2011. Vol.2, No.4, 376-381
Copyright © 2011 SciRes. DOI:10.4236/psych.2011.24059
Assessment of Drawing Age of Children in Early
Childhood and Its Correlates
Saziye Senem Basgul1, Ozden Sukran Uneri2, Gulcan Basar Akkaya3,
Nilay Etiler4, Aysen Coskun5
1Department of Child and Adolescent Psychiatry, Goztepe Education and Research Hospital,
İstanbul, Turkey;
2Department of Child and Adolescent Psychiatry, Bakirkoy Mental Health, Education and Research
Hospital, Ankara, Turkey;
3Atatürk Faculty of Education, Department of Education for Mentally Handicapped,
Marmara University, İstanbul, Turkey;
4Faculty of Medicine, Department of Public Health, Kocaeli University, Kocaeli, Turkey;
5Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli University, Kocaeli, Turkey.
Received January 24th, 2011; revised March 28th, 2011; accepted May 7th, 2011.
Aim: The drawing ability of children develops parallel to their mental and physical development. The present
study aims to investigate the compatibility of children’s drawings with their mental and physical development
and variables affecting this compatibility in early childhood. Methods: Children between the ages 3 and 5 were
asked to draw a human/child figure on a given sheet of paper and their drawings were analyzed. Results: 175
children were evaluated. The mean age was found to be 3.94 ± 0.81 and the mean drawing age was 3.42 ± 1.75.
The drawing age was found to be statistically lower than the calendar age. It was found that children who had
low birth weights, who did not go to kindergarten and who masturbated had lower drawing age. Low drawing
age was not found to be related with psychological disorders. Discussion: Drawing can be utilized by mental
health professionals as an important assessment tool for young children. Further studies with larger sample sizes
are required to generalize.
Keywords: Early Childhood, Drawing Age, Psychiatry
Children’s drawings have long been utilized to assess per-
sonality traits and psychological disorders of children (Sayil,
2004; Brown & Pipe, 2007; Bonoti & Metallidou, 2010). Some
studies on plastic arts and human psychology aim to detect
direct links between these two domains (Kellog, 1970). A sig-
nificant change occurs in a child’s artistic activities in parallel
with his/her physical and mental development. There are five
periods of development in children’s drawings (Samurcay,
1) Scribbling Period (Age 2 - 4)
2) Pre-symbolism Period (Age 4 - 7)
3) Symbolism Period (Age 7 - 9)
4) Realism Period (Age 9 - 12)
5) Apparent Naturalism Period (Age 12 - 14)
Early childhood, which is also defined as pre-school or play
period, is a period that includes development in physical, cog-
nitive, language, motor and psychosocial domains. Children
between the ages of 2 and 4 who are at the scribbling period
draw random lines and figures on the paper. Human figures
appear in the drawings of children after the age 4 (Senemoglu,
Child drawings are known to be an easy-to-use and often
employed economical method by professionals working with
children (Malchiodi, 1998). A literature review indicates that
there is a scarce number of studies in Turkey on children’s
drawing age and the sociodemographic and psychological cor-
relates. The primary aim of the present study was to detect the
children’s physical and mental compatibility as well as drawing
age through assessing drawings in early childhood. Our second
aim was to find sociodemographic variables affecting drawing
age, and to examine possibly related psychological disorders
while the third aim was to assess the differences between chil-
dren who accepted and did not accept to draw in terms of so-
ciodemographic characteristics, children’s habits and psycho-
logical disorders.
The study was conducted in the center settlement of Kocaeli,
Turkey. It included clinical and population samples. The gen-
eral population sample was selected among 3- to 5-year-old
children (range, 3 years 0 months - 5 years 11 months) residing
in the area served by the Central Kocaeli Health Authority.
There were about 26,000 children in that age group according
to the population data from primary healthcare units for 2004.
The number of subjects to be enrolled was calculated by using
the sample size formula to test a single proportion (Dawson,
1990). In the formula, the probability value (p) was taken as the
incidence of psychiatric morbidity in 3- to 5-year-old children.
The Mental Health Profile of Turkey, published following a
study carried out in 1995 and 1996, reported the incidence of
problematic behavior to be 16.5% for 2- to 3-year-old children
and 16.7% for 4- to18-year-old children (Erol, 2001). In the
present study, the p-value was accepted to be 15%. The calcu-
lation revealed the smallest sample size for the general popula-
tion sample to be 196, and as a result 200 children were en-
rolled in the study. In the clinical sample, a total of 111 children
between the ages of 3 and 5 years (range, 3 years 0 months - 5
years 11 months) admitted consecutively to the Child and Ado-
lescents Psychiatry Clinic in Kocaeli University Faculty of
Medicine between March and September 2006 with various
psychiatric complaints were evaluated and 105 children were
enrolled in the study after 6 were excluded due to unreliable
One of the parents of the child in the field sample was
phoned to provide information about the study and families
who accepted to participate were invited to the health care cen-
ter with their children. One of the parents of the child in the
clinical sample was informed about the aim of the study during
their referral to the Kocaeli University Faculty of Medicine
Child Psychiatry Clinic.
Families in the field and clinical samples were interviewed
for clinical assessment on the basis of the DSM-IV Diagnostic
Classification (Köroğlu, 1994). After the assessment interview,
each child was invited to the drawing room that was designed
to include few stimuli. Children were asked to draw a hu-
man/child figure on a given sheet of paper and the instruction
was repeated one more time without insisting if they did not
want to draw. Drawings of the children were analyzed and the
drawing age was assessed by the third author who was blind to
sociodemographic data and the results of the clinical assess-
ment. Each child was evaluated to determine whether the
drawing age was different from the chronogical age. Children
whose drawing was suitable to their chronogical age were
categorized as “same or high”. If the child’s drawing age was
lower the chronological age, these children were defined as the
“low” group.
Goodenough-Harris Draw-A-Person Test
Goodenough-Harris Draw-A-Person Test aims to measure
mental development (Harris, 1963). It is a drawing test that
gives information about the general aptitude level of young
children. It provides information on mental retardation. How-
ever, it should not be the only test used for assessment. It is not
a periodic test. It is applied individually to children between the
ages of 3 and 14. The test was adapted into Turkish in 1988
(Ozguven, 1996).
Statistical Analysis
Data were analyzed using the Statistical Package for Social
Sciences (SPSS) for Windows, version 10.0. The Pearson chi
square test and Fisher test were employed to compare various
features of the clinical group and population sample. The sig-
nificance level of the statistical tests was set at p < 0.05.
A total of 309 children between the ages of 3 and 5 partici-
pated in the study. Two hundred and four children were in the
field sample while 105 were in the clinical sample. 187 (60.5%)
were boys and 122 (39.5%) were girls. 16 children (11 boys, 5
girls) in the clinical sample and 159 children (82 boys and 77
girls) in the field sample accepted to draw and their drawings
were analyzed. The mean age of these children was found to be
3.94 ± 0.81. The mean drawing age was 3.42 ± 1.75. The dif-
ference between the drawing age and calendar age was statisti-
cally significant in both the field and clinical samples for 175
children who accepted to participate in the study. It was found
that their drawing age was lower than their calendar age.
The differences between the drawing age and calendar age
are presented on Table 1.
There was no statistically significant relationship between
drawing age and gender, maternal employment, presence of
sibling(s), age and education level of parents, psychological
disorders assessed in children, nail biting and finger sucking in
the group of 175 children who accepted to draw pictures.
Drawing age was lower than the calendar age in children who
did not go to kindergarten compared to those who attended
kindergarten, those who had low birth weight compared to
children with normal birth weight, and those who were reported
to masturbate compared to children who did not for the 175
children who accepted to draw pictures (Table 2).
No significant difference was found between two groups in
terms of age when the 309 children were divided into two
groups as children who accepted and did not accept to draw.
There was no gender difference in the group that accepted to
draw but the number of boys was significantly higher in the
group that did not accept to draw. There was no significant
difference between the two groups in terms of education level
of parents, employment status, and kindergarten status. The rate
of children with divorced parents was significantly was higher
in the group that did not accept to draw compared to children
whose parents were together. There was no significant differ-
ence between the two groups in terms of nail biting and mas-
turbation but frequency of finger sucking was significantly
higher in the group that did not draw (Table 2).
It was found that diagnoses of disruptive behavior disorders
were significantly more frequent than other diagnoses in the
group that did not draw. None of the children with a diagnosis
of pervasive developmental disorder accepted to draw. In the
group that did not draw, the frequency of having at least one
diagnosis of psychological disorder was significantly higher
than the group that accepted to draw (Table 3).
In the present study, it was found that for children aged be-
Table 1.
Difference between the drawing age and calendar age in the study
Difference from calendar age No Percent
Same or high 75 24.3
Low (<1 year) 100 32.4
Did not draw 134 43.4
Total 309 100.0
Table 2.
Comparison of the independent variables with the difference from the childrens calendar age.
No. (%) Low (at least 1 age)
No. (%) D i d not draw
No. (%) Total
2 p value
Population sample 67 (32) 92 (45.1) 45 (22.1) 204 111.1 0.00
Clinic group 8 (7.6) 8 (7.6) 89 (84.8) 100
Girls 43 (35.2) 39 (32) 40 (32.8) 122 15.21 0.00
Boys 32 (17.1) 61 (32.6) 94 (50.3) 187
3 31 (27.4) 36 (31.9) 46 (40.7) 113 1.91 0.75
4 22 (21.8) 36 (35.6) 43 (42.6) 101
5 22 (23.2) 28 (29.5) 45 (47.4) 95
Parent Employm ent Status
Working 6 (19.4) 10 (32.3) 15 (48.4) 31 0.57 0.75
Not Working 69 (24.9) 90 (32.5) 118 (42.6) 227
Presence 52 (23.2) 76 (33.9) 96 (42.9) 224 0.99 0.60
Absent 23 (27.4) 24 (28.6) 37 (44.0) 84
Mother’s level of education
Primary school and under 43 (23.0) 69 (36.9) 75 (40.1) 187 4.28 0.11
Secondary school and higher 32 (26.4) 31 (25.6) 58 (47.9) 121
Together 74 (24.7) 100 (33.3) 126 (42.0) 300 8.09 0.01
Separate 1 (11.1) 0 (.0) 8 (88.9) 9
Pre-school education
Attending 21 (27.6) 19 (25.0) 36 (47.4) 76 2.52 0.28
Never attended 54 (23.2) 81 (34.8) 98 (42.1) 233
Birth weight
Over 2500 gr 67 (25.9) 79 (30.5) 113 (43.6) 259 8.10 0.01
Under 2500 gr 4 (12.1) 18 (54.5) 11 (33.3) 33
The age of speaking
Under 9 months 22 (33.3) 25 (37.9) 19 (28.8) 66 15.02 0.005
9 - 16 months 32 (29.1) 38 (34.5) 40 (36.4) 110
Over 16 months 21 (16.7) 37 (29.4) 68 (54.0) 126
Yes 69 77 109 255 6.88 0.032
No 6 23 24 53
Table 3.
Relationship between psychiatric disorders and difference from the childrens calendar age.
Psychiatric Disorders Groups Same/high
No. (%) Low (at least 1
age) No. (%) Did not draw
No. (%) Total
2 p value
Disruptive behavior disorder
Yes 13 (18.1) 18 (25.0) 41 (56.9) 72 7.05 0.02*
No 62 (26.2) 82 (34.6) 93 (39.2) 237
Anxiety Disorders
Yes 14 (19.7) 22 (31.0) 35 (49.3) 71 1.58 0.45
No 61 (25.6) 78 (32.8) 99 (41.6) 238
Mood Disorders
Yes 6 (30.0) 5 (25.0) 9 (45.0) 20 0.66 0.71
No 69 (23.9) 95 (32.9) 125 (43.3) 289
Tic Disorders
Yes 8 (22.9) 7 (20.0) 20 (57.1) 35 3.62 0.16
No 67 (24.5) 93 (33.9) 114 (41.6) 274
Eating Disorders
Yes 8 12 13 33 0.31 0.85
No 67 88 121 276
Elimination Disorders
Yes 5 (13.5) 11 (29.7) 21 (56.8) 37 3.83 0.14
No 70 (25.7) 89 (32.7) 113 (41.5) 272
At least one morbidity
Yes 41 (19.3) 69 (32.5) 102 (48.1) 212 10.2 0.00*
No 34 (35.1) 31 (32.0) 32 (33.0) 97
tween 3 and 6 who drawing age is lower than calendar age both
in the field and clinical samples. Evaluation of the design and
findings of our study did not reveal any finding that may have
led to this situation. The lower drawing ages of the children
accepting to participate in their study compared to their calen-
dar ages may be a characteristic of the sample. The frequency
of drawing was lower in children who applied to the clinic than
in the field sample. This might be related to the children’s
awareness of being in the clinic as a result of their problems.
Children in the field sample were assessed in the registered
health care center without their parents’ application for assess-
ment of psychological problems. This might have led children
in the field sample to have a more accepting attitude. When
field and clinical samples were considered together, the pres-
ence of at least one psychopathology in children who did not
accept to draw might imply that children with psychological
problems have lower compliance to draw in the first meeting. It
might be more suitable to have assessments such as drawing
after an alliance is established with children in clinical settings
(Charman, 2008). Our study supports this recommendation.
When factors related with drawing and calendar age are ana-
lyzed, it was found that gender, education levels of parents and
employment status of the mother did not affect the drawing age
of children but kindergarten attendance, masturbation and fin-
ger sucking were related with a drawing age that is lower than
the calendar age. A review of the literature indicates that habits
like masturbation and finger sucking are more frequent in chil-
dren with inadequate stimulation (Foster, 1998; Lindblad, 1998;
Unal, 2000; Yorukoglu, 2004; Traisman & Traisman, 1958).
Professionals emphasize that the quality of time spent with
children rather than parental education level and employment
status is important for children’s mental development (Gins-
burg KR, 2007). Our findings also underline the importance of
stimulation for mental development of children. The finding
that indicates lower drawing age of children who do not go to
kindergarten is meaningful to show the importance of pre-
school education. Children with lower birth weight are known
to have motor developmental delays more frequently than those
with a normal birth weight (Barnett, 2011). Lower drawing age
in children with low birth rate might be explained by slower
development of fine motor skills in these children.
Two types of usage are found for drawings of a person by
children. The first one is using them for a rough analysis of the
child’s cognitive development as with other visual-motor tests
(Brown, 1990; Cherney ve ark, 2006; Koppitz, 1968). The sec-
ond use is to obtain information on the emotional structure and
or current emotional status of the child (Catte & Cox, 1999;
Matto, 2002, Tharinger & Stark, 1990). The presence of any
psychopathology in the children was not found to affect draw-
ing age. Conduct disorder and major depressive disorder were
found to be significantly higher in children who did not draw. It
might be useful, especially for the clinician, to consider this
finding in clinical application. The findings of the present study
that children with some psychological disorders did not accept
to draw, and that children who have habits that might appear
secondary to inadequate stimulation like masturbation and fin-
ger sucking have lower drawing age support the notion that
drawing is a useful assessment tool for children. There are other
articles on the drawing in children with diffuse developmental
disorder (Evans & Dubowski, 2001; Lee & Hobson, 2006; Ste-
fanatou, 2008). We did not come across any information on
when the drawing activity was held or whether any group re-
fused to draw in these articles. Children with this diagnosis did
not accept to draw in our study. This may indicate that trying to
get children who find it difficult to form social relationships
may not be appropriate. However, we do not know whether
these children accepted to draw in future interviews due to the
design of our study. New drawing studies with these children
could use a study design that also included longitudinal fol-
low-up of children who accepted and did not accept to draw to
determine which visit may be best to use a test such as drawing
Inadequate distribution of sample between field and clinical
samples and small sample size might be considered among the
limitations of the present study. However, when sample size is
evaluated, the fact that clinical interviews were conducted with
all children and their families who participated in the study
should be considered.
A literature review indicates that there is no other study on
the drawing age of children, sociodemographic and psycho-
pathological correlates, accepting to draw and its association
with psychological disorders. Considering the importance of
drawing as an assessment tool for health care professionals,
further studies with larger sample size and more variables are
warranted to generalize assessments of children in the field of
drawing and to utilize findings in clinical studies.
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