Validation Study of Human Figure Drawing Test in a Colombian School Children Population

The aim of this article was to assess the validity of the emotional and developmental components of the Koppitz human figure drawing test. 2420 children's drawings available in a database resulting from a previous cross sectional study designed to determine the prevalence of neurological diseases in children between 0 and 12 years old in Bogota schools were evaluated. They were scored using the criteria proposed by Koppitz, and classified into 16 groups according to age, gender, and presence/absence of learning or attention problems. The overall results were then compared with the normative study to assess whether descriptive parameters of the two populations were significantly different. There were no significant differences associated with presence/absence of learning and attention disorders or school attended within the overall sample. An Interrater reliability test has been made to assure the homogeneity of scoring by the evaluator team. There were significant differences between this population and that of the original study. New scoring tables contextualized for our population based on the frequency of appearance in this sample are presented. We can conclude that various ethnic, social, and cultural factors can influence the way children draw the human figure. It is thus important to establish local reference values to adequately distinguish between normality and abnormality. The new scoring tables proposed here should be followed up with a clinical study to corroborate their validity. Keywords: children, validation, concordance, human figure drawing test. El trabajo tiene como objetivo fue validar los componentes evolutivos y emocionales del test de Koppitz del dibujo de la figura humana. Se revisaron 2420 dibujos de ninos de la base de datos de un estudio de corte transversal realizado previamente para evaluar la prevalencia de enfermedades neuropediatricas en ninos de 0 a 12 anos de colegios de Bogota y fueron divididos en 16 grupos organizados de acuerdo a edad, genero y de presentacion o no de problemas del aprendizaje o de la atencion y evaluados bajo los parametros propuestos por Koppitz. No se encontraron diferencias entre los grupos por la presencia o no de trastornos, ni entre el tipo de establecimiento educativo. Se realizo una prueba de concordancia interevaluador para homogenizar la calificacion. Se encontraron diferencias con la clasificacion propuesta por Koppitz por lo que se construyeron nuevas tablas de calificacion, teniendo en cuenta los porcentajes de presentacion en el presente estudio. A manera de conclusiones se puede decir que diferentes factores socioculturales y etnicos influyen en items especificos del dibujo de la figura humana en el nino. Es de gran importancia tener valores referenciales locales para poder establecer diferencias reales entre lo normal y lo anormal. Se debe realizar un estudio para validar clinicamente las tablas propuestas. Palabras clave: ninos, validacion, concordancia, test del dibujo de la figura humana. The development of the ability to draw the human figure in children is closely allied with neurodevelopment in general, especially the development of the visual and motor skills associated with drawing and writing (Goodenough, 1964). The evaluation of the Human figure drawings (HFD) in children dates from several centuries back and has served not only as a tool for assessment of maturity, with the idea of characterizing the relation between drawing and intellectual capacity, but also to evaluate some traits and projective aspects of personality (Cox, 1993; Goodenough, 1964; Koppitz, 2004). One of the most influential works in this context has been the Human figure drawing Test (HFD) designed by Elizabeth Koppitz (2004), whose results correlated significantly with other tests and Intellectual Quotient (IQ) percentiles. In general, the correlation between the developmental items with mental maturity (Groves & Fried, 1991) and the validity of the test as an approximate measure of a child's intelligence has been corroborated in various studies in which the test has been used as part of a child neuropsychological evaluation (Abell, Von Briesen, & Watz, 1996; Brito, Alfradique, Pereira, Porto, & Santos, 1998; Rae & Hyland, 2001). …