements such as cold weather,

rain or heat exhaustion that in turn could contribute to illness. Furthermore,
the quality of a night’s rest is arguably poor when sleeping cold or fearfully
and reduces children’s energy and levels of psychological functioning
(Phillips, 2002). Children who constantly experience being hungry or cold with
little reprieve are likely to become hopeless and lower their life expectations
(Phillips, 2002).

In accordance with Lewis’s (1999) conceptualisation of stressful events,

abject poverty epitomises accumulative stress. The living conditions that are
associated with poverty could be described as multiple or ongoing stressors.
Parents from lower income groups are constantly battling to cope to support
their families. The relentless stress of not being able to provide basic needs
for a family is a risk factor for parents to develop emotional disturbance. In
addition, overwhelmed parents are unable to provide in their children’s
emotional needs. Parents, who are a potential resource for their children,
consequently jeopardise their children’s emotional well-being. Children who
live in poverty are therefore at increased risk of developing emotional
disturbance.

From the discussion, it is clear that children are especially vulnerable to the
effects of poverty. Living below the breadline places continuous stress on
members of the household. Children feel the effects of not having adequate
food and shelter, and in addition are often exposed to the worst of parental
stress. Furthermore, circumstances might compel some children to leave

21
school in order to supplement the family’s income. Poverty therefore
contributes to emotional disturbance in children who are not educated and
become progressively more disadvantaged (Shell, 2000). For example,
uneducated children are unable to compete in the job market with educated
applicants (Richter, Griesel, Durrheim, Wilson, Surendorff & Asafo-Agyei,
1988). In addition, some schools also offer resources such as counselling and
sometimes run a feeding program for the poorest children. Children who
leave school to help the family will not have access to these resources.

One more impact of poverty is that it indirectly contributes to crime levels.

Critical theory proposes that when there is abundance of wealth in one sector
of the population, while another sector lives in poverty and is witness to this
wealth, differences in value systems lead to an increase in crime (Strydom &
Strydom, 2006). According to this theory, poorer people would thus value
wealth, but not have legitimate means to obtain it (Strydom & Strydom, 2006).
The media, for example, exposes people to the availability of luxuries that are
unobtainable through rightful means. Critical theory would thus predict higher
levels of crime where such disparities between wealth and poverty are
present (Strydom & Strydom, 2006). The exposure to crime, as well as the
violent nature of crime in South Africa, is a credible factor in contributing to
and maintaining emotional disturbance in children.

2.3.2 Crime and Violence

The preceding discussion explained how poverty contributed to the high

incidence of crime in South Africa when it restricts the attainment of desirable
goods. Strydom and Strydom (2006) mirror this view in a study on the causes
of crime. They found that learners from the North West Province perceived
unemployment and poverty to be the main contributors to the high crime rate.

Although seeking unaffordable luxuries drives criminal activity, some people

from poor households might enter a life of crime simply to provide for their
basic needs. For example, child headed households such as those created by
AIDS, often do not have access to grants or any forms of income. The

22
children however, still have the responsibility of taking care of the household
(Conradie, 2003). To provide for the family, children are consequently driven
into a life of crime. This is very dangerous for children who are then at
increased risk of becoming victims of crime (Conradie, 2003).

The prevalence of crime in South Africa is high, displaying some of the

following disturbing trends:
• Crime statistics for 2006/2007 show that there has been an increase in the
category of most serious crimes (e.g. murder and rape), although a steady
decline was observed since 2002/ 2003 (Burger, 2007).
• The incidence of violence with robberies has increased (Burger, 2007).
• Perpetrators torture victims in order to get information, such as PIN codes
and combinations to the safe (Masango, 2004).
• Sometimes perpetrators are aggressive for no apparent reason other than
malice (Masango, 2004).

The vengeful nature of these crimes seems to point to externalising behaviour

in perpetrators, and imply that emotional disturbance is not only a result of,
but also a factor in executing violent crimes (see 2.2.1.1).

The exposure to violence in South Africa is comparable to violence

experienced in war torn countries such as Palestine (Neser, 2006; Ward,
Martin, Theron & Distiller, 2007). Strydom and Strydom (2006) found that over
52% of learners included in their study had experienced crime in some form.
Ward et al. (2007), in a small study of a Cape Town community, found that
50% of the children included in the study had been exposed to violence
directly, while more than 80% had witnessed violence.

The exposure to crime could be experienced as a stressor, a crisis or a

trauma, depending on the intensity of the experience (Lewis, 1999). The
intensity of the experience is related in part to how directly violence is
experienced in the perpetration of the crime. To understand the impact that
violence has on victims, and children in particular, it is helpful to make the

23
distinction between direct and indirect exposure to violent crimes (Rudenberg,
Jansen & Fridjohn, 2001).

A victim who is exposed directly to violence experiences the situation first-

hand, and this includes the victim and witnesses. Victims of direct exposure to
violent crimes might subjectively feel intensely negative and overwhelmed,
and are at risk of being traumatised by the incident (Lewis, 1999). Symptoms
of trauma include increased levels of anxiety, reliving the experience,
disturbance in sleep and thought patterns, as well as avoidance of any stimuli
that remind the victim of the traumatic event (Sadock & Sadock, 2003). In
children, signs of trauma are evident in a mixture of internalising and
externalising behaviours (see Table 2.2, section 2.2.2).

Indirect exposure, on the other hand, would include any encounter through
conversations of friends and family or watching the news on television (Lewis,
1999). Indirect exposure to violence is insidious as it increases stress levels
and could lead to long-term negative changes in perception and attitude. This
in turn affects emotional well-being (Lewis, 1999). Aggressive play,
avoidance, phobias and intrusive thoughts are linked to exposure to violence
(Barbarin & Richter, 2001).

Ward et al. (2007) found that both direct and indirect exposure to violence
lead to internalising behaviours, such as anxiety and depression, but that
direct exposure additionally leads to conduct problems. They reported that
anxiety and depression relate to concentration problems, while conduct
problems, including aggression and substance abuse, put children at further
risk of being exposed to violence. Furthermore, relentless exposure to
violence intensifies this effect (Ward et al., 2007).

The prevalence of emotional disturbance in relation to violence is apparent in

South African children. Williams (2001) found evidence for emotional distress
in drawings of Alexandra township children, using the Koppitz scoring system.
He compared the drawings from children who had either directly or indirectly
witnessed violence, and found that generally a high prevalence of emotional

24
disturbance was present. Further confirmation of emotional disturbance is
evident in the study by Kleintjes, Flischer, Fick, Railoun, Lund, Molteno and
Robertson (2006) in areas of the Western Cape where gang related activity is
rife. They found that the most common mental health disorders in their
sample of children and teenagers were generalised anxiety disorder (11%),
posttraumatic stress disorder (8%) and depressive disorders (8%).
Oppositional Defiant Disorder (6%) and Conduct Disorders (4%) were also
common.

It could therefore be said that both direct and indirect exposure to violence
impact negatively on the personal well-being of children. Indirect exposure
might be considered a constant stressor in the child’s life, while direct
exposure might be experienced as a crisis or trauma that potentially puts the
child at higher risk of developing emotional disturbance (Strydom & Strydom,
2006).

The potential for developing emotional disturbance is increased when

individuals, and especially children who are inherently more vulnerable,
subjectively feel unsafe (Murphy, 1963). When children feel unprotected or
exposed it could result in increased levels of anxiety as they become
constantly vigilant of imposing danger. Children are especially dependent on
adults to provide a sense of safety. Parents and other authority figures
potentially provide a sense of security and act as a buffer against violent
crimes. However, when these authority figures are unable to provide safety or
are themselves perpetrators, the child could experience a crisis and feel
overwhelmed and helpless (Murphy, 1963).

Burger (2007) confirmed that South Africans generally experience a

subjective feeling of being unsafe, as they have a negative view of the
police’s capability to protect them and their property. This subjective negative
experience is comparable with the subjective feelings of being overwhelmed
that form part of emotional disturbance (see 2.2.1).

25
The discussion has thus far focused on the impact that exposure to violence
has on children, mainly in relation to adult perpetrators. However, children are
also constantly exposed to violence in schools. South African children’s
exposure to violence in schools mostly relates to criminal incidences of
intimidation and victimisation, as well as sexual assault. In this regard, Neser
(2006) found that:

• One in six children is afraid of travelling to school.

• One in five has been threatened or hurt at school.
• One in three has been verbally abused at school.

In May of 2006, newspapers reported three fatal incidents in South African

schools that involved stabbings and shootings where children were the
perpetrators (Neser, 2006).

The impact of exposure to peer violence is summarised by Neser (2006), who

observed that higher levels of anxiety and low self-esteem are found in
victims of peer abuse, and that children feel angry and sad after being
exposed to peer victimisation. There is evidence that such children feel
isolated from peers and that they have few friends. Those children that
victimise others tend to come from punitive and abusive homes. Experiencing
family conflict can intensify the risk of developing an adverse reaction to
exposure to violence (Neser, 2006). This reinforces the idea that emotional
disturbance could lead to ingrained behavioural changes such as conduct-
disordered behaviour (see 2.2.1.1).

There is a clear link between violent crime and emotional disturbance, and
the high incidence of such violence implies that increased levels of emotional
disturbance are probably present in South African children. Adults’
experiences of both crime and poverty contribute in varying degrees to
emotional disturbance, and in turn arguably influence the quality of parenting.
The additional stress of illness, such as AIDS, further affects the capacity of
parenting and increases the risk of emotional disturbance in children.

26
2.3.3 AIDS

AIDS plays a significant role as a risk factor for developing emotional

disturbance in many South African children. The long duration of HIV/ AIDS
means that there is prolonged suffering for both the person who is ill and the
family (Whiteside & Sunter, 2000). Shell (2000) stated that the stress
associated with AIDS greatly affects the structure of the family in two main
areas, namely by death of the parents and the subsequent formation of child-
headed households.

Parents who die of AIDS related illnesses prematurely dispossess children of

parental care and guidance. Shell (2000) stated that the Department of Health
had estimated that there were one million AIDS orphans in South Africa in
1999, and Whiteside and Sunter (2000) estimated that this figure would
double by 2010. Orphans are defined in this context as children who have lost
their mothers, due to the high rate of single parenthood and migrant labour
practices in South Africa (Shell, 2000). It is also true that often when children
lose one parent to AIDS related illnesses; it is likely that the other parent is
also infected due to the sexually transmitted nature of HIV (Shell, 2000). This
leads to a double loss for children, and compounds already distressing
circumstances. Parental deaths burden orphans with additional financial
worries such as funeral costs and reduced access to resources that an adult
could provide (Desmond, Michael & Gow, 2000). Lower income, or lack of
income, that children face when parents are ill or deceased, places them at
further risk of emotional disturbance (Desmond, Michael & Gow, 2000).

In the long term, children who inherit the additional responsibility of being the
breadwinner and emotional caregiver for siblings and sick parents are at an
increased risk for emotional disturbance. School-aged children who become
the head of the household often have to leave school (Desmond, Michael &
Gow, 2000). Children who are unable to cope with such responsibility, who
lack parental nurturing similar to neglect and who have to contend with
eventual death of their parents are likely to be emotionally underdeveloped
(Whiteside & Sunter, 2000). Shell (2000) further states that the impact this

27
has on society is that children are left to fend for themselves, and become
vulnerable to sexual exploitation and factors such as crime, homelessness,
poverty and malnourishment, which in turn affects health and well-being
(Desmond, Michael & Gow, 2000; Shell, 2000; Whiteside & Sunter, 2000).
The double stress of losing parents and becoming a parentified child plunges
children into multiple crises that challenge their coping skills and therefore
puts them at risk of developing emotional disturbance.

People living with AIDS are more prone to developing depression and
experience feelings of loneliness (Shell, 2000). This could be partially due to
the nature of the illness being terminal, but also to the stigma attached to
AIDS and HIV. By association, family members might be stigmatised and
thereby become social outcasts. The sense of isolation is similar to that of
those with the illness. Panic attacks, disordered thoughts, denial, aggression
and depression are all observed reactions to the reality of being HIV positive
or having AIDS. The burden that caring for people living with AIDS puts on
caregivers includes dealing with illnesses such as tuberculosis, and perhaps
later with dementia (Shell, 2000).

Another consideration particular to Southern Africa is the high rate of sexual

abuse in relation to AIDS. In a report by Conradie (2003), 14% of participants
believed that having sex with a virgin would cure AIDS. Even for those who
did not share this belief, there seemed to be a trend to have sex with younger
sexual partners to avoid the chance of infection (Conradie, 2003). The
execution of this erroneous belief is for personal healing, but Shell (2000)
reports that other township youths have a more sinister motive. They are
known as “Jack Rollers” and they purposely infect young women by raping
them (Shell, 2000). It would seem that in the townships, sexual violence, for
whatever reason, is extensive (Conradie, 2003). These rates of sexual
violence overflow into the schools (Neser, 2006). The threat of danger, the
traumas of experiencing rape as well as the high risk of becoming infected
with HIV, are risk factors for children to develop emotional disturbance.

28
AIDS, poverty and violent crimes are factors that contribute to the
development of emotional disturbance in South African children. Children
further become the victims of their parents’ inability to manage stresses
caused by these factors, while simultaneously having to cope with their
environment. There is a complex relationship of circular causality between
these factors. There also seems to be a synergistic effect when these factors
are combined so that multiple stressors, crises or traumas result in substantial
damaging effects on the emotional well-being of South Africans. Children
experience symptoms of emotional disturbance and this is evident in
internalising, externalising and mixed indicators such as those described in
Table 2.2 and section 2.2.2.

2.4 Conclusion

Situational factors create the opportunity for emotional development when

present in small, manageable amounts. Stress is necessary for emotional
development and the successful negotiation of difficult events builds coping
skills and a subjective sense of well-being. However, overwhelming
circumstances place increased demands on children, and their limited coping
skills are not sufficient to deal with such circumstances. These stressors vary
in intensity and multiple or ongoing stresses potentially have the same
negative impact on emotional development as that of a trauma. This could
lead to the formation of emotional disturbance in children.

The indicators of emotional disturbance include three clusters of behaviour,

namely internalising, externalising and mixed behaviours. These symptoms
are similar to some childhood disorders described in the DSM IV-TR (2000)
and vary in the intensity with which they manifest. The severity of emotional
disturbance is observable in the level of functioning of a child and lower levels
of functioning are indicative that the child is in need of therapeutic
intervention.

29
The symptoms of emotional disturbance are discernible in many South
African children. Some studies have shown that South African children are at
higher risk for developing emotional disturbance due to the distinctive set of
risk factors that compound stress, such as poverty, exposure to violence and
crime as well as the high prevalence of AIDS. Multiple incidences of trauma
and crises become overwhelming and children might experience the
subjective feelings of hopelessness, fear or exasperation. The process of
negotiation between environment, in terms of coping and socialising, and the
management of overwhelming feelings becomes unbearable for children and
negatively affects their ability to cope with daily demands.

The children exposed to these circumstances in South Africa are mostly also
the children with the least access to resources, such as health care. A
measure that can quickly and inexpensively assess emotional disturbance in
children, and that is administrable by a wide variety of professionals could be
useful to address one component of this problem. One version of the Draw-A-
Person has had some success in identifying emotionally disturbed children in
South Africa, and indicates that a measure such as the DAP: SPED could be
useful in the south African context (Williams, 2001). Chapter 3 will focus on
the potential that the DAP: SPED has for identifying South African children
with emotional disturbance.

30
 CHAPTER 3
LITERATURE REVIEW: DRAW-A-PERSON

3.1 Introduction
The previous chapter clarified the term emotional disturbance, and showed
how South African children might be particularly vulnerable to developing
emotional problems. In the light of the effects of economical and social
problems on psychological well-being, as well as restricted access to
resources, a large part of the South African population could benefit from
quick psychological interventions. This chapter examines the Draw-A-Person
(DAP) as a potential instrument to address this need. A brief look at the
history and development of the DAP will show how it was a forerunner to the
development of the Draw-A-Person: Screening Procedure for Emotional
Disturbance (DAP: SPED).

3.2 Historical Background of the Draw-A-Person Test

To contextualise the DAP: SPED it is necessary to briefly trace its origins
through the many years of development. It should be noted in this regard that
various versions of the DAP have also been known by different names,
depending on the developer and its purpose. Despite the variety of names,
and at times the slightly different administration procedures, the basis of each
version remains the same: Drawn figures of humans are utilised for
psychological assessment. For ease of understanding, the term DAP will be
used throughout the text, unless the specific name of the measure needs to
be used.

The DAP was initially formulated as a cognitive measure by Goodenough

(1926) and this formed the basis for later development of the projective use of
the DAP (Naglieri, McNeish & Bardos, 1991). The latest version of the DAP
as a cognitive measure is the Draw-A-Person: A Quantitative Scoring System
(DAP: QSS) (Naglieri, 1988). The projective branch experienced a second

31
split and this resulted in quantitative and qualitative scoring methods. The
highlights in development of the DAP are represented in Figure 3.1.

32
 Cooke & Ricci recognise link between cognitive development and
drawing skill in the 1800’s

Cognitive
Branch

Draw-A-Man
Projective Branch
(DAM)
Goodenough Humans are the most popular

1926 subjects in children’s drawings

Qualitative
Quantitative
Harris revises to create
the Goodenough-Harris
Drawing Test (GHDT) Machover
1963 Uses
Human Figure
GHDT
Drawing (HFD)
(1949)
Koppitz
Draw-A-Person: Quantitative Scoring 1968
System (DAP: QSS) Other
interpreters
Naglieri 1988
including
Hammer
(1960) and
Jolles

Draw-A-Person: Screening Procedure for Emotional (1971)

Disturbance (DAP: SPED) Naglieri, McNeish &

Bardos
1991

Figure 3.1: The development of the DAP

Note. Compiled by author from the following sources: Naglieri, McNeish and Bardos (1991)
and Peterson and Hardin (1997)

33
3.2.1 The DAP as a Cognitive Measure
The origins of the DAP dates back to the 1800s when Cooke and Ricci
respectively observed that children's drawings change as they develop
(Naglieri, 1988). The DAP in its earliest form was developed in 1926 by
Goodenough, who realised that the increased sophistication in children’s
drawings was related to cognitive ability rather than to chronological age
(Goodenough, 1926). Based on this observation she developed the Draw-A-
Man test to quantitatively measure cognitive development (Harris, 1963). In
1963, Harris revised the test to produce the Goodenough-Harris Drawing Test
(GHDT) (Harris, 1963). Her motivation for revising the test was to include
norms for a wider age range. Two additional drawings of a woman and the
self allowed for greater accuracy in measurement. Recently Naglieri (1988)
updated the GHDT, which resulted in the DAP: A Quantitative Scoring
System (DAP: QSS). Children between the ages of six and seventeen years
were included from different cultures and socio-economic status. The norms
were updated and the categories were refined into half-year and quarter-year
intervals. This resulted in 21 age categories to keep up with rapid
development at certain ages.

The rationale behind the DAP as a cognitive measure relates to the belief that
developmental changes in children’s drawings are concurrent with cognitive
development and that changes in children’s drawings confirm this
development (Jacobs & van der Merwe, 1992). Developmental stages that
are universally recognisable in children’s drawings encapsulate this
development (Golomb, 2002). It is also believed that these changes remain
stable over generations (Di Leo, 1970).

In order to understand better what the developmental stages of drawing look

like, a table was constructed to summarise some of these milestones. Table
3.1 shows the increasingly complex cognitive functioning that underlies this
development.

34
 Table 3.1 Developmental Stages in Drawing
Note. Table compiled by author from the following sources: Arnheim (1971),
Gardner (1980), Goodnow (1977), Kellogg (1979), Koppitz (1968), and
Lowenfeld and Brittain (1969).

Stage Description

Scribbling: • Scribbling can be compared with babbling.

• The act of scribbling is possibly a result of vicarious learning of adult
1. Uncontrolled/
behaviour.
Basic Scribble
• The child doesn’t know what end product will look like. Often the child
Approximately doesn’t even look at the page. It is thought that scribbling is done for the
13 months kinaesthetic pleasure or rhythm.
• Visual pleasure is found in making marks on the paper.
• By 3½ years children name the scribbles.
• A distinction can be made between Patterners (focus on shape) and
Dramatists (focus on story) that might indicate personality differences.

• Six months after the onset of basic scribbling a new phase emerges, namely
2. Controlled controlled scribbling.

Scribble • What is on the paper becomes important.

• Scribbles are more consciously placed in certain places on the page; this is
2 to 4 years
called a placement pattern.
• Repetition in shapes happens while the child is mastering the medium.
• The first shape that is successfully completed is the circle, and it is a
significant moment when the ends meet.
• The circle comes to represent ‘thingness’.
• By the age of four years, the ‘tadpole’ emerges.

The • Often shapes are practiced in small before they are incorporated into the
drawing. Detail is added as the shapes become familiar.
Preschematic
• Idiosyncratic symbols emerge that are not easily recognisable to the adult.
Stage:
• These symbols are not representative of reality, but reflection an inner
4 to 5 years representation of something.
• The human figure is the first recognisable symbol regardless of the child’s
nationality or background.

35
Preschematic • The human figure is often drawn in five points, namely the head and four
limbs.
stage
• The human figure and particularly the face have emotive value.
(continued)

The Symbolic • During this stage only relevant detail is added, for example the arm might be
omitted in one drawing, but when the figure is throwing a ball the arm is
Stage:
included.
5 to 6 years
• Detail might be omitted when space is limited.
• Children do not like crossing lines in drawings, and would rather omit a
detail. For example, if emphasis is placed on long hair, then there might be
no space for arms.
• This is indicative of the child’s inability to plan or think ahead at this age,
which only develops by eight years.
• Sixty percent (60%) of children draw stiff outstretched arms in this stage.
• Straight lines often symbolise elongated objects such as limbs.
• Up to the age of 5 years, drawings become increasingly conventional and
stereotypical. For example, a dog might be representative of all animals.
• Children are quite sure of their lines because of the stereotypical drawings.
• An eraser is seldom used. A child would rather restart or talk a mistake
away.
• Gender is often not depicted. If emphasis is placed on gender they will be
distinguished by the inclusion of hair or a dress.
• Figures are often slanted or upside down. If the figure starts off skew this is
not corrected.
• The bottom of the page is not seen as the ground.
• An upside down figure would only be significant from six years and older.

The Schematic • Cognitive development allows for schema to form. These are fixed ideas
about objects that are categorised.
Stage:
• These schema become automated or stereotyped, and then allow the child
6 to 9 years
to start experimenting with variations, for example, movement.
• Often exaggerations, omissions and additions are found at this stage.
• The drawings are purposeful, and the visual result is important.
• Sometimes disproportion occurs if particular emphasis is placed on certain
detail.
• Multiple perspectives might appear due to the stereotypical nature of the

36
 object.
Schematic
• By 6 years understanding of direction develops, so that the ground is
stage
represented by a baseline. By 8 to 9 years, a baseline is present in 90% of
(continued) drawings. A skyline is also often present.
• The ground line is taken as the nearest point of reference (e.g. a person
climbing a hill is drawn at 90º to the hill rather than the ground).
• X-ray vision or transparencies might occur due to poor planning ability.
• Small figures might be a result of the development of the hand muscles.
• From the age of seven years, spontaneous drawings decline and humans
are drawn less frequently.

The Emergence • Developmentally there is a growing awareness of the child’s place within
society.
Of Realism:
• Previous schemas are no longer adequate to express these new
9 to 11 years
relationships.
• The baseline in drawings acquires a new dimension as the child realises that
detail underground can be filled in.
• Multiple baselines might appear.
• The skyline tends to disappear.
• Some overlapping might occur (e.g. a tree might overlap with the sky). This
implies that multiple relationships between objects is understood.
• Exaggeration occurs less frequently.
• Children want to draw correctly at this age, and can be pedantic and literal.
• X-ray drawings are considered unnatural and therefore disappear in this
stage.
• Children still do not draw what is seen, but draw their experience of reality.
However, they do become aware of techniques that can be used to create an
effect.

The categories of drawing development benefit adults’ comprehension of

children’s drawings relative to the norm. It is important to remember that while
knowledge of drawing development is important in psychological assessment,
the developmental stages are approximate and variation does occur between
children (Jacobs & van der Merwe, 1992). The chronological ages of the
categories should thus serve as guidelines considering the highly individual

37
rate of cognitive development. Simultaneous representation from consecutive
stages might co-occur as the child develops, emphasising the fluidity of the
categories (Di Leo, 1970).

Children’s drawings become increasingly sophisticated to adult standards as

the child develops. Development results in children applying newly learned
skills, such as motor development and observational skills, to their drawings.
Table 3.1 showed that as children include more detail in their pictures, and
the representations become more complex, they are likely to simultaneously
be using more cognitive skills. Subsequently, when several different abilities
are employed concurrently, higher levels of mental development are evident
(Siegler, Deloache and Eisenberg, 2003). Development in drawing, as with
other human development, seems to be at least partly driven by the innate
drive to learn and grow, as described by Piaget (Wicks-Nelson & Israel,
2003). Kellogg (1979) recognised this self-perpetuating development when
she observed that children naturally make marks on paper. She believed that
making marks on paper is a stimulus for brain development in areas such as
reading and letter formation (Kellogg, 1979). This forms the basis of the DAP
as a measure of cognitive development.

Table 3.1 showed that development in drawing reflects cognitive and physical
development and that this forms the basis of cognitive measures like the
Goodenough-Harris DAP and the DAP: QSS. Another important aspect that is
highlighted in Table 3.1 is that certain inclusions, omissions or peculiarities
might be characteristic of drawings at a certain level of development.

The knowledge of developmental peculiarities in drawings is important when

using drawings for assessment purposes. Without thorough knowledge of
these developmental stages, any interpreter of children’s drawings could
erroneously place significance on the presence or absence of certain items in
drawings, when it is actually normative for the specific age group.
Unfortunately, most psychologists have not had the opportunity to study
sufficient amounts of drawings to recognise what is normative. This was a
major concern for Kellogg (1970) who was opposed to the use of drawings for

38
assessment when the assessor had no knowledge of what is ordinary or
unusual in drawings. Therefore, the benefit of having such guidelines as
those described in Table 3.1, is that children’s drawings can be judged within
the context of normative development. Further discussion about this issue
follows in section 3.2.2.

3.2.2 The Projective Use of the DAP

As described above, the early history of the DAP reflected the idea that
development in children’s drawings was related to cognitive ability. Research
showed that as their cognition developed and their experience as well as their
knowledge increased, children's concepts of people were reflected in their
drawings (Malchiodi, 1990). There were two main schools of thought in regard
to the interpretation of these concepts of people in drawings, namely as a
cognitive maturity measure or as a projective measure (see Figure 3.1). The
main promoters of the projective measure at the time were Machover, Levy,
Hammer and Jolles (Koppitz, 1968). One of the projective uses of the DAP
was for the assessment of emotional disturbance. A succinct look at the
projective use of the DAP will give some insight into the rationale for
developing a quantitative scoring measure for emotional disturbance and how
this is related to developmental changes in children’s drawings.

The rationale behind the projective use of drawings is based on the belief that
information about underlying attitudes and feelings is communicated non-
verbally. Trevisan (1996) stated that the feelings, beliefs and current mental
state of the drawer would influence the outcome of what is drawn, and as a
result, one could say that the child projects into the picture. La Roche (1994)
goes a step further and refers to the projective nature of drawings as the
creation of a ‘visual vocabulary’. Both authors seemingly agree that
communication is taking place through projection in drawings. Gardner (1980)
furthermore identified a group of children who consciously seem to tell a story
through their pictures, and named this group Dramatists (see Table 3.1).

39
The specific use of the Human Figure as the projective subject is embedded
in the widespread belief that because children across the world so commonly
draw the human, it is a familiar and non-threatening subject (Golomb, 2000).
The familiarity allows for projection, as the child is not focused on
implementing cognitive constructs to an unfamiliar subject. Both Machover
and Koppitz (1968) believed that drawing of a person would always be a
reflection of the child’s inner representation of the self as that is what the child
knows best. This inner representation is subjective and not meant to reflect
reality. As Jacobs and van der Merwe (1992) explain, it is rather a perception
of reality that is reflected in drawings (also see Table 3.1).

Di Leo (1973) echoed this sentiment. He believed that drawings are not
supposed to be representations of anything, but rather say something about
what is drawn. Although Di Leo (1973) proposed that drawing a person alone
(and not in relation to the family, for example) relies on a concept or schema
of the body image, he also thought that cognitive representations would
change. The schema or stereotype would differ in expression, depending on
where the child’s attention was focused. Di Leo (1973, p. 36) stated that:

Insofar as human figure drawing represents a concept of the body image

as experienced at that time, it will tend to express, unconsciously and
symbolically, the hurt that is making the child painfully aware of his
feelings. As his thoughts are turned inward, the drawing becomes a more
intimately personal statement.

Therefore, Di Leo (1973) argued that well-adjusted children draw an adult as

a cognitive concept (schema) of a person. Such children would have more
freedom to focus on the environment because they are less preoccupied with
the self. On the other hand, emotionally troubled children are more likely to
represent aspects of themselves in drawings, because of increased
introspection. According to Malchiodi (1990), abuse in the family could be a
cause of such introspection and could lead to poor self- and body image. This
manifests directly in artwork and for example, takes the form of excessively

40
small figures, and self-deprecating drawings and statements (Malchiodi,
1990).

Although there is agreement between authors on the usefulness of human

figures as vessels for subconscious communication, subtle differences reflect
each author’s belief of exactly what is projected in terms of body image.
Koppitz (1968) for example, believed that the figure drawn by the child is
representative of the inner self or personal attitudes towards life stresses,
fears and anxieties. Machover (1980), on the other hand hypothesized that
drawings reflect personality. Blau (1992) seemed to have the most
encompassing perspective about what drawings communicate. He stated that
the drawing could be reflective of attitudes towards others, the ideal self-
image of the drawer, that it could indicate emotional tones, or simply be
habitual or stereotypical representations, or any combination of the above.
Preoccupation with the opposite sex in adolescence could even influence the
subjects in the drawings (Blau, 1992).

While authors place different nuances on the meaning of the Human Figure,
there seems to be consensus that drawings serve as a tool for
communication. The manner in which this tool is utilised reflects each author’s
underlying belief. The following two sections will focus on the two main
differences that have emerged over history, namely the qualitative and
quantitative employment of the DAP (also refer to Figure 3.1).

3.2.2.1 Qualitative Interpretation of the DAP as a Projective Technique

Machover (1980) employed the GHDT to reveal personality types based on

psychoanalytic theory. Psychoanalytic theory states that symbols are the link
between the conscious and the unconscious (Sadock & Sadock, 2003). Both
the Human Figure as a whole and aspects of the figure, such as the size of
the hands, are considered symbolic representations of underlying feelings.
Symbols become the focus when analysing drawings for underlying
messages (Jacobs & van der Merwe, 1992). Machover’s (1980) experience

41
with thousands of clinical patients, as well as the psychoanalytical approach
that informs her work, formed the basis of her interpretation of these symbols.

Though Machover’s (1980) main aim was to find personality types, much of
her work with the GHDT identified symbols that pointed to emotional
disturbance. These specific symbols are known as emotional indicators. It is
possible that Machover recognised underlying emotional issues because she
worked with an adult clinical sample with mild to severe levels of emotional
disturbance. Furthermore, the psychoanalytic theory that underpins her work
views personality in terms of habitual defences for emotional pain
(Rudenberg, Jansen & Fridjohn, 1998). This theory is simultaneously a
personality theory, as well as a theory that explains the aetiology of emotional
disturbance (Sadock & Sadock, 2003).

The emotional indicators identified by Machover (1980) included particular

symbols that represented underlying emotional disturbance. The process of
identifying emotional indicators involved examining physical features of the
humans in the drawings of her clinical sample and comparing them with
emotional disorders that she observed in her patients. These include
obsessive-compulsive, impulse control, anxious, schizophrenic and
depressive behaviours (Blau, 1992). Machover (1980) attempted to linearly
link these particular elements to specific diagnoses in the clinical adult sample
that she studied.

To illustrate the connection between emotional indicators and underlying

emotional states, hands and feet and their potential meaning according to
qualitative interpretation are briefly mentioned:
• Machover (1980) connected the omission of hands or feet with behaviours
that suggested insecure social contact.
• Hands placed behind the back supposedly represent an evasive quality,
while hands in pockets could indicate hostility or masturbation guilt.
• Large hands could also indicate hostility or might refer to inferior social
contact skill.

42
• Abnormally long arms could indicate excessive demands for affection.
• Fingers drawn without hands tend to indicate infantile aggression, while
mitten type hands could also indicate sporadic bursts of aggression when
there are evasive tendencies.

Qualitative interpretation also emphasises the overall quality of the drawing.

This includes the quality of the lines, erasures and areas that receive conflict
treatment. Increased pencil pressure, for example, could be indicative of pent-
up emotions such as frustration, or feathery lines could be indicative of
anxiety (Blau, 1992). Conflict areas on the human figure are where the drawer
repeatedly attempts to draw that part of the figure, either with erasures or
without (Blau, 1992). The inclusion of overall quality of the drawing when
interpreting drawings is important. The impression that a drawing leaves the
onlooker with can be quite dramatic, and might communicate a lot of
information about the attitude of the drawer (Blau, 1992).

Although these indicators identified by Machover (1980) and expanded on by

Blau (1992) are widely used, research has shown that specific indicators are
difficult to tie to specific traumas or emotional problems in such a linear way
(Veltman & Browne, 2002). According to Veltman and Browne (2002),
research has been unable to find acceptable levels of reliability across raters
for projective interpretation of drawings. This might partly be due to the
subjectivity involved in the interpretation process with regard to the
subconscious projection of the interpreter’s own underlying emotions. Neither
the respondent nor the administrator is ever completely able to shed their
frame of reference. The meaning that the administrator ascribes to any
particular response might therefore not always match that of the respondent.

Authors such as Riethmiller and Handler (1997) furthermore believe that

linear interpretation disregards the complexity of human behaviour. By
ascribing one or two possible meanings for each indicator, it narrows the
channel of communication. The neatly packaged message consequently
might result in broken-down communication.

43
An added concern is that the qualitative interpretation of drawings is
particularly susceptible to disregarding the age and developmental stage of
the artist. This is the unease that Kellogg (1970) was communicating when
she said that interpreters generally do not have enough experience with
normative drawings of children to differentiate between an emotional indicator
and a developmentally determined factor in a drawing. This is a very
important issue, as emotional indicators are sometimes similar to normal
developmental occurrences in drawings. For example, transparencies, or X-
ray vision, might be common in drawings of children between six and nine
years. This is because the child has inadequate planning skills, and draws the
body first and then dresses it (see Table 3.1). However, transparency as an
emotional indicator means that the drawer has lost touch with reality (Blau,
1992). The inclusion of a baseline is also normal for children at this age, as
their perception of relationships between objects is emerging. Yet, a baseline
as an emotional indicator signifies feelings of insecurity or a need to be
grounded (Blau, 1992).

In defence of Machover, her work was based on an adult clinical sample, and
she aimed to find personality traits in adults (Machover, 1980). Therefore,
developmental stages in drawing would be less relevant. When an interpreter
chooses to use Machover’s indicators to measure children’s drawings, it
would constitute misuse of her work. One could therefore say that indicators
of emotional disturbance in drawings are only relevant once the drawer has
passed a certain stage of drawing development.

The multiple shortcomings of qualitative measures, and their injudicious

application, have motivated the development of quantitative scoring methods
for emotional disturbance. Quantitative measures are descriptive and
therefore do not attempt to ascribe particular meanings to emotional
indicators. Based on the belief that the presence of indicators is sufficient to
evaluate emotional disturbance, Koppitz (1968) developed her Human Figure
Drawing (HFD) which in turn inspired the development of the DAP: SPED.

44
3.2.2.2 Quantitative Interpretation of the DAP as a Projective Technique

In contrast with Machover’s qualitative interpretation, Koppitz (1968)

established a quantitative measure for emotional disturbance. Koppitz (1968)
drew on Kellogg’s idea that the structure of the drawing reflects the child's
age and maturity, while the content reflects attitudes and concerns at the time
of drawing (Koppitz, 1968). According to Koppitz (1968), one could score this
test for cognitive development as well as for emotional indicators.

The rationale behind the quantitative scoring of the DAP is based upon the
belief that the occurrence and quantity of emotional indicators sufficiently
illustrate whether emotional disturbance is present. This eliminates the need
for linearly interpreting emotional indicators while still acknowledging their
presence. Another important aspect of a quantitative measure is that it is
scored normatively. In her measure, the Human Figure Drawing (HFD),
Koppitz (1968) standardised the scoring of emotional indicators by
establishing the frequency with which certain indicators could be expected at
certain stages in development.

The HFD consisted of 30 items that represent emotional indicators, which

resulted from theoretical findings by Koppitz (1968). The initial 38 items were
reduced to 30 when some items could not be validated. Koppitz (1968)
recognised that specific indicators alone were insufficient for the assessment
of a drawing and thus emphasised the importance of the overall quality of a
drawing. This resulted in three underlying categories that are recognisable in
drawings, namely quality, special features and omissions.

Overall quality, as promoted by Koppitz (1968), is recognisable at a glance. It

includes such features as line quality, integration of body parts, proportion
and shading (Oster & Gould, 1987). Similar to the qualitative interpretation,
the drawer’s attitude is discernable from the line quality where lines are drawn
boldly or timidly (Veltman & Browne, 2002). The amount of erasures, as well
as whether these erasures improve the quality of the drawing contribute
towards the assessment of overall quality (Koppitz, 1968). A child might, for

45
example, repeatedly draw certain parts, but never actually improve on the
drawing. Other indicators of overall quality are disorganised features and
include confusing or hard to identify body parts or the drawing of a
disembodied head (where the body is omitted) (Malchiodi, 1990). Di Leo
(1973) also found that scattering of body parts, scribbling over the drawing,
rigid figures, excessive shading, small figures and figures drawn at the bottom
of the page as though for support, related to the overall quality of the drawing
and therefore were indicators of emotional disturbance. According to
Malchiodi (1990), disorganised art is particularly alarming as it could be
indicative of overwhelming emotions expressed in a vulnerable state.

The second and third categories include specific unusual features and
omitted features, such as too small or large head, cut off arms or hands, teeth
or clinging arms (Oster & Gould, 1987). These indicators are similar to the
qualitative indicators discussed in 3.2.2.1.

Various studies on the use of the HFD include children with learning
disabilities (Eno, Elliot & Woehlke, 2001) and sexual abuse or maltreatment
(La Roche, 1994; Webster, 2000). La Roche (1994) compared various
authors’ findings and found much evidence in support of the HFD. He found
that the drawings could be invaluable for early detection of emotional distress
(La Roche, 1994). Based on the early success and popularity of the HFD,
Naglieri, McNeish and Bardos (1991) were inspired to develop a new
measure for emotional disturbance.

3.3 The Draw-A-Person: Screening Procedure for Emotional Disturbance

(DAP: SPED)

It has been shown that the DAP has evolved over more than a century, firstly
as a cognitive measure, and then as a projective measure. Similarly, the
development of the DAP: SPED is founded on a predecessor which is a
cognitive measure. Following the development of the DAP: QSS, Naglieri,
McNeish and Bardos (1991) used the same data to develop a measure for
emotional indicators. (The rationale for using the same data is unknown,

46
although it was presumably economical to use existing data.) They wanted to
create a standardised measure for the emotional screening of children such
as Koppitz’s (1968). Because Koppitz’s measure was developed three
decades previously, Naglieri, McNeish and Bardos (1991) wanted to construct
a measure for emotional disturbance that was more relevant for modern day
use and had updated norms. This resulted in the development of the DAP:
SPED. McNeish & Naglieri (1993) reported that, compared with previous
research findings, the DAP: SPED showed a significant improvement of the
Koppitz (1968) qualitative scoring system.

Following an ‘exhaustive review of the literature’ (Naglieri, McNeish & Bardos,

1991, p. 5), the authors used an actuarial process to identify the indicators
that are most representative of emotional disturbance for inclusion in the
DAP: SPED. The actuarial approach, according to Murphy and Davidshofer
(2001), involves a process of determining how similar individual responses
are in comparison with the group. Indicators that occurred infrequently in the
standardisation process were eliminated while those that occurred frequently
and showed appropriate psychometric properties were included. The
indicators that were included were effective in the pilot study and this was
confirmed in subsequent research that distinguished normal from emotionally
disturbed participants (Naglieri, McNeish & Bardos, 1991).

From the literature reviewed in this chapter, it seems that the DAP: SPED will
be beneficial for use in the following ways:

• As it is based on drawings, it is easy to administer with children.

• The DAP: SPED is quick and simple to administer and score.
• The non-verbal nature makes it ideal for use with children, especially when
assessment is in an unfamiliar language.
• The most relevant emotional indicators have been identified and their
presence is sufficient to identify emotional disturbance. No interpretation is
needed.

47
• The fact that the measure is standardised eliminates the need for the
assessor to have in-depth knowledge of normative drawing development.
• Standardised scoring improves the reliability.
• Standardised scoring allows the DAP: SPED to be administered by a wide
range of trained professionals (Naglieri, McNeish & Bardos, 1991).

Detailed information about the psychometric properties of the DAP: SPED is

presented in 4.3.1.

3.4 Conclusion

Over the greater part of the last century the DAP has been identified as an
accurate and fast assessment tool for intelligence (Jacobs & van der Merwe,
1992). A quantitative scoring procedure resulted in a user-friendly measure,
and had the benefit of showing inter-rater reliability (Harris, 1963). To date
this measure has also been popular for assessing emotional problems, and
authors like Machover (1980) and Koppitz (1968) researched the occurrences
and meanings of emotional indicators in drawings. While Machover used an
interpretive system for adults, Koppitz preferred a quantified system for
children. Recently Naglieri, McNeish and Bardos (1991) created a
standardised quantitative scoring system for emotional indicators in drawings
with several benefits: A standardised measure has the benefit of providing
results with reduced influence of the assessor’s frame of reference in
interpretation and are therefore more objective. Quantitative scoring also
allows for faster and more accurately obtained results. Furthermore, different
norms for different age groups allow for developmental differences in
children’s drawings, which are not always familiar to the therapist (see
3.2.1.1).

A screening measure with good validity and reliability such as the DAP: SPED
is invaluable as a tool for people in the helping professions, especially in
South Africa. As discussed above, the non-verbal nature of the measure

48
allows for children from any language to successfully use this test. The
universality of the human figure and the frequency with which it is drawn
allows for projection on a familiar and emotive subject. Because the human
figure is drawn so frequently, it has been possible to establish norms for norm
referenced evaluation. These benefits suggest that the DAP: SPED would be
useful for assessing emotional disturbance in South African children.

In order to ascertain whether the DAP: SPED might be useful in the South
African context, certain statistical procedures need to be performed and then
reported on. Chapter 4 will focus on the procedures of this research process.

49
 CHAPTER 4
RESEARCH METHODOLOGY

4.1 Introduction

The previous chapters illustrated how psychological problems such as

emotional disturbance increased due to social problems, such as poverty,
exposure to AIDS-related issues, and violent crime. The increased
vulnerability of children, who have limited coping skills, was also highlighted.

Non-verbal communication methods were identified as possibly being useful

to address this challenge. It was suggested that the DAP: SPED might have
potential in the South African context. To establish this, certain psychometric
properties needed to be investigated, which formed the primary aim of the
current research. This chapter will concentrate on the procedures used to
investigate these properties.

4.2 Research Aims

In 1.3, the purpose of the present research was stated to ascertain whether
the DAP: SPED is useful as a non-verbal screening measure for emotional
disturbance in South African children. The DAP: SPED was found to be valid
within the American context across cultures, in varying degrees of
urbanisation and rural areas, as well as across economic strata (Naglieri,
McNeish & Bardos, 1991). No literature revealed the applicability of the DAP:
SPED in South Africa, and thus the current study set out to examine the
usefulness of the DAP: SPED locally.

To attain this primary aim, secondary aims were identified, and these
included:

1. To determine the usefulness of the DAP: SPED by comparing it with

another measure, the Beck Youth Inventory (BYI-II). An independent

50
 measure such as the BYI-II, which has been statistically proven to
measure emotional disturbance, would provide information about how
effective the DAP: SPED is in identifying children with emotional
disturbance. The following hypothesis was proposed to verify that this
secondary aim is met:

H o : There is no correlation between the scores of the DAP: SPED and the
BYI-II in a sample of Grade 4 South African learners.
H 1 : There is a significant correlation between the scores of the DAP:
SPED and the BYI-II in a sample of Grade 4 South African learners.

2. To determine the DAP: SPED’s reliability scores for the measurement of

emotional disturbance in children. If obtained scores are reliable, it
provides information about the usefulness of the measure.

3. To determine the credibility of an inter-rater scoring process of the DAP:

SPED. Reliability is often difficult to determine for projective techniques
due to the subjectivity in scoring. One technique to establish the reliability
of a measure’s scoring system is to compare scores by different raters on
the same set of data (Foxcroft & Roodt, 2001). The following hypothesis
was proposed to verify that this secondary aim was met:

H o : There is no correlation between the scores given by different raters

when the DAP: SPED is scored.
H 1 : There is a significant correlation between the scores given by different
raters the DAP: SPED when the DAP: SPED is scored.

4. To obtain more information about the prevalence of emotional disturbance

within the target group. Chapter 2 showed how children are particularly
vulnerable to developing emotional disturbance, as they depend on adults
to provide in their basic needs. It was proposed that South African
children, due to the high prevalence of violent crime, poverty and AIDS
related social problems, are at increased risk of developing emotional

51
 disturbance. Current levels of emotional disturbance of the sample group
could therefore be recorded and described.

4.3 Research Approach

The current research made use of a quantitative research approach to explore

the relationship between the DAP: SPED and the BYI-II, the reliability of the
DAP: SPED as well as the prevalence of emotional disturbance in the target
group. Within the limited scope of the research, an explorative approach was
used to investigate how useful the DAP: SPED could be in the South African
context. Based on the findings of the current research, further research could
focus on the validity and reliability of the DAP: SPED or possibly initiate
standardisation procedures for local use.

4.4 Sampling

For the purpose of this research, a sample of convenience was used.

According to Neuman (2000), convenience sampling is a form of non-
probability sampling. With convenience sampling, the respondents are
selected from the target group, but might not be representative of all cases
within the target population. Respondents are likely to be included in a sample
due to their proximity to the researcher rather than their representivity
(McBurney, 2001). A limitation of convenience sampling is that there is a risk
that the sample is misrepresentative and consequently results should be
generalised with caution. Despite this, McBurney (2001) is of the opinion that
the results could be extended to other children within the target population.

Another important reason why proximity to the researcher was preferable,

relates to an ethical consideration (see 4.9.2). Participating learners with
emotional disturbance were referred for counselling at their schools, but the
researcher also made her services available at her nearby place of work. A

52
more representative sample might therefore not have had access to gratis
psychological services.

4.4.1 Selection Criteria

Considering that the intended use of the DAP: SPED in the local context
would be as a group screening measure in schools, the target group was a
sample of children from local schools. Therefore, even though the sample
might not be representative of the population at large, the DAP: SPED was
applied in terms of its intended use. One could thus argue that the results
obtained in the current research will reflect how effective the measure might
be in identifying learners at any given Model C school. Furthermore, despite
using a sample of convenience, participants had to meet certain criteria to be
included in the sample. This was necessary since the measures used
imposed certain limitations.

On the one hand the DAP in general has shown to be more accurate on
younger test-takers (Matto, 2002), while on the other hand the BYI-II requires
older children with English reading proficiency (Beck, Beck, Jolly & Steer,
2005). This inferred that the children included in the sample should be neither
too young, nor too old to comply with the best circumstances for both
measures. The result was that Grade 4 learners were selected for fulfilling
these prerequisites.

Two model C schools provided the pool of Grade four learners for the sample
selection. One inclusion criterion for participating schools was the medium of
education, namely English. Despite the fact that English was not the mother
tongue of most of the learners, the fact that these children were schooled in
English indicated that they should have mastered a basic level of competence
in English, especially at a Grade 4 level. In this regard, Foxcroft and Roodt
(2004) are of the opinion that testing is often more advantageous in the
schooling language rather than the mother tongue, especially when test items
resemble school tasks. This is due to the different degrees of westernisation
influencing the linguistic purity of the mother tongue. The school principals

53
assured the researcher that the participating learners would be sufficiently
proficient in English to understand and respond appropriately to the
requirements of the testing situation.

In 2.3, the particular vulnerability of township youths was described, in terms

of exposure to violence and crime, as well as poverty. It is therefore likely that
a higher rate of emotional disturbance would be present within these areas.
However, the researcher did not use township children as respondents,
because of the perceived language barrier and the limitation to English
readers (a more complete description of the limitations follows in 4.5.2.2).
Furthermore, as the two schools had children who travelled daily from
township areas, there is some representivity of this group within the sample.

Other inclusion criteria that guided the selection of the schools were the
proximity to the researcher, as well as their willingness to participate. The
schools are located in suburban areas in the Ekhurhuleni Metropolitan
Council, near the researcher’s home and place of work. These areas are
broadly lower middle class, although many of the children come from a low
socio-economic background. Both the schools were Model C schools,
meaning that they are open to the public and integrate children from all races
and socio-economic status. These schools are likely to be similar to other
schools in suburban areas across the country.

4.4.2 Realised sample

The original sample size of the research was 129 Grade 4 learners, of which
66 attended school A, and 60 attended school B. Four learners’ scores were
eliminated from the data analysis, due to reasons discussed in 4.7. The
realised sample was therefore 125 learners. Figure 4.1 shows the gender
composition of the realised sample.

54
 Gender Composition of Sample

70
68
66
Amount of learners

64
62
Boys
60
Girls
58
56
54
52
50
Gender

Figure 4.1 Gender composition of sample

The ages of the participants varied between nine and twelve years. There is
an age difference of three years and one month between the eldest and
youngest respondents. The average age of respondents was ten years and
two months, and the median age was slightly less at ten years and one
month. Most respondents were between the ages of nine years and seven
months and ten years and eight months. Figure 4.2 shows the ages of the
respondents in the sample.

Age Distribution of Sample

80
70
60
Amount of learne

9yrs
50
10yrs
40
11yrs
30
12yrs
20
10
0
Age

Figure 4.2 Age composition of sample

55
The learners were all educated in English, even though for most this was not
their mother tongue. Home languages varied from Zulu, Sotho and Xhosa to
Portuguese. The majority of learners resided in the immediate area around
the school, although some travelled from townships around Gauteng. A large
majority of learners’ parents in school B were domestic workers in the area.
This supports previous notions that many of these learners are from a low
socio-economic background.

4.5 Measurement Instruments

Measurement instruments that were applicable to achieving the goals set for
the study and testing the hypotheses were implemented. The first measure
was the one being investigated, namely the DAP: SPED. The second
measure, namely the Beck Youth Inventory (BYI-II), was employed as it is
believed to be a reliable measure for identifying children with emotional
disturbance. As a result the DAP: SPED could be compared to this measure
to establish the latter’s efficacy. A third measure, the Qualitative
Questionnaire for Observed Behaviour in the Classroom (QQOBC), was
developed and employed to triangulate the data and to give depth to the data
obtained from the two quantitative measures. A detailed discussion of the
benefits and limitations of these measures follows.

4.5.1 The Draw-A-Person: Screening Procedure for Emotional

Disturbance (DAP: SPED)

The DAP: SPED is based on three drawings, namely that of Man, Woman and
Self. These drawings are quick to administer (5 minutes per drawing). The
measure has been standardised in America for children aged six to seventeen
years. The DAP: SPED is suitable for group administration, which allows for
multiple concurrent assessments.

The standardisation sample yielded the following results for the psychometric
properties of the DAP: SPED:

56
• Internal consistency was measured with Cronbach’s alpha coefficient and
values between .67 to .78 (p<.001) were reported for the three age groups
(Naglieri, McNeish & Bardos, 1991).
• Inter-rater reliability was measured with Pearson's product-moment
correlation coefficient and it was found that r >.90 (Naglieri, McNeish &
Bardos, 1991).
• Intra-rater reliability was measured with Pearson’s product moment
coefficient and it was established that r >.90 (Trevisan, 1996).
• The DAP: SPED was able to distinguish between individuals who belonged
to emotionally disturbed and non-disturbed groups. A significant chi-square
(5.01, p < .05) was obtained, which indicated that the DAP: SPED
classifications were correlated with group membership (McNeish & Naglieri,
1993).

4.5.1.1 Limitations of the DAP: SPED

On studying the literature regarding the DAP: SPED, the following limitations
were noted:
• Information regarding observed behaviour during group assessment is
lost. For example, it is difficult to know whether a child might have
hesitated before drawing, or if they drew carefully or carelessly. Koppitz
(1968) believed that this information is as valuable as the finished product.
• The official answering booklet does not lend itself to group administration,
as the scoring criteria are listed on the booklet. The scoring criteria are
therefore readily accessible to the test-takers and could possibly influence
the drawing.
• All previous validation studies were conducted by individuals who are
apparently affiliated with Naglieri, as is evident from co-authored articles.
Limited independent research has not been able to replicate these
promising findings (see 6.2 and 6.3). The lack of additional independent
research is a possible limitation in the validation studies of the DAP: SPED
thus far.

57
4.5.2 The Beck Youth Inventories of Emotional and Social Impairment
(second edition) (BYI-II)

The BYI-II is a self-report inventory for the verbal assessment of five

emotional states that include depression, anxiety, anger, disruptive behaviour
and self-concept. These emotional states correspond with some of the
syndromes listed in 2.2.2, and are based upon diagnostic criteria of the DSM
IV-TR (2000). The following subscales are contained in the BYI-II (Beck et al.,
2005):
• The Beck Self-concept Inventory (BSCI) measures self-concept as an
element of self-esteem and the child’s global sense of self. As a good self-
concept enhances emotional well-being, this scale is inversely related to
the remaining four scales.
• The Beck Anxiety Inventory (BAI) measures three aspects of anxiety and
the fear response, namely cognition, behaviour and physiology.
• The Beck Depression Inventory (BDI) measures the cognitive, affective
and behavioural symptoms of depression.
• The Beck Anger Inventory (BANI) measures the feelings and cognitions of
anger related to conduct disorder and oppositional defiance.
• The Beck Disruptive Behavior Inventory (BDBI) measures conduct
disorder and oppositional defiance symptoms associated with externalising
behaviours.

Respondents are required to indicate their level of agreement on a Likert

scale for each of the one hundred questions, which renders the measure easy
to administer and score. The self-report inventory provides information about
the presence and intensity of emotional disturbance. According to Beck et al.
(2005), children are not required to generate their own words for
communicating how they feel. Subsequently, it is easier for children to
communicate their feelings through this verbal instrument than other verbal
measures where children are required to think of words to communicate their
feelings. The measure has been standardised on children and adolescents

58
aged seven to eighteen years in America and can be administered in group
settings (Beck et al., 2005).

The following psychometric properties were reported for the standardisation

sample:
• Internal consistency measures yielded values between .86 and .92 for the
ages 11 to 14 years (Beck et al., 2005).
• The same age group achieved test-retest reliability coefficients that ranged
from .84 to .93 (Beck et al., 2005).
• Validity was established by comparing clinical and non-clinical samples, as
well as by comparing the BYI-II with various equivalent measures, such as
the Children’s Depression Inventory, Revised Children’s Manifest Anxiety
Scale, Conners-Wells’ Adolescent Self-report Scale, Children’s Inventory of
Anger and the Self-esteem Inventory (Beck et al., 2005). A comparison with
these equivalent measures yielded correlation coefficients above .68 for
relevant subscales (Beck et al., 2005).
• The internal structure of the BYI-II (between the subscales) showed good
correlation coefficients, with the highest correlations found between the
depression, anxiety and anger scales (Beck et al., 2005).

Although the BYI-II has not been standardised for South African use, Jooste
(2004) stated that it is a reliable tool for research purposes. Moreover, the
criteria for diagnosing childhood disorders in the DSM IV-TR (2000) provided
the criteria for the items of the BYI-II subscales. It follows then that as the
DSM IV-TR (2000) is widely used as a diagnostic tool in South Africa, that the
BYI-II would be equally usable in South Africa. In order to ascertain how
reliably the BYI-II could be used in South Africa, some of the psychometric
properties were studied from the data obtained in the sample group. The
following results were found:

59
4.5.2.1 Results of the BYI-II in a South African context

Internal reliability for the BYI-II was calculated within the five individual
subtests, as well as between them. Because the data of the BYI-II was
normally distributed, the internal reliability for each of the five subscales was
determined using Pearson’s reliability coefficient. Values close to 1.0 show a
high correlation between these subtests, while values close to -1.0 indicate
that there is a strong negative correlation. Values around 0.0 show that no
correlation is present. The results are charted in Table 5.5.

Table 4.1 Reliability Coefficients of the Individual Subscales of the BYI-II

Scale BSCI BAI BDI BANI BDBI

Pearson’s
reliability .823** .875** .929** .895** .833**
coefficient
**Reliability is significant at the .01level (2-tailed) N=125

These reliability coefficients are high and indicate that there is good internal
reliability for the individual BYI-II subtests.

The Pearson’s correlation coefficient was used to determine the relationship

between the subtests. Table 5.2 shows the degree of correlation between the
subtests.

60
Table 4.2 Pearson’s Correlation Coefficients between Subscales of the
BYI-II

Pearson
BSCI BAI BDI BANI BDBI
Correlation

BSCI 1 -0.156 -.532** -.399** -.377**

BAI -0.156 1 .522** .498** .345**

BDI -.532** .522** 1 .689** .488**

BANI -.399** .498** .689** 1 .506**

BDBI -.377** .345** .488** .506** 1

** Correlation is significant at the 0.01 level (2-tailed). N=125

From Table 4.2 above, it is clear that the subscales of the BYI-II are
significantly correlated. The four subscales of the BYI-II that are related to
syndromes of emotional disturbance (i.e. the BAI, BDI, BANI and BDBI) are
positively correlated. This means that high scores on one of these four
subscales would likely coincide with high scores on one of the other four
subscales for emotional disturbance. The strongest correlation seems to exist
between the depression (BDI) and anger (BANI) subscales (r = 0.689 at p>
0.01) (N= 125). The weakest relationship between the emotional disturbance
subscales exists between the anxiety (BAI) and behavioural (BDBI) scales (r =
0.345 at p> 0.01) (N=125).

A negative correlation exists between the BSCI and the other four subscales.
Negative correlations suggest that an increase in value from one variable
would signify a decrease in value for the other variable (Field, 2005).
Therefore, a high score on the BSCI would correlate with a low score on any
of the other four subscales of the BYI-II, and vice versa. In practical terms,
this indicates that the higher a learner’s self-concept, the less likely that
learner is to show signs of emotional disturbance. The correlation is stronger

61
between the self-concept scale (BSCI) and depression (BDI), anger (BANI)
and disruptive behaviour (BDBI) subscales than between the BSCI and the
anxiety subscale (BAI).

The reliability scores for the BYI-II supports Jooste’s (2004) claim that the
measure can be used reliably in the South African context. All of the
subscales demonstrated that they have good internal consistency.
Furthermore, the good correlation between the subscales illustrate that all of
the concepts measured are closely related to the same construct, namely
emotional disturbance.

Within the limited scope of the present study, these positive results suggest
that the BYI-II is a good independent measure of emotional disturbance within
the South African sample. It could therefore be used with relative confidence
for comparison with the DAP: SPED.

4.5.2.2 Limitations of the BYI-II

Despite the good reliability and validity on the BYI-II, some limitations were
noted. These limitations affected the sampling criteria, as mentioned in 4.4, as
well as the administration procedure.
• The BYI-II is limited in its use to English-speaking test takers. It requires
the respondent to be able to read English at a minimum of Grade 2 level
and comprehend what has been read, as well as understand the format in
which to answer (Beck et al., 2005). In a group setting the BYI-II can
therefore only reasonably be used with confidence with children who are
literate and who are able to follow instructions.
• The five scales take a combined time of up to 50 minutes to complete,
depending on reading proficiency. It therefore requires sustained
concentration from children.
• There is no social desirability scale incorporated in the measure. As
discussed in 2.2.1, disclosure of emotional disturbance is often
discouraged by caregivers and society. This might inhibit full disclosure of

62
 emotional status (fake good). A respondent might for example deny
stealing behaviour because it is socially unacceptable, even if the
behaviour is present. On the other hand, a respondent might also be
motivated to exaggerate symptoms in order to get attention (fake bad).
Jooste (2004) stated that extremely low scores are probably exaggerations
and can be linked to histrionic or borderline personality disorders.
Although Jooste (2004) was referring to the Beck Depression Inventory for
adults, the same might be true of the BYI-II. Interpreting the answering
style qualitatively and focusing on specific answers might provide valuable
information regarding these tendencies. For example, if a respondent has
a tendency to downplay most of the negative symptoms listed, but has a
low self-esteem; one might expect that some form of social desirability is
present. However, this is not an accurate gauge, and caution in its
application is advisable.

4.5.3 Qualitative Questionnaire of Observed Behaviour in the Classroom

(QQOBC)

Foxcroft and Roodt (2004) as well as Jooste (2004) recommend that an

assessment should not just rely on psychometric measures, but should
include background information from interviews with relevant parties.
Furthermore, Murphy (1963) stated that emotional disturbance should always
be measured in relation to previous behaviour. Within the limited scope of the
study and the quantitative design, individual interviews with each participant’s
parents or teachers were not feasible. For this reason, the teachers of the
participating learners were asked to complete a qualitative questionnaire on
specific behaviours that they observed in the classrooms.

Another function of the QQOBC (see Appendix A) was to provide information

about the general attitude, mood and behaviour for each child from the
perspective of the teacher. As mentioned in 4.5.1.1, group administration of
the DAP: SPED impedes observations of individual learners so that valuable
information about each participant’s behaviour and attitude might be lost. This
information is regarded important in the assessment process and various

63
authors recommend that careful observations be made (Foxcroft & Roodt,
2004; Riethmiller & Handler, 1997). This is true in any assessment situation,
and especially valuable for non-verbal measures.

The measure was constructed exclusively for the purpose of the present
study. As it was not central to ascertaining the usefulness of the DAP: SPED,
no psychometric properties were ascertained beforehand. The questionnaire
was kept as short as possible to ease the workload on the teachers, as well
as to keep the data analysis uncomplicated. The content of the questionnaire
was based on the five scales of the BYI-II to provide easy comparisons
between the two verbal measures.

One could argue that psychological terms on the measure would be too
technical in nature, and that individual understanding of states such as anxiety
could differ dramatically between raters. To minimise the effect of technical
jargon, psychological terms were described by using other terms such as
nervous, fearful and worry.

The QQOBC furthermore allowed for additional background information to be

obtained for each learner. An overview of the questionnaires revealed who
had been identified by the teachers as having emotional disturbance and
being in need of further intervention, as well as the type and severity of their
problems. Comments pertaining to each learner were added to the existing
data, so that qualitative information could provide detailed information about
each learner.

4.6 Data Collection Procedure

Data collection happened in two phases. The first phase entailed testing the
participating learners at the two schools respectively. The second phase
involved distributing the QQOBC to relevant teachers and subsequently
collecting the measure. The following procedure was followed during Phase 1:

64
1. The school principles were approached and permission was obtained to
conduct the research at their schools.
2. Letters were sent out to the parents informing them of the research and
requesting permission to include their children in the research (see
Appendix B).
3. Research assistants were appointed. One was an intern psychologist and
the other was a psychometrist. Training consisted of working through the
manual of the DAP: SPED, as per recommendation of Naglieri, McNeish
and Bardos (1991).
4. Testing started at approximately 08h30 and continued for one hour.
5. The DAP: SPED was administered first. According to Jooste (2004) the
non-verbal nature and the familiarity of the task helps to put test-takers at
ease.
6. Learners were given five minutes for completing each drawing, in
accordance with the administration procedure (Naglieri, McNeish &
Bardos, 1991).
7. The BYI-II was administered next. The instructions and individual items
were read aloud to account for different levels of reading proficiency.
8. Debriefing for participating children took place by allowing individual time
with the administrators at the end of each testing session. Children were
given the opportunity to ask questions, and the administrators advised the
children appropriately (see 4.9.2).

During Phase 1 of the data collection procedure, certain difficulties were

encountered:
• Testing conditions around the classrooms were noisy and caused
distraction between periods.
• Testing conditions inside the classroom were cramped. This possibly
influenced the results of both the DAP: SPED and the BYI-II.
• Close proximity sometimes lead to learners drawing similar pictures. They
were repeatedly encouraged to draw their own pictures.
• The BYI-II is subject to motivational distortion, and close proximity to other
learners would possibly discourage learners to be honest about asocial

65
 types of behaviours. Learners were therefore given the opportunity to
change answers once the questionnaires were completed.
• Although only five minutes were allocated for each drawing, during the
collection, some learners continued to draw until the last possible moment.
With more resources, interesting information regarding these learners could
have been obtained. For example, it would have been good to know
whether these learners had higher levels of anxiety than other learners who
completed their pictures on time.

Phase 2 involved distributing the QQOBC to the relevant class teachers and
then collecting the data from them once the questionnaires were completed.

4.7 Scoring of Instruments

The scoring process identified administration problems, which in turn

influenced the sample size (see 4.4.2) and produced additional unexpected
challenges. Two types of scoring problems were identified which concerned
invalid response patterns and subjective scoring judgements. The first scoring
problem related to a general administrative problem. The second pertained
specifically to the DAP: SPED and will be discussed accordingly.

During the scoring process, invalid responses resulted in the exclusion of

some of the participants from the current study. Two learners used the same
identifying number on their work, which meant a duplication of identities.
Although it was possible to distinguish the style of the drawings, and to match
these to the handwriting on the BYI-II, it was not possible to link the learners
to the class lists. This rendered the data worthless, as gender and birth dates
could not be determined to convert the raw data to norm scores.

Another participant was excluded from the sample post facto, as there were
significantly more omissions (about two items per page) on the BYI-II than the
other learners showed. The instructions clearly require participants to answer
every question, but two omissions per page are permissible (Beck et al.,

66
2005). As seven omissions for 100 questions were recorded for this learner,
compared with an average of two per 100 questions for other learners who
had omissions, this respondent’s data was excluded. The participant in
question identified herself and informed the researcher that she had a vision
deficit that might explain the high frequency of omissions.

The last participant whose responses were excluded was a boy who did not
understand how to respond to a Likert scale, and therefore placed all answers
in the margin of the booklet. His answering style therefore invalidated his BYI-
II. The boy’s behaviour suggested that mild mental retardation might be
present. The elimination of these four participants resulted in a final sample
size of 125 learners. (The data from these four learners were excluded from
Figures 4.1 and 4.2.)

4.7.1 Scoring of the DAP: SPED

During the scoring of the DAP: SPED, it became apparent that within the
standardised scoring system of the DAP: SPED subjectivity was a more
prominent issue than anticipated.

The two trained research assistants that helped with administration of the
measures, helped with the scoring of the DAP: SPED. The research
assistants were trained in accordance with the DAP: SPED manual (Naglieri,
McNeish & Bardos, 1991). This involved working through the manual and
doing practice examples. This was the best training available in the absence
of training courses in South Africa, and was sufficient according to Naglieri,
McNeish and Bardos (1991).

Both scorers marked all of the drawings. As they had no stake in the outcome
of the present research, they were considered to be objective scorers. The
research assistants received monetary compensation after the fact for all their
help.

67
During the scoring process, it became evident that the scoring guidelines
stipulated by the manual of the DAP: SPED were broad in order to be
inclusive. The result was that some accuracy was lost, and scoring criteria
were insufficient for clear decisions with some drawings. As explained in
3.2.2.1, objectivity in rating drawings is always in danger when there is room
for subjectivity. Therefore, the manual was consulted carefully again so as
uphold the standardised scoring system. After close but unproductive
consultation of the manual, the researcher contacted Naglieri (J.A. Naglieri,
personal communication, April 8, 2008). This communication offered little
insight into the specific scoring difficulties and how to deal with these
discrepancies, as Naglieri referred the researcher back to the manual. The
lack of clarity regarding scoring necessitated decision-making based on
logical reasoning and past literature on the DAP and Human Figure Drawings.
Therefore a subset of scoring rules was created for the South African sample
so that scoring would be standardised. Table 4.3 provides an outline of
ambiguous scoring criteria and the scoring decisions applied to the data in the
current study.

68
Table 4.3 Discrepancies in the Scoring System

Scoring Item Scoring criteria* Challenges Decisions

12. Lettering and Scored when any letters or numbers appear outside of Learners were asked to supply an Names on the pages were scored

Numbering the figure on the page identification number on the front of as additional lettering.
the page. They often included their
names, even though the instructions
clearly indicated not to do so.

16. Failed “Failed Integration is scored if any of the following are These instructions are unclear. This item was scored when:

Integration present but not attached: (a) body parts are attached in the
a. Head is attached to neck or top of torso. incorrect place (e.g. arms too low
b. Two arms (one if in profile) are attached to the top half of down on the torso, or arms
the torso (above the halfway mark in the vertical sprouting from the head) or (b) if it
measurement of the torso or bottom of the dress). The seemed that the body parts were
torso extends from the top of the trunk, where it meets the not securely attached.
head or neck, to the bottom, where it meets the legs or
crotch.
c. Two legs (one if in profile) are attached at the bottom of
the torso (below the halfway mark in the vertical
measurement of the torso or bottom of a dress). “

69
Table 4.3 Discrepancies in the scoring system (continued)

Scoring Item Scoring criteria* Challenges Decisions

18. Restart Any attempt at restart should be Item 29: Crotch Erasure. Refers to erasure and Restart was only scored for erasures
scored, including erasures and could be confused with restart. Erasures below above the torso.
abandoning a first attempt. the torso are scored as crotch erasure.

20. Hair omitted Any attempt at drawing hair, including Some drawings showed no hair on the head, as This item was scored when no facial hair,
facial hair is recognised and therefore the head was covered with a hat. However, it is including eyebrows and eyelashes were
not scored. possible that hair was inferred by the drawer, but visible.
that no space was available to draw hair.

24. Torso omitted When any of these body parts are In the event of only a head being drawn, every The items were scored according to the

25. Arms omitted omitted, the respective items are one of these items should be scored. The instruction, although hands cut off were
scored. premise of scoring hands cut off when there are excluded when there were no arms.
26. Fingers omitted
no arms seems incorrect.
45. Hands cut off

30. Crotch shading An area is shaded when additional Pockets on pants and zip detail, as well as brand Any additional lines were scored. This

32. Feet shading lines are present such as reinforced names on shoes are debatably shading. could possibly lead to an
pencil strokes or patterning on overrepresentation of these items.
material.

70
Table 4.3 Discrepancies in the scoring system (continued)

Scoring Item Scoring criteria* Challenges Decisions

34. Vacant eyes Empty circles for eyes are Eyes with an iris but without a pupil look vacant, Vacant Eyes was only scored when there was
scored. although they technically were not. no iris or pupil drawn in.

49. Aggressive Any aggressive symbols What constitutes as an aggressive symbol is open The presence of muscles was not scored.

symbols are scored. This includes to interpretation. For example, the “Bad Boy” logo
profanity and weapons has angry looking eyes. In other pictures muscles
such as guns. were drawn and clothing torn to reveal these
muscles. Not all muscles seemed to depict
aggression, as some apparently represented
masculinity.

52. Monster Non-human figures and Some figures were human, but gave the impression Only drawings that were clearly non-human,
monsters should be of being scary. such as a figure drawn like the cartoon
scored. character “Spongebob Squarepants”, were
scored.

71
Table 4.3 Discrepancies in the scoring system (continued)

Scoring Item Scoring criteria* Challenges Decisions

55. Uniformed Any depiction of a uniform Girls often drew brides. These were usually only Pictures that were clearly recognisable in

figure such as a policeman or a recognisable by the word “bride” written somewhere uniform were scored. When blazers or shirts
cowboy should be scored. on the page. Other figures looked like they had suits and ties were drawn, they were only scored
on. This could argualbly be a work uniform. when an emblem was also included.

*Scoring criteria as set out in the manual of the DAP: SPED by Naglieri, McNeish and Bardos (1991, pp 27-29)

72
Once the assistants returned the drawings and scoring sheets to the
researcher, the raw scores were converted to norm (t) scores. During this
process, it became clear that the data had to be rechecked for irregularities.
The researcher rechecked all the drawings, and some adjustments were made
to the scores according to the criteria in Table 4.3. Data was therefore cross-
checked and re-examined by the researcher before being captured. The
adjusted scores from the assistants were used as the raw data for the current
research. In order to determine the credibility of the rating system, the two
independent raters’ original scores, as well as the researcher’s scores were
used in the calculations of inter-rater reliability.

4.7.2 The scoring of the BYI-II

The researcher scored and processed all of the BYI-II answering sheets. There
is no room for interpretation in this measure, as scoring simply involves adding
pre-established values as chosen by the participants on the Likert scale. In the
event that the respondent selected more than one option, the one with the
highest value was scored, as recommended by Beck et al. (2005). The scoring
procedure for the BYI-II was relatively simple and quick. Overall, the
impression was that the learners understood the instructions well and were
able to respond appropriately. The process of scoring and finding the norms
was relatively quick, and the only margins for error in terms of scoring lie with
incorrect adding and incorrectly converting the raw scores to norm scores. The
researcher controlled for these errors by randomly rechecking some BYI-II
answering sheets.

4.7.3 The Scoring of the QQOBC

Data from the QQOBC needed no scoring or processing apart from

consolidating it with the data from the other two measures. This process
involved creating a spreadsheet containing all the information gathered by the
QQOBC. As the behavioural scales on the QQOBC correspond with subscales
and intensity of the BYI-II, it was relatively easy to compare the qualitative and
quantitative verbal information once the spreadsheet was compiled.

73
4.8 Statistical analysis

Raw scores were calculated and transformed into norm scores. Then the norm
scores for the DAP: SPED and BYI-II were subjected to statistical techniques.
SPSS computer software was utilised for statistical analysis of the data. Basic
descriptive statistics were employed to summarise the data. Inferential
statistical techniques were employed to investigate the relationships between
the scores of the two instruments. The statistical techniques and their results
will be discussed in more detail in the next chapter.

4.9 Ethical Considerations

The following ethical considerations were relevant to the present study, and
ethical protocol was observed as follows:

4.9.1 Consent for Participation

Both the parents and the schools gave permission for the learners to
participate in this study. A letter (see Appendix B) informed the parents of the
nature and purpose of the study. The letter notified parents of the voluntary
nature of participation, that withdrawal was permitted at any time, as well as
explaining the procedures that ensured confidentiality.

Identifying information on the actual answer sheet was limited to an allocated

number, which corresponded with the class register list. This procedure
allowed for optimal confidentiality of the participants, while still providing
access to relevant information as needed.

4.9.2 Debriefing

Debriefing took place immediately after testing. The participants were

reassured that the results were unrelated to schoolwork. The basic purpose of
the assessment was explained again and learners were given the opportunity

74
to ask questions. Learners were informed that if the results pointed to
emotional distress, their parents would be informed. During the question and
answer time, after completion of the assessment, learners had the opportunity
to talk to the administrators about personal problems. This allowed an
opportunity to address emotions that might have surfaced during assessment.
Learners were encouraged to contact their school counsellors or speak with
their parents, depending on the presenting problem. Furthermore, at the time
of approaching the schools in connection with participation, the psychological
services of the researcher’s place of work were offered to participants at the
schools if they chose to make use of them. Parents received relevant contact
numbers on the permission slip, as well as on the feedback letter.

4.9.3 Feedback to parents about emotional disturbance

All parents of participating learners received correspondence regarding their

children’s emotional status, as per the assessment. In this regard, one of two
letters was sent out indicating whether the learner participated and what level
of emotional disturbance was present (see Appendix C and D). Learners who
were excluded from the sample due to incorrect answering styles were still
taken into account in the feedback to the parents, and recommendations were
made accordingly. Furthermore, learners who did not obtain high scores on the
DAP: SPED or BYI-II, but whom the teachers identified as emotionally
disturbed, were further monitored for emotional disturbance.

The decision to use information from the QQOBC for all participants,
regardless of the outcome of their DAP: SPED and BYI-II, prevented oversight
of any learner by the present study. A previous study by Matto (2002) showed
that although the DAP: SPED was able to identify emotionally disturbed
children correctly, the measure was unable to identify all cases of emotional
disturbance within that target group. A similar pattern of identification was
present with the BYI-II (Beck et al., 2005). The process of gathering data from
multiple sources therefore allowed for more accurate identification rates and
consequently, more accurate recommendations. This was essential as parents
who permitted their children to participate would most likely be interested in

75
their children’s emotional status. Inaccurate or incomplete information would
give the wrong impression and could lead to decision-making that is not in the
best interests of the children.

4.10 Conclusion

Extensive literature reviews have set the boundaries of this study and
explained relevant concepts for investigating the DAP: SPED. In order to
establish whether the DAP: SPED could be useful in the South African context,
it is necessary to explore the psychometric properties of this measure, as well
as determine how successful it is in distinguishing emotionally disturbed
learners from those who are not. Another measure, the BYI-II served as an
equivalent measure and served as a control for the DAP: SPED. In-depth
qualitative information was obtained in the form of the QQOBC. This chapter
explained the data gathering and -analysis procedures, along with the
challenges encountered along the way. Chapter 5 reports the results of the
statistical calculations of the data obtained during the processes described in
the present chapter.

76
 CHAPTER 5
RESULTS

5.1 Introduction

Chapter 4 contextualised the aims of the present study and described the
research processes implemented to achieve these goals. In-depth discussions
were presented on the challenges encountered in administration and scoring,
and how the raters contended with these issues. This chapter will report on the
findings of the research process implemented to realise the aims presented in
4.2.

5.2 The Usefulness of the Draw-A-Person: Screening Procedure for

Emotional Disturbance (DAP: SPED)

In order to compare the success of the DAP: SPED against that of the BYI-II,
a correlational study was conducted. Correlations between two sets of data
provide information about the strength of their relationship (Murphy &
Davidshofer, 2001). A good relationship between the DAP: SPED and the
BYI-II would be evident in correlations close to 1.0, which would suggest that
the DAP: SPED measures emotional disturbance well.

Before describing the results of the correlational study, the descriptive

statistics for the two measures will be reported.

5.2.1 Descriptive Statistics of the DAP: SPED and the BYI

Descriptive statistics summarise large amounts of data in order to easily

understand the main characteristics of the data set (Bless & Kathuria, 2001).
The data summary for both standardised measures will be presented next.

77
5.2.1.1 Descriptive Statistics for DAP: SPED

The descriptive statistics in Table 5.1 shows the central tendencies, variation
and range for the DAP: SPED.

Table 5.1 Descriptive statistics of the DAP: SPED

Description DAP: SPED

Sample size 125

Mean 59.63

Median 60.00

Mode 60.00

Std deviation 9.170

Minimum 39.00

Maximum 80.00

5.2.1.2 Descriptive Statistics for the Beck Youth Inventory (BYI-II)

Table 5.2 provides a summary of the data from the sample group for the BYI-
II.

78
Table 5.2 Descriptive statistics for the BYI-II

Description BSCI BAI BDI BANI BDBI

Sample size 125 125 125 125 125

Mean 50.37 60.65 53.12 53.02 51.28

Median 53.00 61.00 49.00 52.50 49.00

Mode♦ 54 55 49 53 44

Std deviation 8.947 12.233 12.414 11.160 9.750

Minimum 22.00 37.00 34.00 30.00 37.00

Maximum 67.00 98.00 100.00 86.00 88.00

♦The smallest value is shown as multiple modes exist

The measures of central tendency provide information about the data set as a
whole. However, no inferences regarding the aims of the study are possible
without further statistical calculations. The following section will report on
inferential statistical techniques that relate to the aims described in 4.2.

5.2.2 Results of the Correlational Analysis between the DAP: SPED and
the BYI-II

The data of the DAP: SPED required non-parametric statistical calculations,

as it is not normally distributed. At the onset of data analysis, a Levene’s test
was conducted on the data and it indicated that the assumption of
homogeneity of variance for the data of this specific measure was violated.

Table 5.3 shows the results of the correlational analysis between the DAP:
SPED and the BYI-II.

79
Table 5.3 Spearman’s Rho Correlation between the DAP: SPED and the
BYI-II Subtests

DAP: SPED BSCI BAI BDI BANI BDBI

DAP: SPED -.092 .068 .079 .105 .095

Sig. .306 .448 .382 .246 .292
(2-tailed)
N=125

None of the correlations was significant at either the .05 or .01 level, therefore
rejecting the hypothesis that significant correlations would be found between
scores of the DAP: SPED and the BYI-II. Because the DAP: SPED achieved
such low correlation coefficients with the BYI-II, an investigation into the DAP:
SPED’s ability to distinguish between the presence or absence of emotional
disturbance was launched. This involved further correlational studies, as well
as other inferential statistical techniques, such as the Mann-Whitney U-test.

5.2.3 Results of the Correlational Analysis between the DAP: SPED and
the BYI-II for Emotional Disturbance Present and Absent Groups

Since the scores of the BYI-II proved to be reliable in the context of the
present study (see 4.5.2), they were used to divide the respondents into
emotional disturbance Present and Absent groups. As both measures work
with t-scores with a maximum of 100 and a mean of 50, the following
procedure was followed: Respondents with scores above 55 on the BYI-II (the
cut-off score for emotional disturbance on the DAP: SPED) were categorised
as emotional disturbance present (Present), while scores under 55 would
result in an emotional disturbance absent (Absent) categorisation.

The ability of the DAP: SPED to distinguish between the presence and
absence of emotional disturbance was then examined by calculating

80
correlation coefficients with the subscales of the BYI-II. High correlations
between the DAP: SPED and subscales of the BYI-II for the two conditions
(Present or Absent) would indicate that the DAP: SPED is able to discriminate
between the emotional disturbance Present and Absent groups. Spearman’s
rho correlation coefficient was used to determine these correlations.

Table 5.4 below shows the correlation coefficients for the emotional
disturbance Present and Absent groups. The specific focus was on the four
subscales of the BYI-II that pertain to emotional disturbance, as described in
2.2.2. These include the anxiety scale (BAI), the depression scale (BDI), the
anger scale (BANI) and the disruptive behaviour scale (BDBI).

Table 5.4 Spearman’s Rho Correlations between the DAP: SPED and the
BYI-II for emotional disturbance Present and Absent Groups

Emotional DAP:
Status SPED BAI BDI BANI BDBI

Absent DAP: .130 .169 .080 .241*

Emotional SPED .246 .132 .478 .030
Disturbance Sig N=81 N=81 N=81 N=81
(2-tailed)

Present DAP: -.209 -.081 -.406 -.022

Emotional SPED .174 .599 .768 .885
Disturbance Sig N=44 N=44 N=44 N=44
(2-tailed)
*Correlation is significant at .05 level (2-tailed)

From Table 5.4 it is evident that the DAP: SPED was unable to yield
significant correlations with the Present and Absent emotional disturbance
groups. The only exception was a significant relationship between the

81
disruptive behavioural scale (BDBI) and Absent emotional disturbance (r s =
.241; p< .05).

These results do not support the tentative assumption that the DAP: SPED
would be functional in the South African context (see 1.2). Further exploration
into the DAP: SPED’s ability to distinguish between Present and Absent
emotional disturbance groups was therefore undertaken. This was done by
conducting a Mann-Whitney U test.

5.2.4 Results of the Mann-Whitney U Test

The non-parametric statistical technique of the Mann-Whitney U test was

used as it allows for the exploration of differences between two groups (Field,
2005). When non-parametric statistical techniques are utilised, parametric
calculations are performed on the ranks of the data, rather than on the data
itself (Field, 2005). Data were thus ranked from high to low and once ranks
were assigned, statistical calculations were applied.

In the present study, the Mann-Whitney was used to examine the extent to
which scores on the DAP: SPED differed for the emotional disturbance
Present and Absent groups. If the DAP: SPED is useful to identify the
presence of emotional disturbance in the group of children in the present
study, then the emotional disturbance Present group would obtain
significantly higher scores than the emotional disturbance Absent group.
Table 5.5 shows the results of the Mann-Whitney U test.

82
Table 5.5 Mann-Whitney U Test for Present and Absent Emotional
Disturbance (ED) Groups

ASYMP.
MANN-
DAP: MEAN SUM OF SIG.
WHITNEY
SPED BAI N RANK RANKS (2-
U
TAILED)

DAP: Absent ED 38 67.29 2557.00

SPED Present ED 87 61.13 5318.00
Total 125 1490.000 .380

Asymp.
Mean Sum of Mann-
Sig.
BDI N Rank Ranks Whitney U
(2-Tailed)

DAP: Absent ED 82 60.60 4969.50

SPED Present ED 43 67.57 2905.50
Total 125 1566.500 .305

Asymp.
Mean Sum of Mann-
Sig.
BANI N Rank Ranks Whitney U
(2-Tailed)

DAP: Absent ED 73 59.51 4344.00

SPED Present ED 52 67.90 3531.00
Total 125 1643.000 .200

Asymp.
Mean Sum of Mann-
Sig.
BDBI N Rank Ranks Whitney U
(2-Tailed)

DAP: Absent ED 92 59.48 5472.00

SPED Present ED 33 72.82 2403.00
Total 125 1298.500 .069

83
The following is evident from Table 5.5:

• The emotional disturbance Present group (Mean Rank 61.13) did not differ
significantly in Anxiety (BAI) levels from the emotional disturbance Absent
group (Mean Rank 67.29), U = 1490.000, ns, r = -0.079; > .05.

• The emotional disturbance Present group (Mean Rank 67.57) did not differ
significantly in Depression (BDI) levels from the emotional disturbance
Absent group (Mean Rank 60.60), U = 1566.500, ns, r = -0.092; > .05.

• The emotional disturbance Present group (Mean Rank 67.90) did not differ
significantly in Anger (BANI) levels from the emotional disturbance Absent
group (Mean Rank 59.51), U = 1643.000, ns, r = -0.115; > .05.

• The emotional disturbance Present group (Mean Rank 72.82) did not differ
significantly in Disruptive Behaviour (BDBI) levels from the emotional
disturbance Absent group (Mean Rank 59.48), U = 1194.000, ns, r = -0.163;
> .05.

The Mann-Whitney statistical procedure showed that the DAP: SPED was
unable to yield significantly different results between Present and Absent
groups of emotional disturbance.

The first aim of the present study pertained to the usefulness of the
DAP: SPED in the South African sample. The Spearman’s rho
correlation coefficient showed that no significant correlations were
present between scores of the DAP: SPED and the BYI-II, thereby
accepting the null hypothesis. It is thus concluded that there is no
correlation between the scores of the DAP: SPED and the BYI-II in a
sample of Grade 4 South African learners.

84
The alternative hypothesis (H 1 ) was rejected, indicating that the DAP: SPED
is unable to successfully distinguish between emotionally disturbed and non-
disturbed children in a sample of Grade 4 South African learners.

5.3 The Reliability of the Scores of Emotional Disturbance in the DAP:

SPED

The second aim of the current research was to determine the reliability scores
for the measurement of emotional disturbance by the DAP: SPED. From the
preceding section, it was clear that the DAP: SPED was unable to distinguish
between Present and Absent emotional disturbance. The reliability with which
the DAP: SPED measures emotional disturbance was consequently
questioned, and it was necessary to investigate the reliability coefficients for
the DAP: SPED within the South African context.

Neuman (2000) described reliability as the dependability or consistency of a

measure. In order to understand the reliability of the DAP: SPED scores for
measuring emotional disturbance the, internal reliability was investigated.
Internal reliability refers to the cohesiveness between different parts of a
measure (Field, 2005). Internal reliability is determined using Cronbach’s
alpha coefficient (α) and this statistical technique was applied to data from the
DAP: SPED. Correlation values close to 1.0 show a strong relationship, while
values close to 0.0 show little relationship at all. Negative values are
indicative of an inverse relationship, i.e. when one value increases, the other
decreases.

On careful inspection of the DAP: SPED manual, it became apparent that

Naglieri, McNeish and Bardos (1991) excluded the first nine items in their
reliability calculations (see also 1.1 and 5.2). These nine items are the
measurement items and relate to the sizes of the drawn figures. Although the
authors of the DAP: SPED did not explain why these items were excluded, it
was decided to recalculate reliability scores excluding the nine measurement

85
items. To illustrate how the omission of these nine items influenced the
reliability coefficient, both coefficients are reported in Table 5.6.

Table 5.6 Internal reliability of the DAP: SPED

Cronbach’s alpha
DAP: SPED Sample Size
coefficient

DAP: SPED
125 .448
(55 Items)

DAP: SPED
125 .525
(46 Items)

The results of the reliability coefficients were generally low. This prompted a
re-examination of the DAP: SPED manual. In the manual, reliability
coefficients were reported for different ages (Naglieri, McNeish & Bardos,
1991). These same age categories were then utilised to calculate appropriate
reliability coefficients for the South African sample. Table 5.7 shows the
Cronbach’s alpha coefficients for the different age groups.

Table 5.7 Internal Reliability Coefficients for Different Ages

9-10 Years 11-12 Years

DAP: SPED
N= 114 N= 11

Cronbach’s alpha coefficient .403 .705

DAP: SPED (55 Items)

Cronbach’s alpha coefficient .477 .780

DAP: SPED (46 Items)

86
Table 5.7 shows that internal reliability increases when the nine measurement
items are omitted.

Although the internal reliability coefficients were not reported for the three
respective drawings in the manual of the DAP: SPED, a decision was made
to investigate them. Table 5.8 shows these reliability coefficients for the
measure with all the items included, as well as for the measure with the nine-
item omission.

Table 5.8 Internal Reliability for the Three Drawings of the DAP: SPED

DAP: SPED 55 Items 46 Items

Sample size (N) 125 125

Cronbach’s alpha coefficient .135 .238

Man

Cronbach’s alpha coefficient -.025 .106

Woman

Cronbach’s alpha coefficient -.298 -.119

Self

Table 5.8 shows extremely low internal reliability for each of the three
drawings. These rates are lower than the internal reliability for the measure as
a whole (Table 5.6). The low internal reliability of the three separate drawings
indicates that internally the items of the drawings lack coherence, but when
the three drawings are together the internal reliability of the measure is
increased (Table 5.6).

87
The relationship between the three drawings was examined next, even
though Naglieri, McNeish and Bardos (1991) did not report on this
relationship. This decision was made for two reasons. Firstly, it was curious
that the internal reliability for the three individual drawings was low, but when
put together they increased the reliability of the measure. Secondly, the
investigation of the BYI-II included a correlational study between the
subscales (see 4.5.2), and therefore, it seemed relevant to do the same with
the DAP: SPED. The non-parametric Spearman’s rho correlation coefficient
was used for the DAP: SPED correlational study. As the DAP: SPED showed
higher internal reliability when the first nine items were omitted, the 46 item
total was used for this calculation.

Table 5.9 Spearman’s Rho Correlation between Drawings of the DAP:

SPED

DAP: SPED TOTAL 46 MAN 46 WOMAN 46 SELF 46

Total 46 1 .803** .796** .772**

Man 46 .803** 1 .459** .426**

Woman 46 .796** .459** 1 .488**

Self 46 .772** .462** .488** 1

** Correlations significant at the .01 level.

Table 5.9 shows that although the three drawings are significantly correlated
with one another, these correlations are low. Interestingly, each drawing
correlates highly with the total score of the DAP: SPED.

The second aim of the current research was to investigate the reliability
of scores of the DAP: SPED concerning emotional disturbance. The
reliability scores transpired to be moderately low for the measure as a
whole, and even lower for individual parts of the measure.

88
5.4 The Credibility of Inter-rater Scores

The third aim of the present study was to investigate the credibility of the
DAP: SPED’s scoring system. In order to study the scoring system, the inter-
rater reliability coefficient was calculated for the scores allocated by the three
raters. This form of reliability is used to determine the extent to which different
raters achieve similar results on the same measure (Smit, 1991). Two or
more raters score one set of answers (data) to determine the degree of
correlation between them. A standardised measure should have well-defined
scoring criteria that minimises the possibility of rater bias. Under these
conditions, different raters should record similar results (Smit, 1991). Similar
results are reflected in high values for the correlation coefficients.

The original scores by the two independent raters were utilised for the
calculation, as well as the scores of the moderator, namely the researcher
(see 4.7). The inter-rater reliability scores were determined by using the non-
parametric Spearman’s rho correlation coefficient. The inter-rater reliability
measured in the current research on the DAP: SPED in South Africa, is
shown in Table 5.10.

Table 5.10 Spearman’s rho correlation coefficients for Inter-rater

reliability

Raters A B C

A 1 .816** .687**

B .816** 1 .811**

C .687** .811** 1
** Correlations significant at the .01 level

Table 5.10 shows that correlations were significantly high between the three
raters.

89
The third aim of the current research pertained to the scoring system of
the DAP: SPED. The level of agreement between raters was examined by
finding correlations between the raters. Inter-rater reliability between the
three raters varied within acceptable ranges. Significant correlations
between raters’ scores indicate that the alternative hypothesis is
accepted. It is thus concluded that there is a significant correlation
between the scores given by different raters the DAP: SPED when the
DAP: SPED is scored.

5.5 Occurrence of Emotional Disturbance

The fourth aim of the current research was to explore the occurrence of
emotional disturbance in the South African target group. Although some
insight regarding this matter could be obtained by studying the descriptive
statistics (see 5.2.1), more detailed information is presented in the following
frequency distributions for the DAP: SPED en BYI-II. Frequency distributions
make it easy to understand large amounts of data by showing how many
times each score occurred (Field & Hole, 2003). These scores are shown
within certain classes or categories. Next, the results of the Qualitative
Questionnaire of Observed Behaviour in the Classroom (QQOBC) will be
reported.

5.5.1. Occurrence of Emotional Disturbance measured by the DAP:

SPED

The following frequency table was compiled in order to understand the

occurrence of emotional disturbance in the target group, as measured by the
DAP: SPED.

90
Table 5.11 Frequency Table of Emotional Disturbance scores measured
by the DAP: SPED

Cumulative Cumulative
T-Scores Frequency Percentage
Frequency Percentage

0-9 0 0 0 0

10-19 0 0 0 0

20-29 0 0 0 0

30-39 1 1 0.8 0.8

40-49 18 19 14.4 15.2

50-59 39 58 31.2 46.4

60-69 45 103 36 82.4

70-79 20 123 16 98.4

80-89 2 125 1.6 100

90-100 0 125 0 100

From Table 5.11 above, it is evident that 67 learners achieved scores above
60 on the DAP: SPED. Although not directly discernable from Table 5.11, it
should be noted that 18 learners achieved scores above 55. This brings the
total amount of learners identified with emotional disturbance by the DAP:
SPED to 85 or 68%.

5.5.2 Occurrence of Emotional Disturbance measured by the BYI-II

A frequency distribution was compiled for the BYI-II subscales. The four
subscales of emotional disturbance are reported individually, and total scores
are also shown.

91
Table 5.12 Frequency distribution for emotional disturbance measured
by the four subscales of the BYI-II

T-Scores BAI BDI BANI BDBI TOTAL

0-9 0 0 0 0 0
10-19 0 0 0 0 0
20-29 0 0 0 0 0
30-39 6 11 15 4 36
40-49 21 55 36 60 172
50-59 33 27 41 40 141
60-69 32 17 24 14 87
70-79 25 9 8 4 46
80-89 6 5 1 3 15
90-100 2 1 0 0 3
Total 125 125 125 125 500

Table 5.12 shows that the majority of learners obtained t scores between 40
and 59. Scores above 60 varied between the subscales, and anxiety levels
were particularly high.

The prevalence of emotional disturbance could also be described in terms of

the three broad clusters of behaviour that were discussed in 2.2.2. These
three clusters of behaviour, namely Internalising, Externalising and Mixed
behaviour contain the more specific syndromes, some of which are measured
by the BYI-II subscales. When the information from the subscales is grouped
into the larger behavioural clusters, additional information regarding emotional
disturbance becomes apparent. The results of a brief qualitative exploration of
the BYI-II data are reported below.

Respondents were categorised using scores on the BYI-II, according to the

following criteria:

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• Learners with scores above 55 on the BAI and/ or BDI scales were placed
in the Internalising category.
• Learners with scores above 55 on the BANI and/ or BDBI scales were
categorised as Externalising.
• Learners with high scores on BAI and/ or BDI, as well as high scores on
BANI and/ or BDBI were categorised as Mixed.

Table 5.13 shows how the clusters of emotional disturbance manifested in the
respondents in the current research.

Table 5.13 Behavioural Clusters of Emotional Disturbance in Target

Group

Behavioural Clusters Percentage of Respondents

Internalising 30.4
Mixed 44.0
Externalising 1.6
Total 76.0
N=125

When the above criteria are used, the nature of emotional disturbance in the
South African sample manifests mainly in the form of mixed behavioural
symptoms. Internalising behaviour is also common in respondents.
Externalising or acting out behaviour mostly co-occurred with depression or
anxiety.

Qualitative information from the Qualitative Questionnaire for Observed

Behaviour in the Classroom (QQOBC) largely concurred with these findings.
Furthermore, it provided information regarding the teachers’ perceptions of
emotional disturbance. These results are reported next.

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5.5.3 Results of the Questionnaire for Observed Behaviour in the
Classroom (QQOBC)

As discussed in 4.5.3, the QQOBC (see Appendix A) was developed using

the five subscales of the BYI-II. The teachers were asked to rate each
learner’s behaviour on one of five scales, and then they were given an
opportunity to comment on their ratings (see Appendix E). The ratings
provided consistent information, but the quality of the comments varied
between teachers. The information supplied by the QQOBC was not as
comprehensive as anticipated.

The ratings of emotional disturbance in children by their teachers are

summarised in Table 5.14.

Table 5.14 Teachers’ Ratings of the Prevalence of Emotionally Disturbed

Behaviour in Learners

Percentage Of Learners
Teachers’ Disruptive
Anxiety Depression Anger
Ratings Behaviour

Never 73 71 87 59
Sometimes 20 19 14 24
Often 6 10 8 13
Always 1 0 1 4
Total 100 100 100 100

The answering style between the four teachers varied considerably, with
some supplying minimal information about the learners in question, while
others gave repetitive and stereotypical answers. The following observations
were made regarding the answering styles of the teachers:

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• Teachers tended to recognise externalising behaviour, and often
described such learners as “disruptive” or “naughty”. These children were
often rated as being very “confident”.

• In some instances, learners whose teachers identified them as disruptive

or naughty had elevated scores on the DAP: SPED, but these learners
rated their own angry or anti-social behaviour very low. There was thus
better agreement between DAP: SPED scores and the QQOBC insofar as
disruptive behaviour was concerned.

• Overall, however, the teachers’ ratings had a low agreement with the
DAP: SPED (53% of the ratings did not agree with scores on the DAP:
SPED).

• The teachers often overlooked internalising behaviour, as measured by

the BYI-II.

• Although it is difficult to ascertain the level of emotional disturbance from

the teachers’ reports, it showed that emotional disturbance is mainly
problematic when learners act out.

• Teachers seemingly developed their own classification system, and each

teacher tended to describe students according to two dimensions relating
to the same factor. For example, one teacher typically referred to learners
as either “hardworking” or “disruptive”. Another portrayed the learners as
either “confident” or “quiet”, while a third tended to use descriptions such
as “underhanded” or “well mannered”.

The fourth aim related to describing the occurrence of emotional

disturbance in the sample of South African children. The results show
that when emotional disturbance is measured in the broadest sense,
namely including all possible cases of emotional disturbance, the
prevalence is high.

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5.6 Conclusion

This chapter has reported on the results of the data as measured by the three
measures used in the study, namely the BYI-II, the DAP: SPED and the
QQOBC. A discussion of these results, as well as recommendations for
further research follows in Chapter 6.

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 CHAPTER 6
DISCUSSION OF FINDINGS, LIMITATIONS, RECOMMENDATIONS AND
CONCLUSION OF THE STUDY

6.1 Introduction

The current research has aimed to establish how useful the Draw-A-Person:
Screening Procedure for Emotional Disturbance (DAP: SPED) would be for
identifying emotional distress in a group of South African children. Literature
indicated that the non-verbal nature of the DAP: SPED may make it ideal for
the multilingual population, while the standardisation of administration and
scoring could make it quick and simple to use. This measure was thought to
be particularly useful within the South African context as it was postulated that
high levels of emotional disturbance would be present amongst children.
Literature seemed to indicate that the DAP: SPED would be a good match to
fulfil this need. Despite the good potential for the DAP: SPED in the South
African context, the results of the present study were not that promising. A
discussion of these results will follow.

6.2 The Usefulness of the DAP: SPED

At the onset of the present study, it was theorised that the DAP: SPED would
be useful in the South African context if it could screen a group of learners for
the presence of emotional disturbance. The current study was embarked
upon to test this theory. It involved the DAP: SPED being administered to a
group of learners whose emotional status was unknown, to see if and how
well it could identify emotional disturbance.

The target group was a pre-existing group of Grade 4 learners. Since no

information regarding their emotional status was available, an independent
measure was needed to ascertain learners’s emotional status. The results of
the DAP: SPED could then be compared with the results of the independent

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measure by means of a correlational analysis. The independent measure that
was selected was the Beck Youth Inventory (BYI-II). This instrument proved
to be a reliable measure of emotional disturbance.

Emotional disturbance was described in Chapter 2 as the subjective

experience of unhappiness when an individual is unable to cope in the face of
overwhelmingly stressful circumstances. The presence of emotional
disturbance is observable in various behaviours, which include internalising
behaviour, such as depression or anxiety, as well as externalising behaviours,
such as disruptive behaviour and anger. As the BYI-II measures these
aspects of behaviour, it was used as a control measure to identify emotional
disturbance in the target group. The behaviours associated with emotional
disturbance that are measured by the BYI-II, also contributed insight into the
global scores of emotional disturbance provided by the DAP: SPED.

The following results were evident in studying the usefulness of the DAP:
SPED within the context of the present study:

• The correlational study made use of the Spearman’s rho correlation

coefficient. Results showed that the DAP: SPED achieved extremely
low correlation coefficients with the BYI-II subscales, and none were
significant (see Table 5.3). This indicates that the DAP: SPED did not
measure emotional disturbance as well as any of the five subscales of
the BYI-II for the target group. A corollary of this finding is that the
DAP: SPED might actually measure a different construct, such as
cognitive maturity, or that cognitive maturity is a confounding variable
in the measurement of emotional disturbance.

• Two groups were created post facto, namely the emotional disturbance
Present and -Absent groups. The scores of the DAP: SPED achieved
low correlation coefficients with the emotional disturbance Present
group, while better coefficients for the emotional disturbance Absent
group were present, but also low (Table 5.4). If high scores on the

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 DAP: SPED correlate better with low emotional disturbance scores on
the BYI-II, there is an inverse relationship between the measures.
These findings confirm that the DAP: SPED did not measure emotional
disturbance well, and that a confounding variable might be a source of
error. A possible confounding variable is cognitive ability. From the
literature study presented in Chapter 3, it was clear that cognitive
developmental levels are reflected in children’s drawings, and thus
cognitive ability could influence the quality of a drawing. There is also
some evidence that artistic ability might be a confounding variable.
These factors will be discussed shortly.

• The DAP: SPED was unable to detect significant differences on the

subscales of the BYI-II for the emotional disturbance Present and
Absent groups when the Mann-Whitney U Test was performed (see
Table 5.5). This confirms the notion that the DAP: SPED cannot
distinguish between the presence or absence of emotional disturbance
in the South African group of children.

• Although the DAP: SPED identified the majority of learners as

emotionally disturbed (68% of respondents), not all the learners who
actually presented with emotionally disturbance were identified by the
DAP: SPED. Once this was realised, a qualitative analysis of the data
was conducted.

This analysis involved the creation of a Microsoft Excel spreadsheet,

which contained the scores of all three measures in the study (see
Appendix E). Learners’ scores on the DAP: SPED were then compared
to the scores obtained on the BYI-II and the QQOBC. Whenever the
DAP: SPED score was high and the other two scores were low, the
DAP: SPED score was labelled as a false positive. On the other hand,
when the DAP: SPED score was low while the other two scores were
high, the DAP: SPED score was labelled as a false negative.

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 The results of this informal analysis were turned into percentages and
it was found that the DAP: SPED scores contained 26.4% false
negatives and 16.8% false positives.

The usefulness of a measure is concerned with the amount of correct

decisions that are made when the measure is utilised (Murphy & Davidshofer,
2001). In this respect one could argue that if the DAP: SPED were able to
identify even one learner who would otherwise go undetected, and that the
said learner could receive therapeutic assistance, then the measure would
have been helpful. On the other hand, resources within the South African
context are limited, and it is doubtful whether the cost of the measure would
be justified when only low identification rates are present.

Another question of utility relates to the importance of the decision made

when the specific measure is used. Beach and Connolly (2005, p. 198) stated
that ‘screening measures are perhaps the most important part of the decision-
making process, if only because it dictates which options end up in the set
from which a choice is made’. Although decisions never should be based on
one measure alone, the initial screening by the DAP: SPED would determine
who would be evaluated further. Should the recommendation for further
evaluation rest on the scores of the DAP: SPED, too many learners would go
unidentified. The possibility also exists that scarce resources would be
exhausted on children who are actually emotionally well. It is therefore argued
that the decision made based on the screening of emotional disturbance
would be an important one. As explained in 2.2.2.1, emotional disturbance
potentially has far-reaching effects for children, and includes clinical levels of
mental and behavioural disorders, as well as long-term dysfunctional
behavioural patterns. In addition, Messick (1988) was concerned about the
effects that such a decision would have on society. At worst, one could argue
that undetected and untreated emotional disturbance could lead to disabling
levels of depression or anxiety, or even antisocial behaviour in some
instances (see 2.2 and 2.3).

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The results of the current research contradict previous findings by Naglieri,
McNeish and Bardos (1991) and Matto (2002), where researchers have
reported that the DAP: SPED is useful to identify emotional disturbance in
children. In 4.5.1, the results of these studies were summarised and showed
that good psychometric qualities for the DAP: SPED were reported. These
researchers also concluded that moderate identification rates were
acceptable for a screening measure (Matto, 2002; McNeish & Naglieri, 1993;
Naglieri, McNeish & Bardos, 1991). The current research, however, has found
that the DAP: SPED has low identification rates of emotional disturbance in a
group of Grade 4 learners. A closer look at other studies might shed light on
the contrary findings of the present study.

6.2.1 Findings from Related Research

To date, standardisation and validation studies by Naglieri and his associates

(Matto, 2002; McNeish & Naglieri, 1993; Naglieri, McNeish & Bardos, 1991;
Naglieri & Pfeiffer, 1992) had reported how useful the DAP: SPED is in
identifying children with emotional disturbance. In this section, the original
process of standardising and validating the DAP: SPED will be discussed
critically, and will show that the results of these studies are equivocal.
Furthermore, the results of independent researchers will be referred to in
order to show that data does not support the optimistic findings of the
standardisation and validation studies of Naglieri and associates.

The DAP: SPED was standardised on a sample of American learners who

took part in the development of the Draw-A-Person: A Quantitative Scoring
System (DAP: QSS) (see 3.3). Assessment measures that were administered
to this group included the DAP: QSS and the Matrix Analogies Test- Short
Form developed by Naglieri (Naglieri, McNeish & Bardos, 1991). For the
standardisation of the DAP: QSS, 4 468 children between 5 and 17 years
were tested. Of these learners, the drawings of 2 260 were used to develop
the DAP: SPED. No indication was given of how these 2 260 individuals were
selected from the pool, or how it was determined which learners were

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emotionally disturbed. The assumption therefore is that no control measure
was present, either in the form of a control group or in a control instrument at
that stage of the development of the DAP: SPED. This lack of control at this
early stage of development is likely to have incorporated a systematic error
into the measure, affecting its usefulness (Field, 2005; Murphy & Davidshofer,
2001).

The next step in the standardisation process involved selecting representative

items of emotional disturbance. Emotional indicators in drawings formed the
units of measurement for emotional disturbance on the DAP: SPED.
Representative items would have been any item in the measure that yielded
similar results to the measure as a whole (Field, 2005). For the measure to be
useful, all items in the measure should have represented an aspect of the
measured construct. As the construct of emotional disturbance is vague, and
remains undefined by Naglieri, McNeish and Bardos (1991), representative
item selection would have been difficult. Furthermore, the abstract nature of
the emotional indicators increases the complexity of item selection.

The method used by Naglieri, McNeish and Bardos (1991) for selecting
representative items was an actuarial process. As discussed in 3.3, the
actuarial approach involves a process of determining the similarity of
individual responses in comparison with the group (Murphy & Davidshofer,
2001). Unusual responses are identified during the actuarial process. The
unusual responses would apparently be indicative of deviance in emotional
status, i.e. emotional disturbance.

The process of discovering emotional indicators also involved an exhaustive

review of the literature, where probable emotional indicators in drawings were
identified (Naglieri, McNeish & Bardos, 1991). These indicators were
examined in the drawings of the standardisation sample, and unusual
indicators were then selected. Unusual indicators consisted of those occurring
less that 16% of the time, that were absent among ‘normal’ individuals and
that showed appropriate psychometric properties (Naglieri, McNeish &
Bardos, 1991, p 5). However, as explained above, there was no control in

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place to differentiate between emotionally disturbed and emotionally well
children.

The psychometric properties were then determined by calculating item means

for eighty emotional indicators (unrelated to the size of the drawn figures) to
determine whether these items should be included in the final measure. Next,
Naglieri, McNeish & Bardos (1991) reported that independent raters
conducted several cycles of review and modification of these emotional
indicators. The exact process was not explained and therefore remains
unclear.

The selection of emotional indicators for the DAP: SPED seems to be flawed.
Emotional indicators were selected based on atypical presence, and the
unusualness of their presence was used to validate that they were indicators
of emotional disturbance. This tautological reasoning is a source of error
(Neuman, 2000) and questions the usefulness of these indicators, and in turn
the usefulness of the measure.

Subsequent to the development of the measure, validation studies focused on

seeing how well the DAP: SPED could discriminate between pre-existing
groups (Naglieri, McNeish & Bardos, 1991). These studies made use of
control groups, namely children from mainstream schools. The experimental
groups were selected from various backgrounds that included psychiatric
hospitals and special education children (Naglieri, McNeish & Bardos, 1991).
The results showed that the emotionally disturbed group achieved
consistently higher scores on the DAP: SPED compared with the control
group. Significantly higher scores were attained (t scores differences of
between 3.85 and 7.41, p < .001) for these four validation studies in the
manual (Naglieri, McNeish & Bardos, 1991). The findings were thus that the
DAP: SPED was useful in identifying emotional disturbance, and for
discriminating between pre-existing groups.

Despite the good results, the four validation studies reported in the manual
should not be accepted without question. Firstly, it is important to note in this

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regard that no information regarding the scoring process was provided, apart
from the training of the raters (Naglieri, McNeish & Bardos, 1991). It is
therefore possible that the scorers had knowledge of the respondent’s
emotional status (in terms of group membership). A critical discussion
regarding scoring follows in section 6.4.

Secondly, Lilienfeld, Wood and Garb (2000) criticised validation studies of

projective measures as they usually use matched samples with one group
having known pathology. They stated that construct validity is often
overestimated when this method is used, because equal amounts of
respondents are included. Yet, pathology such as emotional disturbance often
has a low base rate within the population so that predictive validation studies
in real settings do not have the same identification rate. They present this
argument eloquently in the following statement (Lilienfeld, Wood & Garb,
2000, p.28):

An instrument that exhibits construct validity as evidenced by significant

differences between pathological and non-pathological groups may
nevertheless be useless for real world predictive applications. This is
because in many of the studies conducted on psychological instruments,
including projective techniques, researchers begin with known groups (e.g.
individuals with versus without a history of childhood sexual abuse) of
approximately the same size…. Because [sic] clinicians are typically
interested in detecting the presence of low base rate phenomena, most
research designs with known pathology groups will overestimate the
predictive validity of test indicators.

Subsequent validation designs followed the same research design. McNeish

and Naglieri (1993) administered the DAP: SPED to pre-existing groups of
emotionally disturbed and non-disturbed children. They found that the
measure was able to identify 59% of the emotionally disturbed children and
55% of the non-disturbed children correctly (McNeish & Naglieri, 1993).
Naglieri and McNeish (1993) were satisfied with these results, stating that
scores were 18% more accurate than if predicted by chance. However, it is

104
important to note that 41% emotionally disturbed learners remained
unidentified, while 45% non-disturbed learners were identified incorrectly.
This is also contradictory to other findings that stated that although the DAP:
SPED did not identify all learners, all the identified learners were emotionally
disturbed (Matto, 2002).

As noted in 6.2 above, the decisions based on the measure determine how
accurate the measure should be. In this regard, Saklofske and Wrightson
(2000) argued that one would expect a screening measure to over-identify
cases of emotional disturbance, rather than under-identify. Furthermore, it
should also correlate highly with other instruments measuring the same
construct (Saklofske & Wrightson, 2000). The lack of independent measures
of emotional disturbance is therefore a major criticism of standardisation and
validation studies up to this point.

In her study of 68 children receiving clinical therapeutic treatment, Matto

(2002) compared scores of the DAP: SPED with the SAC, a shortened form
of the Child Behavior Checklist. The participating child’s parent or therapist
filled out the SAC, and internalising and externalising behaviours were
reported on a three point Likert scale. A second comparative measure, the
Child and Adolescent Adjustment Profile (CAAP) was used as a measure of
the child’s psychosocial adjustment (specifically hostility and withdrawal), and
was also completed by the parent or therapist. Zero order correlations (partial
correlations using Pearson’s correlation coefficient) were significant at the .01
level for the DAP: SPED and the SAC Internalising (r = .341, p> .01), SAC
Total (r = .347, p>. 01) and CAAP Hostility (r =. 316, p> .01) scales. Although
good results were found between the SAC Internalising scale and the DAP:
SPED, moderately low correlations were found between the DAP: SPED and
the CAAP Withdrawal scale (r = .05, p>.01). Negative correlations were
present for the CAAP Withdrawal and the DAP: SPED Man (r = -.05, p>. 01)
and DAP: SPED Woman (r = -.031, p> .01).

According to Matto (2002), the results showed that correlations were

significant in hypothesis testing, and were of moderate strength. The

105
significant correlations seem to indicate that the DAP: SPED had moderate
equivalence in measuring internalising behaviour (SAC), as well as hostile
behaviour (CAAP). However, Matto (2002) found that the DAP: SPED was
not significantly able to predict externalising behaviours and could not explain
variation in externalising behaviour beyond the Hostility scale of the CAAP.

Matto (2002) compared the results of the DAP: SPED with those of other
measures of emotional disturbance, and as a result provided information
about how well the DAP: SPED was able to measure the emotional
disturbance construct. Although Matto (2002) found a significant relationship
between internalising behaviour and the DAP: SPED, the correlation was
moderate and limited to one scale. The implication is that the DAP: SPED
does not measure the whole range of experiences of the construct of
emotional disturbance described in Chapter 2. Another problem is that the
part of emotional disturbance that is measured is measured only moderately
well.

This finding is confirmed by several other studies. In a Canadian study,

Saklofske and Wrightson (2000) made use of control measures for emotional
disturbance. Their research focused on the concurrent validity of the DAP:
SPED compared with two other measures, namely the Devereux Behavior
Rating Scale (DBRS) and the Child Behavior Checklist (CBC). Teachers or
parents completed both of these measures. Respondents were members of
one of three pre-existing groups. These included mainstream learners,
children with severe behaviour problems requiring specialised schooling and
little chance of reintegration, and children with moderate behavioural
problems with the possibility of being integrated into mainstream schools. The
results echoed those of Matto (2002), indicating that the DAP: SPED had
limited ability in identifying behavioural disorders. Low positive correlations of
the DAP: SPED with the DBRS and CBC were reported (between r = .20, p<
.075 and r =.31, p< .01 for the subscales of these measures) (Saklofske &
Wrightson, 2000). On the other hand, the DBRS and the CBC were highly
correlated (r = .86, p< .01) with each other (Saklofske & Wrightson, 2000).

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Another study confirming that the DAP: SPED is not as useful as originally
thought, is one very similar to the present study. In this study by Williams and
Alfred (1997), the DAP: SPED did not correlate well with either the
independent self-report measure used, namely The Revised Child Manifest
Anxiety Scale and The Reynolds Child Depression Scale. It also did not
correlate well with informant observed ratings based on the Behavior
Assessment System for Children (Williams & Alfred, 1997). Williams and
Alfred (1997) concluded that the DAP: SPED Total score was not useful for
identifying internalising disorders.

The results of the abovementioned studies show that the DAP: SPED at best
measures only part of the construct emotional disturbance. However, in the
light of the flawed standardisation process there is a reasonable chance that
the DAP: SPED in fact measures a different, although related construct. Two
different sets of research support this argument.

Wessel, Carter, Jones, Hatch, Kasten, Noll, Schofield and Surges (1993)
studied the use of the DAP: SPED in learning disabled-, emotionally
disturbed- and cognitively disabled children. Results showed that the DAP:
SPED was inaccurate in identifying large percentages of learners, and both
false positive (30%) and false negative (47%) classification errors were
present. The DAP: SPED in particular was unable to distinguish between the
cognitively disabled group and the emotionally disturbed group. These
findings suggest that the DAP: SPED is inaccurate as a screening measure
and that cognitive ability is a confounding variable in the measurement of
emotional disturbance.

Naglieri, McNeish & Bardos (1991) addressed this issue in the manual, and a
brief investigation reported that cognitive ability had no effect on the scores of
the DAP: SPED. Yet, past independent research has shown that emotional
indicators were confounded with indicators of conceptual maturity, a factor
related to cognitive ability (Cox & Catte, 2000). From Table 3.1 in Chapter 3, it
was clear that conceptual maturity manifested in children’s drawings, and that
the drawings reflect cognitive ability. The visual representation of cognitive

107
development in children’s drawings motivated the development of the DAP as
a measure of cognitive maturity.

In their research about confounding variables on emotional indicators in

children’s’ drawings, Cox and Catte (2000) studied the Koppitz HFD scoring
system for emotional disturbance and the Goodenough-Harris DAP for
cognitive maturity. On the Koppitz scale, the item ‘hand cut off’ is an indicator
of emotional disturbance, while the absence of hands indicates cognitive
immaturity on the Goodenough-Harris scale (Cox & Catte, 2000). The same
indicator is thus suggestive of both cognitive maturity and emotional status,
indicating that confounding variables influence the scores of each measure.

Cox and Catte (2000) further argued that drawing ability influences the quality
of the drawing, and consequently the perception of disturbance is
contaminated. According to them, drawing ability better accounts for
differences between drawings than does emotional disturbance (Cox & Catte,
2000). One could therefore argue that confounding variables such as drawing
ability negatively influence the efficacy of the DAP in measuring emotional
disturbance. These confounding variables suggest that the DAP in general
might not be useful as an accurate measure of emotional disturbance.

From the above independent studies, the usefulness of the DAP: SPED is
disputable. On the one hand, Naglieri and associates have focused on limited
successes of the DAP: SPED while downplaying large margins of error
(Matto, 2002; McNeish & Naglieri, 1993; Naglieri, McNeish & Bardos, 1991;
Naglieri & Pfeiffer, 1992). On the other hand, independent researchers have
found that the DAP: SPED is unable to measure the general construct of
emotional disturbance (Saklofske & Wrightson, 2000; Wessel, et al., 1993), or
that a confounding variable interferes with the accuracy of the scores (Cox &
Catte, 2000; Wessel, et al., 1993). The latter results correspond with the
findings of the present research.

Now that it has been established that results from the DAP: SPED have been
equivocal in different applied contexts, it is also important to note that the

108
usefulness of a measure is influenced by various other factors as well, such
as the properties of the measure and the characteristics of the target group
(Murphy & Davidshofer, 2001). Although doubt has been cast over the
properties of the measure, certain differences in respondents might also
account for the lower efficacy of the DAP: SPED locally. Cultural differences
between the South African and American populations should be kept in mind
when evaluating the usefulness of the DAP: SPED within the context of the
present study.

Table 3.1 described developmental milestones in children’s drawings, stating

that drawings were universally so similar that certain trends could be
identified. Based on this assumption, the DAP was developed as a culture-
free assessment measure. Matto and Naglieri (2005), who investigated the
difference in scores between race and ethnic diverse respondents, directly
addressed this issue. Drawings from the standardisation sample were used
and respondents were matched for gender, grade and school. Results
showed that there were no significant differences between black, white and
Hispanic respondents.

These results seem to confirm that the DAP: SPED is not influenced by
cultural differences, although criticisms against the methods used in the
standardisation sample exist and have already been extensively discussed. If
one, however, agrees with the results of the research by Naglieri and his
colleagues, and accepts that the measure is culture free within the American
context, the question still needs to be asked if emotional indicators are as
universal as the developmental milestones in children’s drawings are.

The question of whether the emotional indicators in human figure drawings

are universal thus perhaps needs attention in further research. A meta-
analysis of research on human figure drawings supported the notion that they
are not culture free (Lilienfeld, Wood & Garb, 2000). Azibo (2003) argued that
projective measures and the interpretation thereof, is very Eurocentric. The
constructs of psychometric measures value westernised thinking, and
therefore are not necessarily representative of other cultures. He argued that

109
African cultures have different values that could influence their responses. It
is therefore possible that the emotional indicators are not representative of
emotional disturbance for African people.

If these indicators are not valid for an African population, then they might also
be invalid for other non-European cultures. Although not much information is
available about the usefulness of the DAP: SPED outside of America,
research findings by Kwan Sau-kuen (1998) indicated that within the Chinese
population, the DAP: SPED was not useful to identify emotional disturbance.
Such findings cast further doubt on the usefulness of the DAP: SPED outside
of the American context. As was previously mentioned, further research is
needed on the subject in order to make conclusive findings.

6.3 Reliability of Scores for Emotional Disturbance on the DAP: SPED

The study into the usefulness of the DAP SPED showed that it was unable to
identify emotionally disturbed children accurately, and that it could not
successfully distinguish between high and low emotional disturbance in a
group of South African children. A closer investigation into the internal
reliability of scores of the DAP: SPED confirmed these findings.

Internal reliability examines how coherent the different parts of a measure are
(Murphy & Davidshofer, 2001). According to McIntire and Miller (2007), the
more homogenous the test is in terms of the constructs that are included, the
higher the reliability coefficients would be. Another way of understanding
internal reliability is that any individual item in the scale should generate
results that are consistent with the overall measure (Field, 2005). Internal
reliability is examined using the statistical technique of Cronbach’s alpha
coefficient, which involves finding the average of several correlation
coefficients when the measure is repeatedly and varyingly divided into two
halves (Bryman & Duncan, 2001; Field, 2005).

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The moderately low internal reliability coefficient of the DAP: SPED in the
present study, compared with reliability coefficients reported by Naglieri,
McNeish and Bardos (1991) and Matto (2002), prompted an investigation into
the internal reliability of each of the three drawings. The results showed that
the individual drawings had lower internal reliability than the measure as a
whole, and that negative values were obtained in some instances (see Table
5.8). Negative reliability coefficients generally indicate that as the value of one
variable increases the value of the other decreases (Field, 2005; Murphy &
Davidshofer, 2001). Within a measure one would therefore expect that if
items were inversely correlated, that the scale would make use of negative
scoring. This is however, not the case with the DAP: SPED.

The relationship between the three drawings was also examined, and low
correlations were evident (r s = . 426, p<. 01 to r s = .488, p< .01). What was
peculiar however, is that while the three drawings attained low correlations
with one another, each individual drawing’s score attained significantly high
correlations with the total score of the DAP: SPED (Table 5.9). This implies
that each of the three drawings contributes significantly to the total score but
at the same time show low relationships with one another. Due to the
peculiarity of the matter, it is recommended that this state of events should be
further researched.

Limited information about reliability coefficients is available from other

researchers of the DAP: SPED. Apart from the reliability study by Naglieri,
McNeish and Bardos (1991) where the first nine items were omitted, Matto
(2002) was the only other author to report the reliability coefficient. In her
study with a sample of 63 children, she reported a reliability coefficient for the
DAP: SPED (r = .62; p< .05), ostensibly inclusive of all items (Matto, 2002).
This is similar to the reliability coefficient attained by Naglieri, McNeish and
Bardos (1991).

Matto (2002) also reported the results of the relationships between drawings,
although her focus was on the relationship between the DAP: SPED as a
whole and the SAC and CAAP respectively (see 6.2). Correlation coefficients

111
between the drawings were significant for hypothesis testing and ranged
between r = .180 and r = .425 (p< .01). The highest correlation between a
single drawing and the measure as a whole, was between the DAP: SPED
Total score and DAP: SPED Woman score (r = .497, p< .01). These
correlation coefficients were generally lower than for the South African
sample.

Although Matto reported good results for the overall reliability of the DAP:
SPED, correlations between the drawings were much lower. Matto (2002) did
not discuss these findings. Like with the current research, these findings
suggest that the results from the three drawings are so dissimilar that there is
a weak relationship between them.

The overall results show that the scores for the DAP: SPED are
insufficiently reliable for the type of decision-making it is intended for in
the South African context. Because of this, and the findings related in
6.2, the usefulness of the DAP: SPED for identifying emotional
disturbance in South African children is doubtful.

As was the case with establishing the usefulness of the DAP: SPED, two
reasons may be offered for the moderately low reliability coefficient:

• The measure is not consistent in measuring emotional disturbance as

a construct. This, once again, may be attributed to the fact that the
DAP: SPED might not comprehensively measure emotional
disturbance (see 6.2 and 6.2.1).
• Reliability coefficients are affected by several factors (Murphy &
Davidshofer, 2001). It was shown in 6.2.1 that one of these factors is
the cultural context in which the instrument was administered. Since it
was postulated that the South African cultural context is different from
the American context for which the DAP: SPED was originally
developed, it is assumed that this could have impacted upon the
reliability of the instrument.

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6.4 Credibility of Inter-rater Scores

The credibility of the scoring system of the DAP: SPED was investigated by
calculating the correlation coefficient of scores assigned by the raters
involved in the study. The degree to which raters’ scores agree reflects the
efficacy of the standardisation process, and therefore on the reliability of the
measure. A standardised measure should have well-defined scoring criteria
that minimises the possibility of rater bias (Smit, 1991). Under these
conditions, different raters should record similar results. Inter-rater reliability is
used to determine the extent to which different raters achieve similar results
on the same measure (Smit, 1991).

The results from of the inter-rater reliability scores were presented in Table
5.10. The correlation coefficients between scores of the three raters were
calculated using the Spearman’s rho correlation coefficient. The scores of the
two independent raters correlated moderately well (r s = .687, p<.01), and all
correlations were significant at p< .01. The significant correlations show that
the scoring system is sufficiently standardised, and therefore rejects the null
hypothesis which stated: There is no correlation between the scores given by
different raters when the DAP: SPED is scored.

Although the scoring system showed moderately strong correlations, these

coefficients were not as strong as the r> .90, p< .01 reported by Naglieri,
McNeish and Bardos (1991). The lower correlation coefficients in the present
study could thus reflect inadequate training.

In this regard, Smit (1991) stated that two important factors influence the
scores on a measure, namely the effectiveness of the training of scorers, and
the accuracy in recording the scores (Smit, 1991). To ensure that the
standardisation conditions are upheld, it is imperative that the administrative
guidelines are followed as closely as possible. This would ensure that similar
results are attained with each measurement. When raters have undergone
sufficient training in the use of a particular measure similar scores could be
expected, and therefore yield a high correlation coefficient for inter-rater

113
reliability. However, even when administration and scoring is standardised,
error in measurement is possible when administrative mistakes, such as
faulty computations, take place. Therefore, raters need to be well trained and
conscientious about the application of the measure in use.

Concerning these two factors, the following measures were put in place:
Raters were trained in accordance with the manual of the DAP: SPED. As no
training is available in South Africa on the DAP: SPED (see 4.5.1), the
authors of the measure recommend that the manual be followed carefully
(Naglieri, McNeish & Bardos, 1991). Due to the lack of formal training, it is
therefore possible that training was inadequate to ensure a standardised
scoring procedure. Calculations were minimal for the DAP: SPED and
through the process of moderation all scores were checked for computational
mistakes.

A third factor in scoring accuracy has become evident during the scoring
process. Subjectivity in scoring, or rater bias, refers to the decision of whether
to score an item or not (Smit, 1991). The choice of whether to score a
particular item could depend on many different factors, such as motivation
and perception (Smit, 1991). If, for example, the rater has the attitude that all
possible incidents of emotional disturbance should be identified, the rater’s
scoring style would be over-inclusive. On the other hand, a rater who is not
very motivated to score a large amount of response sets might have a
careless approach and miss some of the items.

Rater bias might also be present in the decisions whether to score items
when the criteria are unclear. Table 4.5 in Chapter 4 summarised the items
that were unclear in the manual, and clearly showed that certain decisions
were made to standardise the scoring procedure for this set of data. Even this
secondary standardisation process was subject to interpretation and bias as
the decision whether to score might rest on subjective feelings or past
experiences (Lilienfeld, Wood & Garb, 2000). Subjective reasoning on how to
score items could result in inaccurate measurement and therefore affect both
inter-rater reliability and the validity of the measurement.

114
Bruening, Wagner and Johnson (1997) conducted research on the possibility
of rater bias with the DAP: SPED. Their study focused specifically on the
impact of rater knowledge in sexually abused girls. Twenty abused and 20
non-abused respondents were randomly placed into one of two groups,
namely Pretend and Actual. Raters were fed details about each respondent
(either true or false information) before scoring the drawings. No significant
effects were found to indicate that scoring bias would be a confounding
variable. Results therefore showed that the scoring system of the DAP: SPED
was sufficiently objective to dismiss the idea that rater bias might influence
the scores (Bruening, Wagner & Johnson, 1997).

According to the researchers, one of the limitations of the study was the small
sample size (Bruening, Wagner & Johnson, 1997). Another limitation was
that the raters were suspicious of the purpose of the study. This could have
resulted in the raters being overly careful in the experimental circumstances
compared with everyday test administration (Bruening, Wagner & Johnson,
1997). Another consideration in this research is that all the participants were
clinic patients. It is thus assumed that some form of emotional disturbance
was likely present in all respondents. This would in turn result in higher DAP:
SPED scores on emotional disturbance for the group as a whole. As a result,
a small margin of difference would occur on emotional disturbance scores
between the sexually abused and non-abused groups, which would lead to
unjustified conclusions regarding the objectivity of the scoring system.

Despite the moderately high correlations for inter-rater reliability in the present
research, it was evident that there was a margin for error in the scoring
process. This margin of error has also not been excluded from other studies,
such as the one conducted by Bruening, Wagner and Johnson (1997).
Furthermore, the lack of information regarding the scoring process on the
validation studies by Naglieri, McNeish and Bardos (1991) prevents critical
examination of the said procedures. There is, for example, no mention of
whether respondents’ drawings were scored within the pre-existing groups or

115
not. The extent to which knowledge of group membership may have biased
the decision to score items could therefore not be established.

Projective measures are difficult to standardise, as there are infinite possible

responses to given stimuli (Lilienfeld, Wood & Garb, 2000). An attempt to
provide inclusive scoring guidelines would inevitably result in vague criteria,
while very specific criteria would exclude a wide range of responses.
Lilienfeld, Wood and Garb (2000) also reported that results show that
standardised scoring procedures for projective measures often fail, and that
there was not enough support in the literature to support the use of
standardised scoring systems.

Riethmiller and Handler (1997) made another salient point. They argued that
attempts to make the scoring of drawings completely mechanical would
inevitably be unsuccessful, as drawings should be studied within context. For
example, when a picture contains a lot of detail, this detail should be viewed
in relation to other indicators in the drawing. A sparsely drawn human figure
that contains a lot of detail concentrated in one area would be more indicative
of pathology such as hypervigilance or obsessive compulsive behaviour than
an artistically well-drawn human that generally contains a lot of detail.
Riethmiller and Handler (1997) subsequently suggested that the most
effective way of using the DAP as a measurement instrument involves a
phenomenological approach where empathising with the drawing would give
the interpreter a sense of what is being communicated. This implies that
research should also involve qualitative interpretations of the drawings. In this
regard, the authors stated that observation of the drawing process as well as
interaction with the drawer concerning the picture will be helpful (Riethmiller &
Handler, 1997).

The moderately high correlation coefficients of the inter-rater reliability

scores in the present study showed that the scoring system is
sufficiently standardised. However, the application of scoring criteria
produced problems. As the scoring guidelines of the DAP: SPED are too
general, they cannot be deemed specific or clear enough. This creates a

116
margin for error, where the rater has to rely on previous experience and
knowledge. Although the margin for rater bias was not big enough to
affect the significance of inter-rater reliability correlation coefficients in
the present study, subjective decisions of whether to score an item
could have in turn affected the usefulness of the DAP: SPED. This
variability between scorers could have resulted in unreliable scores of
emotional disturbance as measured by the DAP: SPED.

6.5 The Occurrence of Emotional Disturbance in the Target Group

The fourth aim of the present study was to observe the occurrence of
emotional disturbance in the South African context. Two standardised
instruments, namely the BYI-II and the DAP: SPED, measured the presence
of emotional disturbance in a group of Grade 4 learners (see 5.7). Both
instruments yielded similar results in terms of the amount of learners that
were identified as emotionally disturbed (68% on the DAP: SPED and 76% on
the BYI-II). An in-depth investigation to identify the learners revealed that the
instruments did not identify the same learners. This could explain the
extremely low correlations between the DAP: SPED and BYI-II scores.

Anxiety levels measured by the BAI seemed abnormally high within the target
group. Different levels of anxiety were reported within this group. Severe
anxiety was present in 33 cases (26.4%). According to Sadock and Sadock
(2003), generalised anxiety disorder is estimated to occur in only three
percent of school-aged children. Other anxiety related issues, such as
separation anxiety, nail biting, and bed-wetting, are likely to increase the
prevalence rate. However, the extremely high rate of the severest intensity of
anxiety in the local study indicates that emotional disturbance is elevated in
the children who participated in the study.

The anxiety levels might have been artificially high due to the testing
conditions. The learners might have been apprehensive about being ‘tested’,
and this could have evoked similar feelings experienced during exam times.

117
Furthermore, learners who were afraid of what the results might reveal about
them, and how this information would be used, would also experience
increased levels of anxiety. As was evident in 4.9.2, children had many
questions regarding the test results during the debriefing stage of the data
collection process.

Severe depression, as measured on the BDI, was reported in a smaller

quantity of children (12%), although these levels also appear to be elevated.
Major depression is diagnosed in approximately two percent of primary school
children, while dysthymic disorder occurs in about two and a half percent of
the same age group (Sadock & Sadock, 2003).

The occurrence of the most severe levels of anger (BANI) and disordered
behaviour (BDBI) in the target group was low (7.2% and 5.6% respectively for
t scores above 70). The total number of learners with disruptive behavioural
problems, as identified by scores above 60 on the BYI-II, came to 16.8% (21
learners, see Table 5.11). When one looks at the prevalence rates of
emotional disturbance within the standardisation sample of the BYI-II (8.41%
for t scores above 70), it is apparent that South African children have similar
rates of disruptive behaviour. Although Sadock and Sadock (2003) reported
that prevalence rates for the disruptive behaviour disorders are between 16 to
22% of school-aged children, it could be assumed that this includes moderate
as well as severe forms of disruptive behaviour. These figures are similar to
the prevalence rates within the target group when scores are inclusive of
moderate levels of disturbance.

Despite similar percentages of disruptive behaviour between the group of

South African children and the American samples, the issue of social
desirability needs to be examined. It is possible that if respondents were
anxious about the feedback to their parents regarding their emotional
disturbance, and were scared of getting into trouble, that they would have
minimised the seriousness of their disruptive behaviour. The findings of the
Qualitative Questionnaire of Observed Behaviour in the Classroom (QQOBC)
seem to confirm that learners presented with motivational distortion (faking

118
good). According to teachers’ reports on the QQOBC, 48% of the learners
were considered disruptive. It is therefore likely that due to social desirability
learners were not forthcoming on their true emotional status. The differences
between scores on the BYI-II and ratings by teachers on the QQOBC indicate
that social desirability plays a significant role in verbal self-report inventories,
such as the BYI-II. However, the extent to which social desirability influenced
learners’ scores on the BANI and BDBI is unknown. Initial findings show that
when emotional disturbance is assessed in children, it is important to include
information from various sources to control for errors in measurement.
Further research in this matter could provide information regarding the level of
motivational distortion and the extent to which these levels are similar to
those of American children.

The results of the QQOBC showed that although many children had
symptoms of emotional disturbance from time to time, these symptoms
occurred intermittently. Ratings from teachers indicated that only a few
children were highly emotionally disturbed. According to the teachers’ ratings
on the QQOBC, consistent levels of anxiety were only present in seven
percent of the learners, while depression only occurred in ten percent of the
learners (see Table 5.14). Severe behavioural problems were identified in
16.8% of learners. These findings suggest that externalising behaviour is
more readily identified than internalising behaviour. This corroborates findings
from the literature, which suggest that caregivers observe emotional
disturbance in the form of externalising behaviour more easily. Caregivers are
more likely to respond to externalising behaviour, as it is more uncomfortable
to bear when children are disruptive (Wicks-Nelson & Israel, 2003).

The literature review in 2.3 indicated that South African children would
have comparatively higher rates of emotional disturbance due to factors
such as poverty, violence and crime, as well as the high prevalence of
AIDS. The results of the present research confirmed these initial
suppositions, indicating that identifying emotionally disturbed children
is important. Furthermore, it indicates that intervention plans are both
necessary and urgent.

119
6.6 Limitations of the Study and Recommendations for Future Research

The four aims of the present study related to how useful the DAP: SPED
would be in the South African context. The research focused on comparing
the results of the DAP: SPED with an independent self-report measure, the
BYI-II. Additional information was gained from a third measure, the QQOBC,
where teachers were asked to rate the behaviour of each child participating in
the study. The DAP: SPED was applied within a context where it had to
screen for emotionally disturbed learners from a group of children with
unspecified emotional status. Previous studies focused mainly on the efficacy
of the DAP: SPED between pre-existing groups or on comparing the DAP:
SPED with adults’ ratings of respondents’ behaviour. Further investigation
into the efficacy of the DAP: SPED in comparison with other measures is
recommended.

One of the limitations of the current study was the small sample size obtained
through convenience sampling. This sample was not representative of the
population at large and results should therefore be generalised with caution.
Further research on the DAP: SPED within the South African context should
thus focus on a larger and a more representative sample.

Another limitation of the study is that it did not initially take into account the
impact of cultural diversity on the scores obtained on the DAP: SPED. Since it
was noted that cultural diversity might have an impact on the usefulness of
the DAP: SPED in a South African context, it is recommended that future
research should determine whether cultural differences impact on how
emotional disturbance is defined. Such research should also focus on what,
within the South African culture, will constitute indicators of emotional
disturbance in children’s drawings.

A third limitation of the study concerns the efficacy of the BYI-II in a South
African context. Within the boundaries of the current study, the BYI-II was
found to be a reliable instrument and offered valuable information regarding
the nature of emotional disturbance. Not only was it successful at pointing out

120
emotionally disturbed children, but it also identified internalising behaviour
that is easily overlooked by parents and teachers. The problem with the BYI-II
is that it is limited to an English speaking and literate population, and
therefore would not be applicable within the wider multi-cultural South African
context. The search for an instrument that measures emotional disturbance
and can be used on individuals from different backgrounds should thus
continue.

Another problem identified when the BYI-II was used, was that it did not
control for socially desirable responses. Socially desirable responses could
have had a negative impact on correlations between the DAP: SPED and the
BYI-II. The results of the present study showed low correlations between the
DAP: SPED and externalising behaviours, as measured by the BDBI and
BANI subscales of the BYI-II. Due to the limited scope of the present
research, no statistical analysis was undertaken to examine the extent to
which social desirability influenced correlations between the DAP SPED and
the BYI-II. Such an examination could include finding correlations between
the results of the DAP: SPED and the QQOBC. Further research should
therefore include a data analysis between the scores of the DAP: SPED and
independent observers’ ratings. Standardised measures for observers such
as those used by Matto (2002) and Saklofske and Wrightson (2000) might be
more helpful in further research than the QQOBC.

The importance of a third measure that could gather information from an

additional source (such as the teacher) is confirmed by the presence of
motivational distortions on the BYI-II. However, the QQOBC was not as
helpful as initially theorised. Teachers were chosen to provide information
regarding their learners as they are in constant contact with the children and
should therefore be in a good position to comment on their behaviour.
However, it seems that the workload of the teachers prevented them from
providing detailed information regarding the learners’ observed behaviour.
Furthermore, the motivation of teachers to do additional work might have
been low, thereby influencing the quality of their responses. One possible
solution would be getting additional information from parents. On the other

121
hand, structured interviews with either teachers or the parents would perhaps
be more helpful than questionnaires.

The importance of finding a measure for emotional disturbance was described

in Chapter 2, and the results for the incidence of emotional disturbance shows
that it is vital to identify learners, as well as to implement plans, where
emotional disturbance could be addressed. Perhaps educational systems
could incorporate programs into the life-skills training courses and therefore
be pro-active at addressing emotional distress in learners. Once such
programs were implemented, they could serve as preventative measures, as
well as giving emotionally disturbed learners the opportunity to make their
emotional status known.

6.7 Conclusion

Initially it was theorised that the DAP: SPED would have some potential in the
South African context due to the many potential benefits of the measure. The
positive results reported by Naglieri and his colleagues for the DAP: SPED
supported this notion. However, results of the present study showed that
these findings could not be corroborated in the context of the present study.
The DAP: SPED was unable to distinguish between the presence or absence
of emotional disturbance within the group of Grade 4 learners who
participated in the study. The DAP: SPED also presented with low internal
reliability. Statistical analysis showed that the standardised scoring system
was good. However, the application of the scoring criteria presented problems
that might have influenced the reliability of the measure as a whole.

Had the results of the DAP: SPED matched the moderate success reported
by Naglieri and colleagues, this success rate would still be insufficient for use
in South Africa. Too many false positive and negative results would lead to a
high degree of faulty decision-making. This in turn could result in wasted
resources and emotionally disturbed children that remain untreated. The
prevalence of emotional disturbance within the group of South African

122
children was high, and indicates that effective intervention is urgently needed.
The quest for a measure that could successfully identify emotional
disturbance within the diverse South African population should thus continue.

123
 REFERENCE LIST

American Psychiatric Association. (2000). Diagnostic and Statistical Manual

of Mental Disorders Text Revision (4th ed.). Washington, DC: Author.

Arnheim, R. (1971). Art and Visual Perception: A psychology of the creative

eye. Berkeley: University of California Press.

Azibo, D. A. (Ed.). (2003). African Centered Psychology: Culture-focusing for

multi-cultural competence. Durham, NC: Carolina Academic Press.

Barbarin, O.A. & Richter, L. (2001). Economic status, community danger and
psychological problems among South African children. Childhood, 8 (1), 115-
133. Retrieved January 28, 2008, from
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=19934552

Beach, L.R. & Connoly, T. (2005). The Psychology of Decision Making:

People in Organizations (2nd ed.). Thousand Oaks, CA: Sage.

Beck, J.S., Beck, A.T. & Jolly, J.B. (2001). Beck Youth Inventories of
Emotional and Social Impairment. New York: The Psychological Corporation.

Blau, T. (1992). The Draw-A-Person Test: A Summary of Commonly Utilized

Interpretive Features. Florida: Psychological Seminars.

Bless, C. & Kathuria, R. (2001). Fundamentals of Social Statistics: An African

perspective. Cape Town: Juta.

Brannon, L. & Feist, J. (2004). Health Psychology: An introduction to

behavior and health (5th ed.). Belmont, CA: Thompson.

Bruening, C.C., Wagner, W.G. & Johnson, J.T., (1997). Impact of rater
knowledge on sexually abused and non-abused girls’ scores on the Draw A
Person: Screening Procedure for Emotional Disturbance (DAP: SPED).
Journal of Personality Assessment, 68(3), 665-677.

124
Bryman, A. and Duncan, C. (2001). Qualitative data analysis with SPSS
release 10 for windows: a guide for social scientists. London: Routledge.

Burger, J. (2007). Time to take action: The 200/ 2006 crime statistics. SA
Crime Quarterly. (21), 1-7.

Conradie, H. (2003). Are we failing to deliver the best interest of the child?
Retrieved January 28, 2008, from
www.crisa.org.za/fighting_crimes.pdf.hd

Cox, M. V. & Catte, M. (2000). Severely disturbed children's human figure

drawings: are they unusual or just poor drawings? European Child &
Adolescent Psychiatry 9 (4), 301-307.

Cronbach, L.J. (1988). Five perspectives on the validity argument. In Wainer,

H. & Braun, H.I. (Eds.), Test validity. Hillsdale: Lawrence Erlbaum.

Cross, M. (2004). Children with emotional and behavioural difficulties and

communication problems. London: Jessica Kingsley.

Davidson, G.C. & Neale, J.M. (2001). Abnormal Psychology (8th ed.). New
York: John Wiley.

Department of Health (1997, April). White Paper for the Transformation of the
Health System in South Africa [Announcement]. Retrieved March 8, 2004,
from http://www.gov.za/whitepaper/1997/health.htm

Desmond, C., Michael, K. & Gow, J. (2000). The hidden battle: HIV/Aids in
the household and community. South African Journal of International Affairs.
7(2), 39-58.

Di Leo, J.H. (1970). Young children and their drawings. New York: Brunner/
Mazel.

125
Di Leo, J.H. (1973). Children's drawings as diagnostic aids. New York:
Bruner/Mazel.

Eno, L., Elliot, C. & Woehlke, P. (1981). Koppitz emotional indicators in the
Human Figure Drawings of children with problems. The Journal of Special
Education. 15(4), 459-470.

Field, A. (2005). Discovering statistics using SPSS (2nd ed). London: Sage.

Field, A. & Hole, G. (2003). How to design and report experiments. London:
Sage.

Foxcroft, C. & Roodt, G. (Eds.). (2004). An introduction to psychological

assessment in the South African context. Cape Town: Oxford University.

Gardner, H. (1980). Artful Scribbles: The significance of children’s drawings.

New York: Basic Books.

Goleman, D. (1996). Emotional Intelligence: Why it can matter more that IQ.
London: Bloomsbury.

Golomb, C. (2002). Child art in context: A cultural and comparative

perspective. Washington, DC: American Psychological Association.

Goodenough, F.L. (1926). Measurement of Intelligence by Drawings. New

York: Harcourt, Brace & World.

Goodnow, J. (1977). Children’s drawing: The developing child. London:

Fontana/ Open Books.

Harris, M. & Radaelli, S. (2007). Paralysed by fear: Perceptions of crime and

violence. SA Crime Quarterly, 20 (June), 1-7.

126
Harris, D.B. (1963). Children’s drawings as Measures of Intellectual Maturity:
A revision and extension of the Goodenough Draw A Man Test. New York:
Harcourt, Brace & World.

Jacobs, L.J. & van der Merwe, S.E. (1992). Die Interpretasie van
kindertekeninge. Pretoria: Academia.

Jooste, M.J.L. (2004). Introduction to Psychological Testing and Assessment

in South Africa. Johannesburg: Rand Afrikaans University.

Kellogg, R. (1970). Analyzing Children’s Art. Palo Alto: Mayfield.

Kellogg, R. (1979). Children’s Drawings/ Children’s Minds. New York: Avon.

Kleintjes, S., Flisher, A.J., Fick, M., Railoun, A., Lund, C., Malteno, C. &
Robertson, B.A. (2006). The prevalence of mental disorders among children,
adolescents and adults in the Western Cape, South Africa. South African
Psychiatry Review (9), 157-160.

Koppitz, E. M. (1968). Psychological evaluations of children's Human Figure

Drawings. New York: Grune & Stratton.

Kwan Sau-kuen, P. (1998). A Validation study of the Draw-A-Person:

Screening Procedure for Emotional Disturbance in Hong Kong. Published
Thesis: university of Hong Kong. [Abstract] Retrieved October, 10, 1008, from
http://hub.hku.hk/handle/123456789/30571

La Roche, G.A. (1994). Emotional Indicators Identified In The Drawings Of

Sexually Abused Children. American Journal of Art Therapy, 33(2), 45-51.

Lewis, S. (1999). An adult’s guide to childhood trauma: Understanding

traumatized children in South Africa. Cape Town: David Philip.

127
Lillenfield, S.O., Wood, J.M. &Garb, H.N. (2000). The scientific status of
projective techniques. Psychological Science in the Public Interest, 1 (2), 27-
66.

Louw, D. A. (1990). Menslike Ontwikkeling (2nd ed.). Pretoria: HAUM.

Lowenfeld, V. and Brittain, W.L. (1969). Creative and Mental Growth (4th ed.).
New York: Macmillan.

Machover, K. (1980). Personality Projection in the drawings of The Human

Figure.: A method of Personality Investigation. Springfield: Charles C.
Thomas.

Malchiodi, C. A. (1990). Breaking the silence. New York: Brunner/Mazel.

Masango, M.J. (2004). Aggression, anger and violence in South Africa. HTS:
Theological Studies, 60(3), 993-1006.

Matto, H.C. (2002). Investigating the validity of the Draw-A-Person: Screening

Procedure for Emotional Disturbance: A measurement validation study with
high-risk youth. Psychological Assessment, 14 (2), 221-225.

Matto, H.C. & Naglieri, J.A. (2005). Race and ethnic differences and Human
Figure Drawings: Clinical utility of the DAP: SPED. Journal of Child and
Adolescent Psychology, 34 (4), 706-711.

McBurney, D.H. (2001). Research Methods. Australia: Wadsworth.

McIntire, S.A. & Miller, L.A. (2007). Foundations of psychological testing: a

practical approach. Thousand Oaks, CA: Sage.

McNeish, T. J. and Naglieri, J. A., (1993). Identification of individuals with

serious emotional disturbance using the Draw A Person. Journal of Special
Education, 27 (1), 115-122.

128
Messick, S. (1988). The once and future issues of validity: Assessing the
meaning and consequences of measurement. In Wainer, H. & Braun, H.I.
(1988). Test validity. Hillsdale: Lawrence Erlbaum.

Murphy, K.R. & Davidshofer, C.O. (2001). Psychological Testing: Principles

and applications (5th ed.). New Jersey: Prentice Hall.

Murphy, L.B. (1963). Problems in recognizing emotional disturbance in

children. Child welfare (Dec) 473-486.

Naglieri, J. A. (1988). Draw A Person: A Quantitative Scoring System. New

York: The Psychological Corperation.

Naglieri, J.A., McNeish, T.J & Bardos, A.N. (1991). DAP: SPED Draw-A-
Person: Screening Procedure for Emotional Disturbance Examiner’s Manual.
Austin, Texas: Pro-ed.

Naglieri, J.A. & Pfeiffer, S. I. (1992). Performance of disruptive behavior

disordered and normal samples on the Draw A Person: Screening Procedure
for Emotional Disturbance. [Abstract] Psychological Assessment, 4 (2), 156-
159. Retrieved March, 31, 2008, from http;//0-
web.ebscohost.com.ujlink.uj.ac.za/ehost/detail?vid=1&hid=103&sid=2960bb

Neser, J.J. (2006). Peer victimisation in public schools: A comparison of the

psychosocial attributes of victims and non-victims. Acta Criminologica, 19 (3),
123-144.

Neuman, W.L. (2000). Social Research Methods: Qualitative and Quantitative

Approaches (4th ed.). Boston: Allyn & Bacon.

Oster, G. D. & Gould, P. (1987). Using Drawings in Assessment and Therapy.

New York: Brunner/Mazel.

129
Pert, C.B. (1997). Molecules of emotion: Why you feel the way you feel.
London: Simon & Schuster.

Peterson, L. W. & Hardin, M. E. (1997). Children in Distress: A guide for

screening children’s art. New York: W.W. Norton.

Phillips, D. (2002, November, 4). The lifelong impact of poverty. BBC News
World Edition. Retrieved January 28, 2008, from
http://news. bbc.co.uk/2/hi/uk_news/scotland/2394193.stm

Richter, L. M., Griesel, R.D., & Wortley, M.E. (1989). The Draw-A-Man test: A
50-year perspective on drawings done by black South African children. South
African Journal of Psychology. 19 (1), 1-5.

Richter, L. M., Griesel, R.D., Durrheim, K., Wilson, M., Surendorff, N. &
Asafo-Agyei, L. (1998). Employment Opportunities for Graduates in South
Africa: A Contemporary Analysis. South African Journal for Psychology. 28
(1), 1-7.

Riethmiller, R.J. & Handler, L. (1997). Problematic methods and unwarrented

conclusions in DAP research: Suggestions for improved research procedures.
Journal of Personality Assessment, 69 (3), 459-475.

Robertson, B. & Berger, S. (1994). Child Psychopathology in South Africa. In

Phillip, D. (Ed.). Childhood and adversity: Psychological perspectives from
South African research (pp 156-). Cape Town: David Philip.

Rudenberg, S.L., Jansen, P. & Fridjhon, P. (1998). The effect of exposure

during an ongoing climate of violence on children’s self-perceptions, as
reflected in drawings. South African Journal for Psychology. 28 (2), 107-115.

Rudenberg, S.L., Jansen, P. & Fridjhon, P. (2001). Living and Coping with
ongoing violence in South Africa: A cross-national analysis of children’s
drawings using structured rating indices. Childhood. 8 (1), 31-55.

130
Sadock, B.J. & Sadock, V.A. (2003). Kaplan & Sadock’s Synopsis of
Psychiatry: Behavioral Sciences/ Clinical Psychiatry. (9th ed.). Philadelphia:
Lippencott, Williams & Wilkins.

Saklofske, D.H. & Wrightson, L. (2000). Validity and reliability of the Draw A
Person: Screening Procedure for Emotional Disturbance with adolescent
students. Canadian Journal of School Psychology, 16 (1), 95-102.

Seedat, M. (1998). A Characterisation of South African Psychology (1948-

1988): The Impact of Exclusionary Ideology. South African Journal for
Psychology. 28 (2), 75-83.

Senior, L. (2002). Attachment Theory. In Hook, D., Watts, J. & Cockroft, K.

(Eds.). Developmental Psychology. Cape Town: University of Cape Town.

Shell, R. (2000). Halfway to the Holocaust: The economic, demographic and

social implications of the AIDS pandemic to the year 2010 in the Southern
African Region. HIV/ AIDS: A threat to the African Renaissance? Occasional
Paper produced by Konrad-Adendauer-Stiftung.

Siegler, R.S, Deloache, J.S., & Eisenberg, N. (2003). How children develop.
New York: Palgrave Mcmillan.

Smit, G.J. (1991). Psigometrika. Pretoria: HAUM.

Strydom, H. & Strydom, C. (2006). Perceptions of learners regarding crime.

Acta Criminologica. 19 (1), 19-32.

Trevisan, M.S., (1996). Review Of The Draw A Person: Screening Procedure

For Emotional Disturbance. Measurement & Evaluation in Counseling &
Development, 28 (4), 225-229.

131
Veltman, M.W.M. & Browne, K.D., (2002). The assessment of drawings from
children who have been maltreated: a systematic review. Child Abuse
Review. 11(1), 19-37.

Ward, C.L., Martin, E. Theron, C. & Distiller, G.P. (2007). Factors affecting
resilience in children exposed to violence. South African Journal of
Psychology. 37 (1), 165-187.

Webster, R.E., (2000). Identifying sexually abused children using Human

Figure Drawings. Paper presented at the annual meeting of the National
Association of School Psychologists. (March, 29 to April, 1).

Wessel, J., Carter, D., Jones, S., Hatch, K., Kasten, H., Noll, T., Schofield, D.
& Surges, K. (1993, April). Use of the DAP: SPED with a sample of students
enrolled in ED, CD, and LD public school programs. Paper presented at the
Annual Convention of the National Association of School Psychologists,
Washington, DC.

Whiteside, A. & Sunter, C. (2000). AIDS: The challenge in South Africa.

Caper Town: Human & Rousseau.

Wicks-Nelson, R. & Israel, A.C. (2003). Behaviour disorders of childhood (5th

ed.). New Jersey: Prentice Hall.

Williams, J.A., (2001). An analysis of the drawings of sexually abused,

traumatised and a non-clinical population of girls. Unpublished MA
dissertation. University of the Witwatersrand.

Williams, K. S. & Alfred, U. (1997). Relationships among DAP: SPED

indicators, self-report anxiety and depression scores and behavior ratings of
children ages 8-11. The Sciences and Engineering, 57 (10-B), 6643.
Retrieved March,31, 2008, from http;//0-web.ebscohost.com.ujlink.uj.ac.za/
ehost/detail?vid=1&hid=120&sid=46640a

132
Williams, J.A., Xintolo, N., & Nombaca, B. (2001). Emotional distress reflected
in drawings of children from Alexandra Township. Southern African Journal of
Child and Adolescent Mental Health. 14 (2), 44-46.

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 APPENDIX A
Qualitative Questionnaire for Observed Behaviour in the Classroom
(QQOBC)

Dear teacher,

Please take the time to complete this questionnaire on behaviour you might have
observed of ___(insert name of participant) . This will help to conclude the
research and to further identify which children are in need of emotional support.
Please note that each parent has already granted permission for your feedback.

Thank you for all your efforts at this busy time

Francoise Kubierske

1. How would you describe this learner?

___________________________________________________________________
_____________________________________________________________
2. How would you rate this learner’s self-confidence?
Good High Average Low Average Low
Comments:
___________________________________________________________________
_____________________________________________________________
3. Have you noticed fear, nervousness or worry with this learner?
Never Sometimes Often Always
Comments:
___________________________________________________________________
_____________________________________________________________
4. Have you noticed that this learner is withdrawn, sad or teary?
Never Sometimes Often Always
Comments:
___________________________________________________________________
_____________________________________________________________

5. Does this learner seem to have outbursts of anger?

Never Sometimes Often Always
Comments:
___________________________________________________________________
_____________________________________________________________

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6. Does this learner get into trouble?
Never Sometimes Often Always
What for?
___________________________________________________________________
_____________________________________________________________
7. Are you aware of any emotional or social problems for this child?
Yes No
Comments:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

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 APPENDIX B
Permission to partake in Research

Dear Parents

I am currently a student of Psychology at the University of Johannesburg. In order to

complete my Master’s degree, I am required to do research. The research I have
chosen to do concerns a psychological test that can identify children with emotional
problems. I would like to find out how well this test might work in South Africa.

For me to conduct this research, I need to assess children in Grade 4. This involves
filling out a questionnaire as well as completing three drawings. It would also be
necessary to obtain collateral information from you as the parent, or from the class
teacher. The assessment will take place one morning during school hours, and would
take approximately two hours.

Participation is voluntary. If you do not want your child to participate, the school will
make alternative arrangements for that period. A total of 120 children need to be
assessed for the research, and they will be chosen randomly from those for who
consent have been obtained.

All information will be strictly confidential. This means that the school will receive
global results. If any individual child needs further help, the parents will be contacted
and appropriate recommendations will be made.

Any further queries can be directed to Francoise Kubierske on 082 563 9278
Please fill out the form below to indicate whether you would like your child to
participate.

Many thanks

________________________________
Francoise Kubierske
MA (Psych) Intern
University of Johannesburg

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Please tear along the line and return to school by Tuesday 30 October 2007

I, _____________________________________ parent/ guardian of

_____________________________________ in Grade 4, hereby do/ do not (please

mark clearly) give consent for my child to participate in the assessment.

Signature of parent/ guardian _______________________________

Contact Numbers _________________________ _______________

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 APPENDIX C
Feedback for participants Regarding the Presence of Emotional
Disturbance

Dear Parent,

Thank you for allowing ____(insert participant’s name)______to participate in

the research. Your child’s contribution has been very valuable.

The results of the screening procedure for emotional troubles indicate that
your child’s level of emotional distress at the time of testing was:

□ Low □ Mild □ Moderate □ High

Please seek further assistance for moderate and high scores. Your
headmaster or school counsellor can guide you in this regard. Alternatively,
my office contact details are as follows:

Francoise Kubierske
Mindsense Counseling and Learning Centre
Suite 10
123 Rietfontein Rd
Primrose
Tel: (011) 822 2959

Kind regards
Francoise

____________________________

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 APPENDIX D

Dear Parent,

Thank you for giving permission for your child to participate. As indicated, a
limited amount of learners could be accommodated in the research due to the
restricted availability of testing material. I would therefore like to inform you
that your child was not included in the sample, and no emotional evaluation
was carried out.

If you have any concerns in this regard, please feel free to contact your
headmaster or school counselor. Alternatively, my office contact details are as
follows:

Francoise Kubierske
Mindsense Counseling and Learning Centre
Suite 10
123 Rietfontein Rd
Primrose
Tel: (011) 822 2959

Kind regards,
Francoise Kubierske

____________________________

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APPENDIX E
Example of Qualitative Analysis Spreadsheet

ID QQOBC BSCI BAI BDI BANI BDBI

DAP: Teacher’s comments
SPED
SN1 57 42 44 33 37 48
high
QQOBC s/times never never s/times Friendly, competitive, hardworking. Chatty in class
ave
SN2 58 45 37 36 44 72
Naughty, temper tantrums, conflict with peers, doesn’t follow instructions. On
QQOBC low ave never never often often ritalin
SN3 43 72 84 62 55 61
QQOBC low s/times often never s/times Slow, withdrawn. Intimidated by clever sister, won’t ask for help.

SN4 50 61 47 52 47 66
QQOBC low ave never never never s/times Quiet, reserved. Trouble for not doing homework

SN5 51 68 59 59 48 56
high
QQOBC never never never s/times Intelligent, talkative, racial incidents, wrong friends. Hostile to high achievers
ave
SN6 34 56 61 55 53 59
QQOBC good never never never s/times Friendly, chatty

SN7 38 64 49 58 59 60
No boundaries, intelligent, no morals or respect. Racial remarks, bad language.
QQOBC low ave never never s/times often Good home, hates high achievers
SN8 37 53 49 49 55 50
QQOBC low ave never never never often Disruptive

SN9 55 65 44 41 48 41
QQOBC good never never never s/times Friendly, talkative

SN10 57 72 49 44 51 60
QQOBC good s/times s/times s/times often High achiever, poor morals, racial remarks (stealing)

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SN11 60 48 38 39 40 59
QQOBC good never never never never Intelligent, considerate.

SN12 54 61 41 47 45 45
QQOBC low ave s/times s/times never never Slow learner, frustrated with academics, doest ask for help

SN13 54 54 54 64 55 48
QQOBC good never never never s/times Friendly, overenthusiastic, over-familiar

SN14 53 54 44 50 88 47
QQOBC good never never s/times s/times Intelligent, naughty. Good communicator. Language, noisy, backchats

SN15 59 37 37 35 48 43
QQOBC good never never never never Intelligent, hardworking, neat, caring, independent

SN16 48 62 46 56 80 39
Forgetful, needs attention to do work, fear of losing stuff so puts lock on bag.
QQOBC low ave s/times often s/times s/times Homework incomplete. Father died, mother overprotective.
SN17 39 80 88 62 75 61
QQOBC low ave often often never often Naughty, unkempt, tearful, withdrawn when reprimanded. Homework not done.

SN18 47 63 44 52 53 54
QQOBC good never never never never Quiet, reserved

SN19 45 70 46 63 51 54
QQOBC good never never never s/times Talkative, friendly. Disruptive in class.

Key for Appendix E

Internalising Externalising Mixed DAP:SPED high/ DAP: SPED low/
Behaviour Behaviour Behaviour BYI-II low BYI-II high

142