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Using the Draw-A-Man Test as a Personal Neglect Test
The purpose of this study was to determine the validity of a Draw-A-Man test in measuring personal neglect in patients with a stroke affecting the right side of the brain.
The Draw-A-Man test was administered to 51 individuals with a right CVA and 110 age-matched individuals without any brain insult. Individuals who displayed homogeneous bilateral representation of body parts were considered not to have personal neglect and those showing unilateral body parts were administered to the participants with right CVA to validate the Draw-A-Man test.
Personal neglect is a disorder of body scheme. It is seen more often in individuals with a right CVA than in people with left CVA. Individuals with severe personal neglect are usually unaware of the left side of their body, or could be unable to recognize that their numb left extremities exist. People with mild personal neglect may be aware of their left extremities but still may hardly use them and refer to them as objects even if they are not motor impaired.
The hypothesis of this Draw-A-Man test that the author of this article, Mei-Jen Chen-Sea, had established was that “the type of man drawn could reflect the level of functional performance and that persons with personal neglect would be less independent with ADL performance than those without personal neglect.”
These participants had to meet the following criteria: a) post-onset 2-6 months, b) participated in rehabilitation program, C) independent in self-care prior to stroke, D) able to follow directions, E) adjusted to medication, F) right hand dominant.
Fifty-one people completed these consent forms, of which 38 were men. The mean age was 59.41+-8.66 years and the mean duration post onset was 109.31+-62.26 days. 25 individuals had had hemorrhage CVA’s and 26 had had infarctions.
Of the normal participants without CVA’s, which equaled 110 individuals, 70% were men. The mean age was 56.79+-10.98 years.
Out of the 51 participants with cerebrovascular accidents, 38 were considered without personal neglect. This therefore proved that the Draw-A-Man test can discriminate those with or without personal neglect within a group of right brain stroke victims.
With a Pearson chi-square test, it showed no difference in gender distribution between the group with personal neglect and the group without neglect. The group with personal neglect had severe deficits in somatosensory, motor and muscle strength.
Using the Klein Bell Activities of Daily Living (ADL) Scale, the group with personal neglect displayed lower scores in each ADL category than the group without personal neglect. The scores for this Scale are 0-103 for dressing, 0-46 for elimination, 0-68 for mobility, 0-56 for bathing, 0-30 for eating, and 0-10 for emergency phone communication. This is a very precise chart since it documents the slightest change in their performance.
The conclusion of this overwhelming test is that since the group without personal neglect were rated with having intact body scheme proves that the Draw-A-Man test can discriminate individuals with personal neglect in terms of a drawn man. For visual evidence and more detail of this conclusion, see following pages for charts.
Word Count: 514
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