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Journal of Clinical Child and Adolescent Psychology Copyright © 2005 by

2005, Vol. 34, No. 4, 706–711 Lawrence Erlbaum Associates, Inc.

Race and Ethnic Differences and Human Figure Drawings:

Clinical Utility of the DAP:SPED
Holly C. Matto
School of Social Welfare, University at Albany, State University of New York
Jack A. Naglieri
Center for Cognitive Development, George Mason University

This study examined race and ethnic differences on the Draw A Person: Screening
Procedure for Emotional Disturbance (DAP:SPED; Naglieri, McNeish, & Bardos,
1991) for youths 6 though 17 years of age for 2 matched samples. Samples were
drawn from the DAP:SPED nationally representative standardization sample and
matched on gender, grade, and school classroom. No statistically significant differ-
ences were found for big figure, small figure, or shading item composites. A statisti-
cally significant difference was found between Black–White pairs on figure omissions
but showed a small effect size (d value = .25). Further, no statistically significant dif-
ferences were found between the DAP:SPED Total T scores for Black and White youth
(M = 47.67, SD = 10.09; N =138) or Hispanic and White youth (M = 48.20, SD =
9.56; N = 59), showing very small effect sizes. In addition, equivalence testing
showed similarities across race and ethnic pairs for all composites and DAP:SPED
total score, lending preliminary support to the DAP:SPED’s clinical utility as a mea-
sure that yields similar scores across these groups.

Use of human-figure drawings remains a controver- based on specific aspects of the human-figure drawing
sial topic and an example of the disparities between lack both validity and reliability, a composite or global
research and practice. Although human-figure drawing system could be more effective. The approach that
is among the most widely used psychological tests by Naglieri et al. used in the development of their Draw A
clinicians (Camara, Nathan, & Puente, 2000), the va- Person: Screening Procedure for Emotional Distur-
lidity of the technique has been questioned for some bance (DAP:SPED) test substantially improves on
time (Roback, 1968; Swensen, 1957, 1968). Recently, these earlier psychometric deficits and, as such, has led
researchers have again cautioned against the use of some researchers to conclude that it is the “most
most projective techniques, including human-figure psychometrically advanced of the human-figure draw-
drawing tests. For example, Garb, Wood, Lilienfeld, ing instruments” (Matto, 2002, p. 221).
and Nezworski (2002) have been most critical of the Researchers have found, for example, that the
approach, stating that human-figure drawings signifi- DAP:SPED has validity for identification of youths
cantly lack validity. with emotional or behavioral disorders. In one study,
Naglieri, McNeish, and Bardos (1991) argued that the DAP:SPED was found to successfully differentiate
human-figure drawing systems have low reliability and conduct and oppositional defiant disorder and control
validity for several reasons. First, the scoring rules are group youths (Naglieri & Pfeiffer, 1992). Similarly,
often ambiguous, leading to low interrater as well as special-education students with identified emotional
intrarater reliability. Second, the lack of an objective disturbance were differentiated from regular-education
standardized scoring system as well as a nationally students (McNeish & Naglieri, 1993) using this scor-
representative normative sample for the calculation of ing system.
standard scores have resulted in poor psychometric In a recent study, Matto (2002) found that
qualities, which limit clinical interpretation of test re- DAP:SPED scores were related to internalized behav-
sults. Third, although interpretation of individual signs ioral disturbance in youths receiving clinical services
through outpatient or residential treatment centers and
Holly C. Matto is now at the School of Social Work, Virginia offered predictive ability above and beyond a standard
Commonwealth University. paper-and-pencil measure of internalizing disturbance.
Correspondence should be addressed to Holly C. Matto, School
of Social Work, Virginia Commonwealth University, 1001 W. Frank-
However, the DAP:SPED did not show significant pre-
lin Street, PO Box 842027, Richmond, VA 23284–2027. E-mail: dictive ability for externalizing disturbance above and
hcmatto@vcu.edu beyond a standard paper-and-pencil measure of ex-


ternalizing disturbance in this study. Hit rates or other metric experts reject the use of mean score differences
indicators of magnitude were not reported by these au- as evidence of test bias (see Reynolds & Kaiser, 1990),
thors. In a dissertation study, Matavich (1998) exam- mean score differences among racial groups can be
ined the DAP:SPED scores of delinquent adolescents viewed as an indication of test bias if construct-irrele-
with emotional or behavioral disturbance who were vant variance systematically caused the differences
placed in highly restricted educational or correctional (Messick, 1995). Messick suggested that social value
settings for a variety of problems, including sexual of- consequences related to construct-irrelevant variance
fenses (N = 154). Results showed the delinquent group (e.g., bias attributed to race that affects how scores
mean score was significantly higher than a matched are interpreted and acted on) is an important compo-
control group (N = 154) with an effect size d value nent of traditional validity testing. This study contrib-
of 1.6. utes to preliminary exploration of the DAP:SPED’s po-
The accumulation of evidence from these validity tential for score differences by racial and ethnic group
studies on the DAP:SPED has led researchers critical membership.
of projective tests to conclude that “there is some evi- Equivalence tests, along with traditional signifi-
dence that the DAP:SPED (Naglieri et al, 1991) can be cance tests, can provide a more comprehensive under-
used to screen for mental disorders among children” standing of equivalence across groups related to a
(Garb et al., 2002, p. 459). However, the differences meaningful clinical criterion, rather than as difference
found in the existing literature regarding the nature of from zero. Current clinical research often includes ef-
emotional and behavioral disturbance (internalizing or fect sizes and equivalence testing, in addition to tradi-
externalizing) that the DAP:SPED predicts indicates tional significance testing, in presentation of cross-
that more validation work is needed to refine assess- group results (Jaccard & Guilamo-Ramos, 2002; Pina,
ment understanding along these behavioral dimen- Silverman, Fuentes, Kurtines, & Weems, 2003; Rog-
sions. Additional study of this approach, therefore, is ers, Howard, & Vessey, 1993).
warranted. Naglieri et al. (1991) performed a limited examina-
Another important area of further study is examin- tion of race and ethnic differences on the DAP:SPED,
ing the measure’s clinical utility across different race but their analytic methods did not examine composite
and ethnic groups. The potential differential utility of scores across race and ethnic groups or include equiva-
measurement instruments across groups has been of lence testing procedures. Specifically, prior work did
considerable interest to researchers who have devel- not match race or ethnic pairs on important demo-
oped tests for use with diverse groups and for clinicians graphic variables or examine specific DAP:SPED item
who administer, interpret, and make decisions based, composites, such as shading of the figure, that might
in part, on such test results. Studies that ask the ques- represent bias at the item level and contribute to overall
tion of whether race-based test differences exist are differences. This study was conducted to address these
critical for establishing the clinical utility of an instru- limitations. The aims of this study were twofold.
ment and for expanding clinicians’ understanding of a The first study aim was to compare total DAP:SPED
test’s assessment range. This study did not directly test standard scores for Black and White samples, as well
the different negative social consequences related to as Hispanic and White samples, matched on demo-
test application but examined the question of potential graphic variables. Matching procedures were used to
construct-irrelevant variance related to race or ethnicity. select race pairs that were comparable on other vari-
Although race and ethnic differences are often stud- ables, such as grade, gender, and school classroom,
ied for intelligence tests (e.g., Brody, 1992; Naglieri & that could potentially influence DAP:SPED scores and
Ronning, 2000), such comparisons are equally impor- be attributed to race differences. However, in creating
tant for projective tests, particularly for tests that have matched race pairs we recognized that the procedure
the potential to influence the number of minority may have eliminated other “true” differences related to
youths who are placed in special-education programs race not accounted for in the study.
(Messick, 1995). For these reasons, examination of the The second study aim was to examine these race
differences between race and ethnic groups on a scor- and ethnic pairs for differences on four item compos-
ing system such as the DAP:SPED is important, par- ites derived from the human-figure drawing test that
ticularly when minority overrepresentation in spe- could contribute to total score differences.
cial-education programs is of concern (e.g., Oswald,
Coutinho, Best, & Singh, 1999).
Messick (1995) argued that an instrument’s clinical Method
utility must be questioned if the scores it yields con-
tribute to problems such as overrepresentation of mi- The two samples included in this study consisted of
norities in special-education classes for children with Black–White (total N = 276; n = 138 for each race
emotional or behavioral problems (Oswald et al., 1999; group in the pair) and Hispanic–White (total N = 118; n
Reschly & Bersoff, 1999). Although some psycho- = 59 for each race group in the pair) children and ado-


lescents matched on gender, grade, and school class- behavioral problems. Cronbach’s alpha internal reli-
room and drawn from a nationally representative stan- ability estimate of the DAP:SPED is as follows: ages 6
dardization sample (N = 2,355) that mirrored the U.S. to 8 years, .76; ages 9 to 12 years, .77; and ages 13 to 17
population. Data collection was conducted by a private years, .71.
company that followed appropriate procedures and The Matrix Analogies Test–Short Form (MAT–SF;
federal regulations for use of human participants. This Naglieri, 1985) was used as a nonverbal measure of
research was exempt from Institutional Review Board general ability to control for possible differences in
approval because it involved the use of education- ability and was administered in English to all youth at
al tests in typical educational settings and the informa- the time of DAP:SPED standardization. The group-ad-
tion was recorded in such a manner that student con- ministered MAT–SF is composed of 34 progressive
fidentiality was assured. All data collection procedures matrix type items standardized on a sample of 4,750
used were approved by appropriate members of the youths ages 5 through 17 years who represent the U.S.
company. population on a number of key demographic variables.
All youths self-identified as White (European The MAT–SF has been found to possess good reliabil-
American), Hispanic (Spanish-speaking and from His- ity (.83 median internal consistency, Cronbach’s alpha
panic culture), or Black (African American). All estimate). Validity of the test has been demonstrated by
youths in the Hispanic group spoke Spanish and none strong correlations with other nonverbal tests as well as
of the youths in the White group spoke Spanish. The achievement test scores (Naglieri, 1985). Additionally,
average age of the Hispanic–White paired sample was the MAT–SF and its revision, the Naglieri Nonverbal
11.80 years old (SD = 3.14, range = 6.03 to 17.36 Ability Test (Naglieri, 1997), has been shown to yield
years) and the average age of the Black–White paired small mean score differences between White and mi-
sample was 11.30 years old (SD = 3.62, range = 5.05 to nority groups (Naglieri, 1985; Naglieri & Ronning,
17.89 years). There were 45.8% (n = 54) boys and 2000).
54.2% (n = 64) girls in the Hispanic–White matched The samples’ MAT–SF (Naglieri, 1985) mean raw
samples and 47.1% (n = 130) boys and 52.9% (n = 146) scores are as follows: Hispanic (M = 25.23, SD = 6.60)
girls in the Black–White matched samples. This study and White (M = 28.02, SD = 3.47) samples differed
did not include additional standardized measures or somewhat—t = 2.45, p < .05, d value was moderate
administrative reports of youths’ emotional and be- (.53)—but the Black (M = 22.63, SD = 6.77) and White
havioral problems that could have been used to assess (M = 24.32, SD = 5.71) samples were similar—t =
potential differences between the race pairs on re- 1.82, p > .05, d value was small (.27).
ported behavioral problems such as classroom dis-
ruption. However, race pairs were matched by class-
room to create pairs that experienced similar classroom Results
The DAP:SPED was developed using an actuarial Separate analysis of variance procedures were con-
approach to identification of individuals with emo- ducted to examine Hispanic–White and Black–White
tional problems. The scoring system is an objective ap- race differences on DAP:SPED item composites and
proach to determine the frequency with which unusual total T scores. To examine the question of whether mi-
items that may be considered indicators of emotional nority youth might be disproportionately represented
problems occur in nonclinical versus clinical popula- on item composites such as shading, item composites
tions. The scoring system requires the production were analyzed along with the total T scores. Practitio-
of three human-figure drawings (man, woman, self), ners who use the DAP:SPED have consistently argued
which are scored using 55 carefully defined items. Ex- that this is a question that needs answered and that re-
amples of items include failed integration of body search has not yet examined it. For example, many ra-
parts, presence of fists or talons, aggressive symbols, cial and cultural groups may use figure shading to
hands cut off, eyes omitted. The system is normed on more accurately represent skin tone and may do so
2,355 youths ages 6 to 17 years who are representative more frequently than nonminority youth. Given that
of the U.S. population on a number of important demo- the presence of shading is an indicator that increases
graphic variables. According to Naglieri et al. (1991), a youth’s behavioral disturbance score in the total
the sample represents the U.S. population in terms of DAP:SPED calculations, minority youth may show
age, gender, geographic region, race, ethnicity, and so- systematically higher behavioral disturbance scores as
cioeconomic status. Rather than focus on individual in- a function of such test bias rather than reflecting true
terpretation of items, the DAP:SPED is a global system behavioral functioning.
that yields a T score (M = 50, SD = 10), with separate T Other human-figure drawing studies have found
score norms for gender and age. The higher the score, shading, omissions, and figure size to be significantly
the more likely the youth’s drawings are like those pro- related to mental health problems (e.g., poor self-es-
duced by youths who have demonstrated emotional or teem, hostility; Burgess & Hartman, 1993; Burgess,


McCausland, & Wolbert, 1981; Hibbard & Hartman, No significant differences were found between His-
1990; Holmes & Wiederhold, 1982), although conven- panic and White or Black and White matched samples
tional practice is to make assessments from total hu- on the basis of shading item composites, F(1, 116) =
man-figure drawing scores rather than at the item or .014, p = .904, d value = .02; F(1, 274) = 2.852, p =
composite level. .092, d value = .21. Further, no statistically significant
In addition, practicing clinicians using the DAP:SPED difference was found between Hispanic–White youth
have anecdotally questioned the implicit assumption on figure omissions, F(1, 116) = .869, p = .353, d value
that these human-figure drawing constructs (shading, = .17. However, a statistically significant difference
omissions, and figure size) are related to emotional and was found on figure omissions for the Black–White
behavioral disturbance equally for all racial and ethnic sample (Items 24 to 28, 45, 46 summed across man,
groups. To date there has not been any DAP:SPED woman, and self drawings), with Black youth showing
study to test these instrument-utility questions. There- a higher mean score as compared to White youth, F(1,
fore, the four item composites included in this analyses 274) = 4.175, p = .042, d value = .25. Additional analy-
were large figure (Items 1 and 3 summed); small figure ses that partitioned the total figure omission variance at
(Items 2 and 4 summed); figure omissions, to include the item level showed the overall effect not to be statis-
head omissions such as eyes or nose as well as body tically significant, F(1, 274) = 1.379, p = .223, suggest-
omissions such as feet or arms (Items 19 to 28, 45, ing that statistically significant single omission items
46 summed); and shading (Items 30 to 33 summed) cannot be identified in creating a meaningful differ-
summed across man, woman, and self drawings. These ence between these race pairs. Along these lines, no
were included as the dependent variables of interest in statistically significant differences were found be-
the analyses. tween either set of matched pairs on total DAP:SPED
No significant differences were found between the standard score, indicating that the significant differ-
DAP:SPED Total T score means for the Hispanic (M = ence in item composite found for figure omissions on
49.02, SD = 10.34) and White (M = 48.20, SD = 9.56), the DAP:SPED does not seem to contribute to an over-
F(1, 116) = .197, p = .658, or Black (M = 47.99, SD = all total score differentiation between Black–White
10.88) and White (M = 47.67, SD = 10.09), F(1, 274) = race pairs.
.067, p = .796, matched samples, with reported effect To further examine the utility of the DAP:SPED in
size d values for the two matched samples of .08 and assessment with minority youth, equivalence testing
.03, respectively. Similarly, no significant differences using the confidence interval approach (Rogers et al.,
were found between Hispanic and White or Black and 1993; Westlake, 1981) was applied (see Table 1). A
White matched samples on the basis of large figure, 10% equivalence criterion was used for total DAP T
F(1, 116) = .738, p = .392, d value = .16; F(1, 274) = scores for each set of race pairs. As Table 1 shows,
.000, p = 1.000, d value = .00, or small figure, F(1, 116) the 90% confidence interval for both sets of race pairs
= .144, p = .705, d value = .07; F(1, 274) = .185, p = is included within its respective equivalence interval,
.667, d value = .05. demonstrating clinical equivalence across Hispan-

Table 1. Equivalence Testing Using Confidence Interval Approach

Traditional 95% CI Equivalence 90% CI


Total DAP:SPED T Score

Hispanic–White –4.44 2.820 ±4.82 –2.19 3.83
Black–White –2.81 2.160 ±4.77 –1.75 2.39
Large Figure
Hispanic–White –.728 0.288 ±1.22 –0.20 0.64
Black–White –.354 0.354 ±1.31 0.30 0.30
Small Figure
Hispanic–White –.501 0.738 ±1.66 –0.40 0.63
Black–White –.311 0.485 ±1.64 –0.25 0.42
Hispanic–White –.524 0.592 ±1.96 –0.43 0.50
Black–White –.046 0.596 ±1.95 0.01 0.54
Hispanic–White –2.12 0.762 ±8.85 –0.52 1.87
Black–White –1.82 –0.034 ±9.26 0.18 1.68

Note: CI = confidence interval; LCL = Lower confidence limit; UCL = upper confidence limit; DAP:SPED = Draw A Person Screening Proce-
dure for Emotional Disturbance.


ic–White and Black–White race pairs on total DAP T that it is particularly successful in measuring inter-
scores (Rogers et al., 1993). nalizing rather than externalizing behavioral
An equivalence criterion of ±.468 of one raw score disturbance. This study examined a dimension of its
point was used for both the large and small item com- culture-specific utility, offering preliminary evidence
posites, as this fraction represents the estimate for clin- that the DAP:SPED may be appropriately applied
ical significance as scaled to these two 6-item compos- across race and ethnic groups.
ites, using the clinical significance scoring guidelines Further research should be conducted to examine
provided in the DAP:SPED manual. Specifically, this larger, more diverse, and more culturally specific sam-
fraction represents 7.8% of the 6-item total composite ples (e.g., different race and ethnic groups, bilingual
necessary to conclude the lowest threshold for infer- children, cross-cultural populations with specific ac-
ring clinical significance and referring a youth for fur- culturation measures employed) and groups with dif-
ther evaluation. An equivalence criterion of ±.936 of ferent levels of socioeconomic status. An important
one raw score point was used for the 12-item shading limitation of this study is the absence of country of ori-
composite and ±7.02 raw score points was used for the gin data for the youth. New studies should include this
36-item omissions composite, using this same clinical level of detail to examine these culturally specific re-
significance rationale. These calculations were used to search questions.
construct the equivalency intervals, based on the White In addition, new studies that include standardized
group means, and are shown in Table 1. As the results emotional or behavioral measures in the matching pro-
show, all 90% confidence intervals are contained with- cedures across race pairs and that include cross-cultur-
in the equivalency intervals constructed based on clini- ally validated ability measures need to be incorporated
cal cut-off criteria, suggesting equivalence across race into future efforts to broaden understanding of the clin-
groups. ical utility of the DAP:SPED across race and ethnic
groups. Finally, prospective studies that directly exam-
ine the predictive validity of the DAP:SPED should be
Discussion the focus of new research agendas.

In summary, no statistically significant differences

in the item composites tested (i.e., large figure items,
small figure items, or shading) were found for the race References
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Pina, A. A., Silverman, W. K., Fuentes, R. M., Kurtines, W. M., & Received February 26, 2004
Weems, C. F. (2003). Exposure-based cognitive–behavioral Accepted January 26, 2005