(DDS) using the (DAF)

In class tonight, the assignment was to bring in the DDS Assessments administered to an acquaintance or client.

Our instructor told us to blog our experience using the Drawing Analysis Form (DAF) to analyze the DDS.

The Drawing Analysis Form is a rater for the Diagnostic Drawing Series. The categories; color type, blending, idiosyncratic color, line/shape, integration, abstraction or representation, ground-line, people, animals, inanimate objects, abstract symbols, word inclusion, landscape, line quality/pressure, line length, movement, space usage, tree, tilt, and unusual placement, are incorporated. All three DDS drawings are rated in all listed categories. Specific guidelines for each category are to be followed when rating.

Using the DAF to analyze the DDS was a tedious process, but helped me gain a more in depth perspective on the artwork analyzed as well as a deeper understanding of the DAF. Overall, I enjoyed implementing the DAF to analyze the DDS.

Lowenfeld

-Thanks for this, Jac!

Discuss developmental creative markers & Lowenfeld’s developmental levels.

“Many art therapy practitioners believe that assessments provide increased understanding of a client’s developmental level, emotional status, and psychological framework.” (Betts)

1. The Scribbling Stage: Beginning of Self-Expression (2-4 years)

2. The Preschematic Stage: First Representational Attempts (4-7 years)

3. The Schematic Stage: The Achievement of a Form Concept (7-9 years)

4. The Gang Age: The Dawning Realism (9-12 years)

5. The Pseudo-Naturalistic Stage: The Age of Reasoning (12-14 years)

6. Adolescent Art: The Period of Decision (14-17 years)

(Taken from Creative and Mental Growth 8^th ed, by Viktor Lowenfeld and W. Lambert Brittain)

bEnDeR-gEsTaLt

The Bender-Gestalt is a developmental assessment test for children and is used in screening for psychopathology in adults. This test is individually administered. It can assess achievement, I.Q., as well as brain damage. In addition, the Bender-Gestalt screens for visual disorders. The Visual Gestalt function is a fundamental function associated with language ability and is closely associated with various functions of intelligence such as visual perception, manual motor ability, memory, temporal and spatial concepts and organization. Some visual disorders this test can reveal are the following:

Agnosia – inability to visually identify

Hemianopia – half loss of visual field

Scotoma – small lesions, spots in visual field

Optic Ataxia – deficit in visually guided hand movements

Prosopagnosia – facial agnosia Alexia – inability to read

Neglect

The readings for class discussed the six designs (A, 1, 2, 4, 6, and 8) of the test. Then the six-point scoring system was explained as being devised for greater differentiation in scoring each design. Scoring ranged from 0 (random drawing, scribbling, having no concept of the design) to 3 (all major elements present and recognizable with only minor distortions) to 5 (accurate representation). The article does not capture the entire design.

See article below:

Bender Gestalt.pdf

Clock Drawing Test (CDT)

The Clock Drawing Test (CDT) is a screening test sensitive to cognitive impairment and dementia. It is used as a measure of spatial dysfunction and neglect. Participating in the CDT requires verbal understanding, memory and spatially coded knowledge as well as constructive skills.

The CDT can be administered in different ways. The " free-drawn method" is when the participant is instructed to draw a clock from memory and there is no time limit. In the "pre-drawn" method, the participant is given a piece of white paper with a circle and is instructed to draw a clock. Typically, they are expected fill in the numbers and can be asked to draw the hands at a specific time (usually 10 past 11). And finally, during another method, the participant is asked to draw the hands at a specific time on a pre-drawn clock, complete with contour and numbers.

Because there are various ways to administer the CDT, there are different ways of scoring. To make it more simple, I am going to give an example of a test completed by one of my clients.

I am currently an intern at the women's prison. A few weeks ago, my supervisor (the Psychologist at the prison), was concerned about an inmate in terms of memory impairment. Throughout their session, she lost her "train of thought" numerous times and also reported short term memory loss. My supervisor asked me to work with the inmate and present an assessment that would be sensitive to what appeared to be cognitive impairment in this inmate. Both the Psychiatrist and Physician were also scheduled appointments with the inmate.

I decided to administer the CDT during the session (see photo). I gave her the "free drawn method" and instructed her to place the hands at 10 past 11. The participant placed all of the numbers in the correctly, but was not able position the hands at the specified time. The re-tracing of the hands is to be noted as it increases the score.

The method of evaluating the drawing was according to Sunderland's criterion. The results indicate a score total of 6 out of 10.

Diagnostic Drawing Series

Patients are instructed to create 3 drawings. (1. make a drawing with materials provided- no directions, 2. make a drawing of a tree, 3. make a drawing of how they feel)

This assessment is a series of three drawings that are based on:

1. Graphic characteristics are graded

2. Empirical correlation between graphic characteristics and psychopathology

The graphic profile of a client should enable art therapists to give an indication of a possible diagnosis.

There is uncertainty about the reliability and validity of the DDS.

Some concerns include:

-inter-rater reliability of 3 different raters

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Raters are important to eliminate bias and subjective data.

Three ways influences that the DDS determines to be effective

1. the rating of characteristics themselves (color types- understanding the difference between)

2. placing patients within a graphic profile

3. distinguish between 2 populations because of results

Tri-level

DDS Website

CRIT CARD

The Crit Card Method, created by Tom Anderson, involves a communicable aspect of art criticism. He stated that “the art critic’s task, then, is to look at works of art and their contexts to see what they tell us about the human condition” The Crit Card Method is an “interactive model of educational art criticism” consisting of four primary processes: 1) general reaction, 2) description of thematic, formal qualities, or intended emotional impact, 3) interpretation, and 4) evaluation.

CLICK HERE FOR CRIT CARD ARTICLE

I will implement Crit Card 1 on ONE of my favorite works of art ( I can't have ONE favorite!).

The work of art chosen to critique is titled Down with Inflation by Martin Kippenberger.

1) What is your first reaction to the piece?

"Hmmmm this seems a little absurd. I wonder why his pants have fallen off."

2) How does this make you feel?

"At first I feel entertained and lighthearted, but then I feel perplexed."

3) What does it make you think of ?

"It makes me think of a man that should be in distress, but does not appear to be worried."

4) What does it remind you of?

"It reminds me of the photo I secretly took of my friend standing in front of the painting (see below). We found it to be quite humorous!"

Thematic Apperception Test (TAT)

The Thematic Apperception Test (TAT) is a projective assessment including a series of pictures. The participant is instructed to create a story about what they believe is happening according to the pictures displayed. This test reveals some of the "dominant drives, emotions, sentiments, complexes and conflicts of personality" (Murray, 1943). It can also expose inhibited tendencies the subject is not willing to admit or cannot admit because he is unaware of them.

The TAT is to be administered in an interpersonal setting, but responses can be taped if the examiner is absent. 20 cards with ambiguous pictures are presented to the participant.

There are extensive directions for this assessment I am not going to discuss further.

Here is an article about the TAT:

Article

I hope to use this assessment someday in order reveal various inhibited conflicts in personality of a client.

House Tree Person (HTP)

The House Tree Person (HTP) Assessment was designed to reveal information about a client's personality, patterns in behavior, and interpersonal relations. It is also an assessment of brain damage or overall intellectual functioning. The participant is to draw a house, tree, and person. Each image (house, tree, and person) has been viewed as a psychological self-portrait.

I enjoyed participating in this assessment during class. I drew my parents house and the big tree to the left of it. I also added a person (me) swinging from that particular tree. We did not have a swing in that tree, but I loved to swing in the backyard trees. We did not have much time to process this assessment, so I cannot go into more detail about the outcome of my HTP assessment.

The Assessment Interview

There are important interviewing procedures to take into consideration while administering assessments.

-Unstructured vs. Structured Interview

-Interviewer Bias

-Behavior Observations

-Mental Status Exams

-Idiosyncratic Features

-Person's reaction to current life situation

These procedures are vital to remember as they contain information that may be unobtainable otherwise.

Assessments

How is diagnosis related to the use of assessments?
-comparing scores (typical vs. atypical)
-behavioral observations (compare and contrast pre-test and post-test)

What is an Art Therapist's role in diagnosing?
- Able to implement assessments that validate reasoning behind the diagnosis.

- The behavior and artwork link to previous research.

The use of the DSM-IV-TR is vital when using assessments. Assessments can affirm and confirm a diagnosis. A drawing can be compared with a self report, while talk therapy cannot.

Click here for an informative link about Projective Assessments

Example of KFD (By: Me!)

The Kinetic Family Drawing (KFD) is a projective assessment that is used widely. This assessment contains 5 items to study that include; family members, position of self image, distance from self image to other individuals, the size of figures, and action of figures. The purpose of this assessment is to observe the dynamic relations within families.


Posted below are 2 articles that discuss the KFD assessment.

1. Article

2.Article