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Original article  317

Screening intelligence of primary school children using

Draw‑a‑Person test
Ali M. El‑Shafiea, Dalia M. ElLahonya, Mohamed A. Samira, Khaled M. Biramb

Paediatric Department, Faculty of Medicine,

a
Menoufia University, Menoufia, bPaediatric
Department, El‑Amreya General Hospital,
Alexandria, Egypt
Correspondence to Khaled M. Biram, MBBCH,
Pediatric Department, El‑Amreya General
Hospital, 23 Ali Heba Street, Sidi Bishr,
Alexandria, Egypt
Tel: +20 100 318 8432;
Postal code 21611
e‑mail: khaledbiram64@gmail.com
Received 19 August 2017
Accepted 29 November 2017
Menoufia Medical Journal 2019, 32:317–322
Objectives
The aim of this study was to screen intelligence among primary school children using
Draw‑a‑Person test (DAP) in Alexandria, Egypt.
Background
DAP test was created by Dr. Florence Goodenough in 1926. It measures multiple developmental
streams of progress like learning, cognitive, visual, and motor by having the child to draw any
person, with scoring based according to the presence and quality of features. By comparing
the raw score to the typical rates of drawing, the child’s intelligence quotient (IQ) is obtained.
Patients and methods
This study was carried out on 1000 apparently healthy primary school children aged from 6 to
12 years in Alexandria, Egypt. Students were subjected to medical evaluation. Parents were
given a personal/family data questionnaire by the students to assess their socioeconomic
standard (SES), which also contained a part for the student’s medical history to exclude any
serious medical problems or chronic diseases that might affect test score. School achievement
data were obtained from student’s school file. Thereafter, the students performed the test.
Results
The study showed that the number of children with gifted intelligence was 24 (2.4%), with
superior intelligence was 85 (8.5%), with average intelligence was 816 (81.6%), with borderline
intellectual function was 41 (4.1%), and lastly, with mild and moderate mental retardation was
34 (3.4%). Positive correlations were found between IQ and SESs, school achievement, and
residence. No correlation was found between IQ and sex.
Conclusion
The DAP test provides pediatricians with an easy and low‑cost developmental screening
device, alerting them to the possibility of developmental disorders.

Keywords:
achievement, cognition, intellectual disability, intelligence tests, pediatricians

Menoufia Med J 32:317–322

© 2019 Faculty of Medicine, Menoufia University
1110‑2098

the Goodenough‑Harris test, it has guidelines for

Introduction
Draw‑a‑Person test  (DAP) is a projective test that
allows an examinee to respond to questions through
drawings. Projective tests can be applied in various
settings such as schools, corporations, and private
practices to assess many psychological aspects including
personality, family background, intelligence, physical
and emotional abuse, and depression. [1].
Dr.  Goodenough first became interested in figure
drawing when she wanted to find a way to supplement the
Stanford–Binet intelligence test with a nonverbal measure.
The test was developed to assess the maturity in young
people. Dr. Goodenough concluded that the amount of
detail involved in a child’s drawing could be used as an
effective tool. This led to the development of the first
official assessment using figure drawing, which was the
DAP test. Over the years, the test has been revised many
times with added measures for assessing intelligence [2].
Harris later revised the test, with features including
drawings of a woman and of themselves. Now considered
assessing children from age 6 to 17 years. Harris assumes
that changes in the child’s drawings of a man or a woman
represent the development of cognitive complexity or
intellectual maturity expressed by increasingly complex
representations of the human figure. He regards the
child’s concept of a human figure as an index or sample
of their concept generally. As Cox [3] in a comprehensive
review notes that in Western cultures ‘children progress
from a period of scribbling to the production of tadpole
forms, and then to conventional forms, at first composed
of segmented body parts, and then later of more
contoured and integrated sections’.
The aim of our study is to screen intelligence among
primary school children using DAP test in Alexandria,
Egypt.
This is an open access journal, and articles are distributed under the terms
of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0
License, which allows others to remix, tweak, and build upon the work
non‑commercially, as long as appropriate credit is given and the new
creations are licensed under the identical terms.

1110-2098 © 2019 Faculty of Medicine, Menoufia University DOI: 10.4103/mmj.mmj_580_17

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318  Menoufia Medical Journal, Volume 32 | Number 1 | January-March 2019
Patients and method
After approval of the Local Institutional Ethical
Committee of educational affairs of Alexandria and
obtaining written consents from all student’s parents
to participate in our study, the study was carried out on
1000 apparently healthy primary school children aged
from 6 to 12  years from July 2015 to October 2016.
This study involved a mixture of both rural and urban
cultures.
Parents were given a questionnaire by the students
inquiring about their telephone number, full name,
date of birth, and any serious medical problems
in the past, and it also included degree of parents’
education, occupation of husband, family size, and
monthly family income to assess socioeconomic
standard (SES).
All study children were subjected to medical evaluation
to exclude any chronic clinical problems.
School achievement was obtained by the marks of the
previous year using subject’s school records. Marks
of the children from junior one class were obtained
from the midterm, and then school  achievement  was
classified according the most common grading scale:
grade A (90–100, excellent), B (80–89, above average),
C  (70–79, average), D  (60–69, usually the minimum
passing grade), and F (0–59).
DAP test was  performed  with test instructions, and
test setting included a child seated comfortably at
an individual table with enough space to draw freely.
Before asking the student to complete the DAP test,
we  provided  the following: full understanding of the
instructions to the children involved in study, sufficient
lighting, avoidance of distractions and noises, and
materials such as a pencil with soft lead and a sheet of
paper placed on the table.
Administrator requested the children to DAP with
no time limit and did not make any comment on the
drawing or ask the child to correct any details, as this is
not an art lesson but an attempt to ascertain the child’s
concept of the human figure.
Children who refused to draw were encouraged, and
if they did not respond, they were given another time
for testing.
After children had completed the test, drawings were
rated according to the DAP scoring system to be
converted to intelligence quotient  (IQ) by modified
Harris scoring guide [4].
The following features were evaluated in the DAP test:
Gross details
Head present, legs present, arms present, trunk present,
length of trunk greater than breadth, and shoulders
are indicated  (abrupt broadening of the trunk below
the neck).
Attachments
Both arms and legs attached to the trunk, arms and
legs attached to the trunk at the correct points, neck
present, and outline of neck, continuous with that of
head, trunk, or both.
Head details
Eyes present (one or two), nose present, mouth present,
nose and mouth in two dimensions, two lips shown, nostril
shown, hair shown, and hair on more than circumference
of head and nontransparent – better than scribble.
Clothing
Clothing presents (any clear representation of clothing),
two articles of clothing nontransparent  (e.g.,  hat
and trousers), the entire drawing free from
transparencies  –  sleeves and trousers must be shown,
four articles of clothing definitely indicated such as
hat, shoes, coat, shirt, necktie, belt and trousers, and
lastly costume complete with incongruities such as
business suit and soldier’s costume, and hat, sleeves,
trousers, and shoes must be shown.
Hand details
Fingers present  (any indication), correct number of
fingers shown, fingers in two dimensions  –  length
greater than breadth, the angle subtended not greater
than 180 degrees, opposition of thumb clearly defined,
and hand shown distinct from fingers and arm.
Joints
Arm joint shown  –  elbow, shoulder, or both, and leg
joint shown – knee, hip, or both
Proportions
Head not more than half or less than one‑tenth of
trunk, arms equal to trunk, but not reaching knee, legs
not less than trunk not more than twice trunk size, feet
in two dimensions – not more than one‑third or less
than one‑tenth of leg, and both arms and legs in two
dimensions.
Motor coordination
Lines firm without marked tendency to cross, gap, or
overlap; all lines firm with correct joining, outline of
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head without obvious irregularities. Develop beyond
the first crude circle, conscious control apparent,
trunk outline. Score same as 3, arms and legs without
irregularities. Two dimensions and no tendency
to narrow at the point of junction with trunk, and
features symmetrical (more likely to credit in profile
drawings).
Fine head details
Ears present  (two in full face, one in profile). Ears
present in correct position and proportion. Eye
details – brow or lashes and pupil shown; proportion:
length greater than width; eye detail  –  glance  –  only
plus in profile; and chin and forehead shown.
Profile
Projection of chin shown in profile, and heel clearly
shown. Body profile  –  head, trunk, and feet without
error, and the figure shown in true profile without error
or transparency.
For example, if a boy is aged eight years, and his raw
drawing score was 40, then the IQ was 112 by data in
reference table.
Then, the student’s IQ was classified according to
Sattler. The Stanford–Binet Intelligence Scale fourth
edition is as follow: very gifted, 145–160; gifted,
130–144; superior intelligence, 120–129; high average
intelligence, 110–119; average intelligence, 90–109;
low average, 80–89; borderline impaired, 70–79;
mildly impaired, 55–69; and moderately impaired,
40–54.
In our study, we further classified the obtained IQ
scores into five classes: gifted group included very
gifted and gifted scores, 130–160; superior intelligence,
120–129; average included high and flow average,
80–119; borderline impaired, 70–79; and mild and
moderate impaired, 40–69; the results were statistically
analyzed by SPSS, version  20  (SPSS Inc., Chicago,
Illinois, USA).
Two types of statistics were done: descriptive was done
using percentage  (%), mean, and SD, and analytical
one using Student’s t‑test, which is a single test used
to collectively indicate the presence of any significant
difference between two groups for a normally
distributed quantitative variable.
One‑way analysis of variance  (ANOVA)  (F test):
ANOVA is a single test used to collectively indicate
the presence of any significant difference between
several groups for a normally distributed quantitative
variable.
Draw‑a‑Person test El‑Shafie et al.  319
Post‑hoc test: it is a test used after one‑way
ANOVA (F test) or Kruskal–Wallis test to show any
significant difference between the individual groups.
P  value is considered significant if P is less than or
equal to 0.05.
Results
A total of 1000  patients were involved: 423  (42.3%)
females and 577  (57.7%) males. The age range of
the patients was 6–12  years, with the mean age of
8.17 ± 1.6 years. A total of 256 (25.6%) of them were rural
residents and 744 (74.4%) were urban residents. Children
were classified into low SES children 327  (32.7%),
average SES 418 (41.8%), and children with high SES
255 (25.5%). As regarding school achievement, children
were divided into four groups: grades A, B, C, or D,
accounting for 187 (18.7%), 378 (37.8%), 263 (26.3%),
and 172 (17.2%), respectively (Table 1).
The study revealed some points regarding IQ as follows:
First, the number of children with gifted intelligence
was 24  (2.4%), superior intelligence was 85  (8.5%),
those having average intelligence was 816  (81.6%),
borderline intellectual function group was 41  (4.1%),
and lastly, 34 (3.4%) children had mild and moderate
mental retardation (Table 2).
Second, strong positive correlation was found between
SES and IQ levels; those with higher SES have higher
IQ scores  (111.25) in comparison with those with
average (104.18) and low SES (92.67) (Table 3).
Table 1 Distribution of the studied children regarding their
characteristics
Characteristics n=1000
Age (years)
Mean±SD 8.17±1.6
Range 6‑12
Sex [n (%)]
Female 423 (42.3)
Male 577 (57.7)
Residence [n (%)]
Rural 256 (25.6)
Urban 744 (74.4)
SES [n (%)]
Low 327 (32.7)
Average 418 (41.8)
High 255 (25.5)
School achievement [n (%)]
A 187 (18.7)
B 378 (37.8)
C 263 (26.3)
D 172 (17.2)
SES, socioeconomic standard.
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320  Menoufia Medical Journal, Volume 32 | Number 1 | January-March 2019

Third, children living in urban areas had higher IQ
levels  (104.32) compared with those living in rural
areas (97.52) (Table 3).
The fourth finding was the positive correlation between
IQ levels and school achievement; children with high
school achievement  (grade  A) achieved the highest
DAP test score (112.16) and IQ level among the whole
studied sample, and vice versa (Table 3).
the assessment of neural and psychological functions
in children and adolescents [5].
Many studies have been conducted all over the
world to find the effect of many risk factors on child
cognition. The education, occupation, and income
of parents  –  indices of the family’s SES  –  have been
found to moderate the heritability of their children
intelligence, as stated by Turkheimer et al. [6].

The fifth point is there was no significant difference in Because there are many risk factors that contribute
IQ levels between males and females (Table 3). to cognitive achievement, examining these factors
in a cumulative risk model is valuable because the
cumulative risk may be more influential than any
specific risk factor alone in predicting negative child
Discussion development outcomes [7].
The assessment of intelligence has a long controversial
history. However in recent years, one area that has Cox and Howarth [8] reported significant differences
received more intense focus on the study of it has been in drawing by normal children and by children with
developmental delays lagging 4  years behind the
Table 2 Distribution of the studied children regarding normal.
intelligence quotient level
n=1000
This study, regarding IQ results, revealed some findings.
IQ level
Mean±SD 99.73±15.47
First, from Table  2, the mean IQ  (99.73  ±  15.47) is
Range 57‑142
considered higher than IQ measured by many previous
Classification [n (%)]
Very gifted and gifted (130‑160) 24 (2.4)
studies that performed to assess international IQ in
Superior intelligence (120‑129) 85 (8.5) many countries worldwide. For example, according
Average intelligence (80‑119) 816 (81.6) to one study (Flynn effect in Turkey), the population
Borderline intellectual function (70‑79) 41 (4.1) was estimated to have a mean IQ of 87.41 points by
Mild and moderate mental retardation (40‑69) 34 (3.4) DAP test in turkey in 1977 and a mean IQ of 90.93
IQ, intelligence quotient. points [9]. Moreover, in another study (the DAP test
for Ghana), the estimated mean IQ was 88 (male) and
Table 3 Distribution of sex, residence, socioeconomic 84 (female) by DAP test in Ghana [10].
standard and school achievement regarding intelligence
quotient level (n=1000)
The second point from Table  3 was no significant
IQ level Test of P Post‑hoc test
(mean±SD) significance
difference in IQ levels between male and female. This
Sex is similar to a study conducted by Flynn et al. [11], who
Female 99.99±16.56 t=0.48 0.627 ‑ found that male and female obtained roughly equal IQ
Male 99.57±14.53 scores on Raven’s progressive matrices after reviewing
Residence recent standardization samples in five modernized
Rural 97.52±17.80 t=2.09 <0.02* ‑ nations.
Urban 104.32±14.75
SES On the contrary, Lynn [12] stated that although it
Low1 92.67±15.74 F=96.58 <0.001* 1 vs. 2, 1 vs.
is correct that there is no sex difference in average
3, 2 vs. 3
Average2 104.18±14.26
intelligence between the ages of 5 and 15 years, from
High3 111.25±10.78 <0.001* the age of 16 years, males begin to have greater average
School intelligence than females.
achievement
D1 83.64±21.23 F=109.79 <0.001* 1 vs. 2, 1 vs. This disagrees with a 2004 meta‑analysis by Irwing
3, 1 vs. 4, et  al. [13] who found that the mean IQ of male
2 vs. 3, 2 vs.
4, 3 vs. 4 exceeded that of females by up to five points on the
C2 90.53±9.15 Raven’s progressive matrices test.
B3 105±12.29
A4 112.16±11.40 The third finding  (Table  3) states that children
IQ, intelligence quotient; SES, socioeconomic standard. who lived in an urban area had higher IQ levels in
*Significant. comparison with those lived in rural areas, which
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may indicate strong positive correlation between
residency and cognitive functions. This supports the
study conducted by Emmett, which showed that the
rural school children obtained lower scores than urban
children, and that the spread in intelligence among
them was also smaller [14].
Tabriz et  al. [15] found that  the  children’s IQ , as
determined by the Wechsler Intelligence Scale for
children, administered as part of the study, was
positively related to living in metropolitan and urban
areas and the level of the children’s fathers’ education.
On the contrary, Naomi et al. [16] in a study ‘Stability
and Change in Children’s Intelligence Quotient
Scores’ found that IQ was lower among urban
children than those of rural residence. Further research
directed to investigate the relation between children
IQ and residence may be helpful in recognizing the
residence‑related causes that may affect IQ levels,
such as quality of education, nutritional status, genetic
admixture, and pollution.
The fourth finding from Table  3 also shows that a
strong positive correlation was found between SESs
and IQ levels; those children living in high SES have
higher DAP test scores and IQ levels in comparison
with those with average and low SES.
This finding agrees with Fernald et  al.  [17], who
found a positive correlation between SESs and IQ
levels; children who live in high SES have a higher
IQ. Children from disadvantaged family backgrounds
score on average lower on intelligence tests than their
higher SES peers  [18], and their performance has
been suggested to worsen over time, even if they did
relatively well in early assessments. Conversely, high
SES children are thought to gain in intelligence over
time, even if they initially had a lower test score [19].
We think that this may be because of specific risk factors
related to the SES, such as lack of family resources and
parental support, which may lead to low IQ levels.
Sirin [20] conducted a meta‑analysis based on data
of roughly 100 000 students, and he found a weak to
moderate relation between cognitive ability and parental
SES. This finding is similar to what was reported by
1996 American Psychological Association task force’s
report on intelligence. Given this correlation, the
question arises as to whether it is IQ or SES which
causes a variation in the other variable. The answer is
almost certainly both [21].
The fifth finding from Table  3 was the positive
correlation between IQ levels and school achievement;
those children had higher school achievement ‘grade A’
Draw‑a‑Person test El‑Shafie et al.  321
had the highest DAP test scores and IQ levels among
the whole studied sample, and vice versa.
Our study came in line with a study in UK schools was
to relate scores on statewide standardized achievement
tests to measures of cognitive skills in a large and
representative sample of students in a city that includes
traditional district, exam, and charter public schools.
They found substantial positive correlations between
cognitive skills and achievement test scores, especially
in math. These correlations are consistent with
prior studies relating working memory to academic
performance (grades) in UK schools [22].
According to Laidra et al. [23], students ’achievement
relies most strongly on their cognitive abilities through
all grade levels.
Conclusion
From the results of the study, IQ levels obtained
by DAP test were positively correlated with SESs,
residences, and school achievement. No correlation
was found between IQ levels and sex.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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