The Arts in Psychotherapy, Vol. 27, No. 3, pp. 179 190, 2000 Copyright 2000 Elsevier Science Ltd.

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KINETIC FAMILY DRAWING SCORING METHOD FOR CROSS-CULTURAL STUDIES

PATRICIA WEGMANN, MD, and VIJA B. LUSEBRINK, PhD, ATR-BC*

Introduction Culture shapes the psychology of individuals. Emotions are probably similar for all humans, however, the expression of emotions is indeed culturally mediated. Most of the techniques used in psychotherapy and for assessment were developed by Americans or Europeans. More and more often, therapists are confronted with people from different cultures and feel the need to adapt their techniques to fit the cultural background of their patients. Research is needed to examine the influence of different cultures on psychological techniques and to verify the validity of assessment tests used on patients from these cultures. Family patterns and social interactions vary widely from one culture to another. Kinetic Family Drawing (KFD; Burns & Kaufman, 1970), a widely used projective drawing assessment test to measure family dynamics, is a promising test for cultural studies. It was developed in the United States by two American authors, Burns and Kaufman, who empirically defined the criteria of analysis over several years. In their detailed review of the literature on the KFD technique, Handler and Habenicht (1994) listed studies that investigate cultural norms. Many clinicians appear to use the KFD test with non-Caucasian populations without considering the impact of the childs culture on the drawing (Cabacungan, 1985; Fukada, 1990; Ledesma, 1979; McNight-Taylor, 1974). Some

authors compared the KFD test with other psychological tests to verify its validity for non-CaucasianAmerican children (Cho, 1987; Shaw, 1989). These authors made the assumption that the other psychological tests used are valid for non-Caucasian-American populations. Research that investigates the validity of the KFD test with non-American children is rare. A few studies compare American-Caucasian KFDs with those drawn by children from other cultures; and they usually conclude that there are cultural influences on the drawing results. Chuah (1992) compared KFDs of Chinese-American families with those of Caucasian-American families. She concluded that KFDs illustrate cultural influences, and that KFDs are probably a useful tool to investigate the acculturation process (i.e., the assimilation of the American culture by the Chinese-American families). Nuttall, Chieh, and Nuttall (1988) compared KFDs of Chinese children from Beijing with those of American children. They concluded that the drawings reflect the social values and norms of the two cultures. Urrabazo (1986) compared KFDs of Hispanic children with Burns and Kaufmans normative sample and ascertained differences in the activities of the parental figures. Chartouni (1992) compared KFDs of AmericanLebanese children with KFDs of American-Caucasian children. Chartouni concluded that the KFD test is a useful tool to show cultural differences in family life-

Patricia Wegmann is a psychiatrist and psychotherapist in private practice (CH-1052 Le Mont, Switzerland), who is completing work on her medical PhD at Geneva University, Switzerland. Vija B. Lusebrink is Professor Emerita and resides in Palo Alto, California. The authors wish to thank Franc ois Ferrero, Stephan Morgenthaler, Alain Wegmann, Holly Cogliati, Janis Yoshikawa and Sue Parker for their assistance on this study. 179

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WEGMANN AND LUSEBRINK mans writings (1970, 1972), we looked through the drawings and subjectively chose the objects and symbols most frequently drawn by the children in this study. The 20 variables are organized into six categories: 18 are descriptive features and 2 are numerical measurements. Family Composition The first category analyzes the family members that are drawn, or not drawn, and their sizes. We focused on the major figures: the self, the mother and the father. This category contains four variables. Major figure missing. Burns and Kaufman (1972) proposed a variable called omission of figures whereby they search for any family members missing. As the definition of family members may vary widely from one culture to anothernuclear families or extended familieswe found it interesting to compare the presence or absence of the major figures between the cultures. Hence, we define major figure missing as a major figure that is left out of the drawing. Major figures erasure. Burns and Kaufman (1972) proposed a variable called erasure where they search for any erasure on the figures of family members. With the same reasoning as above, we decided to focus on the erasure of only the major figures. The KFD authors did not define erasure. We define major figures erasure as a significant erasure of the self, mother or father where the Gestalt of the figure is altered. We believe that an erasure of a detail that is redrawn in a similar way does not have the same meaning as a significant erasure, which indicates ambivalence towards the figure. Extended family members added. In their cultural studies, Nuttall et al. (1988) and Chuah (1992) observed whether extended family members were drawn. As the definition of family varies from one culture to another, we found it very promising to add a variable related to the extended family. Therefore, we define extended family members added where any members other than self, mother, father or siblings are drawn. They are counted and scored accordingly. Size of figures. Burns and Kaufman (1972) proposed to measure the size of figures in their KFD grid and analysis sheet. They felt it could be a useful variable for cultural studies. Unfortunately, they did not define how to measure the figures, especially when they are curved or partially hidden. We define size of figures as the measurement, of the major fig-

styles. Unfortunately, none of these authors described their methods clearly. When they presented their scoring sheets, usually there were no clear definitions of the variables. Consequently, a duplication of their studies, or the application of these studies to children from other cultures, is not possible. This is all the more unfortunate because there is no consensus on the scoring method used for the KFD. We agree with Handler and Habenicht (1994) when she states, unfortunately, the KFD technique has not been subject to adequate critical research evaluation and, the KFD still remains primarily a clinical instrument with inadequate norms and questionable validity (p. 441). Many authors have criticized Burns and Kaufman for their subjective interpretation of their variables. Most researchers have modified, without consensus, the Burns and Kaufman (1972) scoring system by adding new variables or by modifying their definitions. As a result, the variables are differently interpreted, thereby making the comparison of results difficult or impossible. To be able to study cultural influences with the KFD test, we need a reliable scoring method with clearly defined variables. In order for KFD to be a valid research tool, the definition of the variables must be standardized. The purpose of this study is to describe and validate a scoring method that can be effectively used by other researchers or clinicians and with people from varying cultures. In this article, we focused our attention on the reliability of the variables of three different populations. We combined variables from Burns and Kaufmans (1972) method with variables found through literature review. Then, we collected KFD drawings from children (710 years old) from three different continents. Two judges scored all the drawings. In order to verify the accuracy of the definitions of the variables, we calculated the percentage of identical answers between the judges. We then compared the results among the three populations. We hypothesized that this scoring method is reliable and that its reliability is independent from the cultural background of the child. Scoring System We set a scoring system combining criteria used in other studies with Burns and Kaufmans (1972) criteria. And we added a few new criteria of our own. We determined a set of 44 variables, including 24 objects and symbols. Inspired by Burns and Kauf-

KFD SCORING METHOD ures, in millimeters following the midline of the body. If a figure is curved, its size is measured as the shortest distance between the head and the feet. If a figure is partially hidden, the judge only measures what is drawn, without estimating the probable size of the figure. Distance and Closeness The second category explores the relative position between the figure of the self and the parental figures. It contains five variables. 1. Distance between figures. Burns and Kaufman (1972) proposed to measure the distance between the self and the other figures in their KFD grid and analysis sheet. They did not explain how. We define distance between the figures as the closest distance between any body parts of any two major figures. 2. Compartmentalization. This variable proposed by Burns and Kaufman (1970) was not clearly defined despite the numerous examples of drawings given in their books. We propose to define compartmentalization as lines that organize space and structure the entire drawing. In order to be considered as compartmentalization, all the figures must be placed in a compartment. 3. Encapsulation. This is a variable proposed by Burns and Kaufman (1972). They were interested in its presence or absence in the drawing. They gave many examples of encapsulation, but they did not clearly define it. We found it more meaningful to score the encapsulated figures. We define encapsulation as the lines that enclose or encircle a whole figure, as if the figure were in a capsule and separated from the others in its own constrained space. The capsule may border on the edge of the paper. Two figures may be enclosed together. When lines are part of an object, we consider them as an encapsulation only if the figure appears isolated from the others. 4. Barrier. This is a variable proposed by OBrien and Patton (1974). It was widely used with slightly different definitions by many authors (Chuah, 1992; Habenicht, personal communication, April 26, 1996; Elin & Nucho, 1979; Reynolds, 1978). We propose to score barrier when two figures are separated by an object or by linesincluding the lines of a compartment or of an encapsulation. It is sometimes difficult to differentiate between com-

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partmentalization, encapsulation and barrier. Compartmentalization concerns all or most of the surface of the drawing. Barrier concerns the accessibility of any two figures, whereas encapsulation usually concerns one figure, although sometimes many figures may be encapsulated separately or together. 5. Figure ascendance. In their KFD grid and analysis sheet, Burns and Kaufman (1972) proposed to investigate the relative placement of the figures. They suggested that it could be useful information for cultural studies. But they did not explain how to analyse the location of the figures. In her analysis sheet, Habenicht (personal communication, April 26, 1996) defined a figure ascendance variable. She scored the position of the head on the vertical axis. We assume that the position of the figure on the vertical axis, as well as the position on the horizontal axis, provides valuable information. We propose the use of a transparent grid that divides the page in eight parts. If the head is located within two (or more) zones, the zone with the biggest part of the head is scored. Interactions and Relationship The third category analyses the interaction and relationship between the major figures. It contains three variables. 1. Level of interaction. Burns and Kaufman (1972) categorized actions between figures with a concept called field of force. They gave examples, but did not define how they scored these interactions. Koppitz (1983) and Lyons (1993) scored only whether there was interaction between figures. Rather than scoring interaction per se, most of the other authors deduced interaction from other variables. We propose to introduce a level of interaction variable. It scores the degree of interaction between two figures. We score active interaction when two figures are engaged in a shared activity involving action (e.g., playing ball, eating together, speaking to each other) or when the two figures share the same kind of activity (e.g., doing household chores, sharing a picnic). The two figures have a passive action together if they are involved in the same passive activity (e.g., watching TV together, reading books in the same room, standing in the same place, one figure watching the other). Sitting around a table doing nothing is a passive action, whereas sitting around a table talk-

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WEGMANN AND LUSEBRINK Sexual Identification The fifth category assesses the sexual identification of the self. It contains two variables. 1. Self drawn like. Inspired by Habenichts (personal communication, April 26, 1996) similar treatment of figures variable, we propose a self drawn like variable. This criteria is scored if the self figure is drawn like one of the parental figures and differently from the other parental figure: Mother (or father) is scored if the hair or clothing are drawn with similar details, or if the self and the mother (father) are drawn in markedly similar stances. These similarities must contrast with details used for other figures and be obvious. 2. Self sharing activity with. To see if the child feels him/herself closer to one parent than the other, we added a self sharing activity with variable. It is scored if the self figure is doing the same, or same kind of, activity with one parent and not with the other. Developmental Level The sixth category analyzes the developmental level of the child. It contains five variables. 1. Space organization. According to Lowenfeld and Brittains (1987) description of development stages in art, we introduced a space organization variable that scores the representation of space in the drawing. No space organization is scored when there is no sense of spacial organization (i.e., the objects and figures are floating without any relation to one other). One baseline is scored when the figures and objects are organized in a line or when there is one baseline. The drawing suggests that the child has an understanding of 2D. 3D attempt is scored when there is an attempt to represent 3D. For instance, there are many baselines or many points of view in the drawing (i.e., tilting the table so we can see what it is on it). 3D awareness is used when the drawing shows perspective, when there is a sense of depth, and/or when there are objects or figures overlapping. 2. Incomplete body. The completeness of the bodies drawn is another criteria for scoring development level. Each major figure is analyzed separately. The incomplete body variable is scored if arms, legs, trunk, hands or feet are missing; if stick figures are drawn; if there is a poor integration of

ing or eating is an active action. Sitting together each reading separate books is a passive action; if the book is shared it is an active action; if the two reading figures are in separate places, there is no interaction. 2. Facing. In their study, OBrien and Patton (1974) scored if the figures were facing each other or the viewer. They found links between this variable and the notion of self-concept. Inspired by Habenicht (personal communication, April 26, 1996), Cho (1987), and Chuah (1992), we included a facing variable. This variable is scored if a figure is looking towards another figure, rather than towards objects or looking out of the picture. This other figure may, or may not, look back. Each figure is scored separately. If a figure is oriented towards another figure but not looking at it, this variable is not scored. For instance because it is reading a book, the self may be oriented towards the father and not look at him. 3. Level of nurturance. Inspired by Burns (1982) scoring criteria for figure nurturing and by Habenichts (personal communication, April 26, 1996) KFD analysis sheet, we define a level of nurturance variable. It examines the level of nurturance for each major figure. Feeding/holding is scored if one figure is taking care of another in very close contact. If a figure is taking care of another figure without close contact, cooking/setting table is scored. Eating is scored when a figure is eating and taking care of pet/gardening/housework is scored when a figure is taking care of a pet, a plant or the house.

Activities The fourth category analyses the level of activity of the figures. It contains only one variable. 1. Activity level. We simplified Burns (1982) scoring criteria for figure activity level from nine possible answers to five. Running/sport implies that a lot of energy is spent. Walking/doing implies that some movement is drawn, and standing implies that the figure does not seem to move and is standing. Sitting is scored if the figure is sitting, even though it is doing something (like eating) and laying is scored if the figure is laying.

KFD SCORING METHOD body parts; or if a part of the body is cut-off the page. This variable is not scored if parts of the body are not drawn because they are obscured by an object or another figure. Missing facial features are scored separately. 3. Incomplete face. It is scored if eyes or mouth are missing; if part of the face is cut-off the page; or if there is a poor integration of the facial features. This variable is not scored if the nose is missing or if the face is hidden (e.g., because the figures back is turned). 4. Sexual Differentiation. It is scored if the gender of all figures (except young children and babies) is obvious, even though stick figures are drawn. 5. Akinesis. We set an akinesis criteria inspired by Mostkoff and Lazarus (1983) evasion criteria and by Reynolds (1978) motionless or stick figures. This variable rates whether activities or physical stances are drawn. It is scored if all figures are standing facing forwards, as if they were sitting for a snapshot without any orientation to each other or to tasks. It is also scored if the figures are drawn static, despite objects drawn involving an activity or despite the childs verbal description that the figures are engaged in activities. Method Once our scoring method was defined and documented in a manual, we collected KFD drawings from children from three different continents. This study included over 120 children. Thirty-seven children live in a rural town situated near a university city in Switzerland (Froideville, Vaud); 42 children are Taiwanese and live in a university city situated in a rural region in Taiwan (Hsinchu); and 44 children are Californian, living in a university city (Palo Alto). The Taiwanese and the Swiss children were not exposed to cultural influences other than their own (except for TV and McDonalds). For the American children, we chose for the study only those children who, along with their parents, were born in the USA and had never lived abroad. The children of this study were between 7 and 10 years old. They were nonclinical children, i.e., they attended the usual school classes. Each cultural group completed the KFD test at the same time, in their own classroom during their usual art class. The data were collected as part of a battery of tests, including the Bridge Drawing (Hays & Lyons, 1981). For the KFD drawing, they were asked to follow Burns and Kauf-

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mans (1970) instructions: Draw a picture of everyone in your family doing something. Try to draw whole people, not cartoons or stick people. Remember to make everyone doing something (pp. 19 20). The instructions were translated in Mandarin for the Taiwanese children and in French for the Swiss children. They were given a pencil and a sheet of plain white paper (8 11, A4 in Taiwan and Switzerland). When the drawings were completed, the children identified their family members on the drawings. Two judges, independent from the study, scored all the drawings. The judges were graduate students from University of California Berkeley Extension PostMasters Certificate Program in clinical art-therapy. They were trained in art-therapy techniques and understood the variables definitions. Because they did not have much clinical experience with KFD scoring systems, they could easily accept our proposed scoring system. To train the judges to use our scoring method, we asked them to score, following our manual, a few drawings not included in the study. We discussed their answers with them. When they had scored the 121 drawings we compared the scores of the two judges. First we calculated the percentage of identical answers to obtain the degree of reliability for each variable. Then, to compare the reliability results among the three groups of children, we applied the 2 test to verify whether the results were independent from the cultures. Results We decided that a good reliability result is 80% or more of identical answers between both judges. Results between 75% and 80% are acceptable. For the sizes and distances we decided to accept: for short measurements (up to 40 mm) a difference of 4 mm, for longer distances (above 40 mm) a 10% difference with a maximum of 10 mm difference between both measurements. When we compiled the percentage of agreements between both judges for the three samples as a whole, we obtained a high degree of agreement for 80% of the variables. The 24 objects and symbols reached more than 85% agreement between judges, 14 of the 20 variables reached 80% or more agreement, 3 variables attained an acceptable result, and we obtained an insufficient percentage of agreement between the judges for only 3 variables. However, when we separated the agreement results by population, we saw

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Table 1 Reliability of the Objects and Symbols Variables: Identical Answers Between Both Judges
USA A/T House Emphasis on Roof Emphasis on Wall Smoking Chimney Antenna Door Stairs Grid Window Bed Light Roof Figure Cross-shaped Body Cut-off Head Ball Jump Rope Remote Control Device Clouds Sun Moon Stars Snow Pet Coffin Grid
a a

Taiwan %
b

Switzerland % 100 85 70 95 90 88 98 93 85 88 100 93 95 95 95 98 98 98 93 100 100 100 100 79 A/T 35/37 36/37 34/37 36/37 34/37 35/37 35/37 36/37 30/37 34/37 37/37 36/37 37/37 35/37 37/37 34/37 37/37 36/37 37/37 37/37 35/37 36/37 37/37 32/37 % 95 97 92 97 92 95 95 97 81 92 100 97 100 95 100 92 100 97 100 100 95 97 100 86 global %c 98 93 87 98 94 93 98 96 88 91 100 95 98 95 98 96 98 98 98 99 98 98 99 86 2d

A/T 41/41 36/42 29/41 40/42 38/42 37/42 41/42 39/42 35/41 37/42 42/42 39/42 40/42 40/42 40/42 41/42 41/42 41/42 39/42 42/42 42/42 42/42 42/42 33/42

42/43 42/43 42/43 43/43 43/43 40/42 43/43 42/43 42/43 40/43 43/43 41/43 42/43 41/43 42/43 42/43 42/43 43/43 43/43 42/43 42/43 41/43 42/43 40/43

98 98 98 100 100 95 100 98 98 93 100 95 98 95 98 98 98 100 100 98 98 95 98 93

14.5*

3.7

A agreement: Number of identical answers; T total: Number of answer. % percentage of identical answers. Global % percentage of identical answers for the (3) populations. d 2 test result for the three populations. * Level of significance p .01.
b c

that these good global results were sometimes misleading, and that they may hide conflicting results between the three samples. Twenty-two of the 24 objects and symbols still had a high percentage of agreement between judges for each population (see Table 1). The grid symbol and the emphasis on wall symbol attained good results for the Swiss and the American samples only. They had a lower result for the Taiwanese population (79% for grid and 71% for emphasis on wall).The difference for emphasis on wall is highly significant with the Chi-square test (2 14.5, p 0.01). Differences in reliability results are more frequent with the descriptive and measurable variables (see Table 2). Only 7 of the 14 variables that obtained good global results showed good results for each of

the three populations without significant difference among them with the Chi-square test: major figure missing, major figures erasure, extended family members added, distance between figures, encapsulation, self sharing activity with and incomplete face. Four other variables had good global results; but when we calculated by population, we found good results for one or two populations and only acceptable ones for the other(s): size of figure, level of interaction, level of nurturance and space organization. These four variables have global results around 80% and the Chi-square test did not indicate any significant difference among the three samples. Six variables revealed statistically significant differences of reliability among the three samples. Sometimes these differences were found only for one

KFD SCORING METHOD

Table 2 Reliability of the Descriptive and Measurable Variables: Identical Answers Between Both Judges
USA A/T Omission S M F Erasure S M F Extended Figures Sizes S M F Distances S/M S/F M/F Compartmentalization Encapsulation S M F O Barrier S/M S/F M/F Figures Ascendance S M F Interaction S/M S/F M/F Facing S/M S/F M/S M/F F/S F/M
a a

185

Taiwan %
b

Switzerland % A/T % Global %c 2d

A/T

42/43 43/43 43/43 30/37 34/36 30/35 38/42 29/33 30/33 26/29 23/24 25/27 24/29 41/43 34/37 32/35 31/32 37/42 25/30 22/29 22/32 37/37 34/35 31/32 26/31 24/28 24/30 26/30 28/28 26/30 27/30 25/28 28/30

98 100 100 81 94 86 90 88 91 90 96 93 83 95 92 91 97 88 83 76 69 100 97 97 84 86 80 87 100 87 90 89 93

42/42 42/42 41/42 32/36 34/38 37/38 41/42 29/36 29/37 31/38 27/30 31/31 31/35 33/42 30/36 34/38 36/38 36/42 30/33 28/32 36/37 29/36 33/38 32/38 30/33 30/32 35/37 33/33 30/32 31/33 34/37 30/32 32/38

100 100 98 89 89 97 98 81 78 81 90 100 89 79 83 89 95 86 91 88 97 81 87 84 91 94 95 100 94 94 92 94 84

37/37 37/37 36/37 29/32 23/25 19/22 36/37 23/28 17/22 16/21 19/20 18/19 20/20 33/37 28/32 24/25 21/22 30/36 15/22 14/20 17/22 28/32 23/25 19/22 17/22 18/20 19/22 13/21 18/20 16/22 19/22 17/22 22/22

100 100 97 91 92 86 97 82 77 76 95 95 100 89 88 96 95 83 68 70 77 88 92 86 77 90 86 62 90 73 86 85 100

99 100 98 87 92 91 95 84 83 83 93 96 89 88 88 92 96 86 82 79 80 90 92 89 85 90 88 86 95 86 90 88 91

1.8 1.1 1.6 0.6 3.5 2.9 0.7 2.5 1.7 0.9 2.2 3.8 5.7* 1.2 0.9 0.2 0.3 4.7* 2.5 10.2 7.6** 2.6 3.1 1.9 1.1 3.3 15.2** 2.6 4.9* 0.5 1.1 4.6*

A agreement: Number of identical answers; T total: Number of answer. % percentage of identical answers. Global % percentage of identical answers for the three populations. d 2 * test result for the three populations. * Level of significance p .05. ** Level of significance p .01.
b c

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Table 2 Continued
USA A/T Nurturance S M F Activity Level S M F Self Drawn Like Self Share Activity Space Organization Incomplete Body S M F O Incomplete Face S M F O Sexual Differentation Akinesis
a

Taiwan %
b

Switzerland % A/T % Global %c 2d

A/T

32/37 27/35 28/32 24/37 21/35 23/32 29/36 33/36 34/43 29/38 31/35 23/32 27/42 35/38 33/36 30/32 37/42 31/42 26/42

86 77 88 65 60 72 81 92 79 76 89 72 64 92 92 94 88 74 62

35/36 35/38 34/38 26/36 10/38 28/38 23/33 33/33 35/42 29/36 27/38 28/38 24/41 31/34 32/38 32/38 34/41 34/41 27/42

97 92 89 72 26 74 70 100 83 81 71 74 59 89 84 84 83 83 64

30/32 22/25 21/22 17/32 8/25 13/22 13/21 19/21 29/37 27/32 22/25 19/22 21/35 28/32 25/26 21/32 28/35 23/35 33/35

94 88 95 53 32 59 62 90 78 84 88 86 60 88 96 94 80 66 94

92 86 90 64 40 70 72 94 80 80 82 76 61 90 90 81 84 75 72

3.1 3.5 0.9 2.7 9.5** 1.5 2.5 3.1 0.4 0.7 4.6* 1.7 0.3 0.4 2.6 2.5 1.0 3.0 12.1**

of the figures tested. Barrier results were good for the Taiwanese sample, insufficient for the Swiss sample and were not homogeneous for the US sample (S/M 83%, S/F 76%, M/F 55%). The Chi-square test confirms significant differences for the pairs S/M (2 4.7, p 0.05) and M/F (2 10.2, p 0.05); it did not for the pair S/F. The incomplete body variable did not display homogenous results. The Swiss sample had good results for the three major figures. The US sample showed a good result for the mother, an acceptable for the self and an insufficient for the father. The Taiwanese sample obtained acceptable results for the mother and the father figures and a good result for the self. The Chi-square test demonstrated a statistical difference only for the mother figure (2 4.6, p 0.05). For the other figures, other than the major ones, the results were insufficient for the three populations. The facing variable rates six combinations of figures. Results for these six combinations were not homogeneous. Half of these combinations had good results and showed no significant differences. The other half

showed significant differences: The Swiss sample attained insufficient results for S/M (62%, 2 15.2; p 0.05) and M/S (73%, 2 4.9; p 0.05). The Taiwanese sample got a lower but still good result for the combination F/M (84%; 2 4.6, p 0.05). Compartmentalization attained good results for the American and the Swiss samples. The Taiwanese result was significantly, statistically lower (79%, 2 5.7, p 0.05). Figure ascendance obtained good results for each population. The American sample had higher agreement between the judges when the self figure was rated (2 7.6 , p 0.01). For the mother and the father figures, there was no significant difference between the populations. Akinesis got an insufficient global result; the result for the Swiss sample was excellent (94%), whereas the results were insufficient for the US (62%) and the Taiwanese (64%) samples. These differences were confirmed with the Chi-square test (2 12.1). Three variables attained insufficient results. Sexual differentiation had an global result of 75%. The Tai-

KFD SCORING METHOD wanese sample was good (83%), whereas the US (74%) and the Swiss (66%) were insufficient. The Chi-square test did not confirm these differences. Self drawn like got an insufficient global result. The results were insufficient for the Taiwanese (70%) and the Swiss (62%) samples, but it was good for the American sample (81%). These differences were not confirmed with the Chi-square test. Activity level attained insufficient results for all samples. Discussion When we compiled the three samples as a whole, the good reliability results were misleading: only three variables seemed to have insufficient agreement between judges. However, when we calculated the reliability results for each population and compared them, we noticed that there are statistically significant differences among the three populations. A good overall reliability result for one variable may hide an insufficient percentage of agreement between judges for one population; or conversely, an insufficient global result may hide a good reliability result. For the objects and symbols we obtained good global results. When these results were detailed, we noticed that the reliability was good for the three samples except for the grid and the emphasis on wall symbols. These symbols attained an good reliability result for the Swiss and the American samples only and got a lower result for the Taiwanese population. The grid symbol still attained an acceptable result (79%) and the Chi-square test does not conclude to a highly significant difference (2 3.7). Emphasis on wall did not reach a sufficient percentage of agreement for Taiwanese sample (71%) and this result indicates highly significant differences with the Chisquare test (2 14.5). We assumed that emphasis on wall was not clearly defined. As the Taiwanese children draw more often houses than the American and Swiss children, they draw more walls, thus increasing the opportunities for disagreement between judges. For the twenty variables that are not object or symbol the situation is more complex. Only seven variables attained good reliability results for each sample: major figure missing, major figures erasure, extended family members added, distance between figures, encapsulation, self sharing activity with and incomplete face. The Chi-square test did not indicate any significant difference among the three samples. We concluded that these seven variables are reliable and that their reliability is independent of the thee

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cultures tested. Four variables reached an average result barely above 80% of agreement between both judges: size of figure, level of interaction, level of nurturance and space organization. When the reliability was computed for each sample, the result for one population was below the threshold of 80%. As the Chi-square test did not show significant differences among the results of the three samples and, as each of the results were above 75%, we consider the results for each population as good. These 11 variables attained good reliability results without significant differences between the three samples. They may be used for cross-cultural studies with the three populations tested. We noticed that even the variables that rely on subjective appreciation, such as erasure (changing a Gestalt), or encapsulation (being separated from the others), obtained a high percentage of agreement between both judges. For six variables, the reliability compiled by populations brought to our attention statistically significant differences between the three samples. Sometimes these difference were found only for one of the figures tested. Compartmentalization attained a good global reliability result. The results for each sample show significant differences, with a lower but still acceptable result for the Taiwanese population (2 5.7). Taiwanese children tend to draw X-ray houses with each family member placed in a different room. When the house occupies the whole surface of the paper, the drawing gives an impression of compartimentalization and was usually rated as such by the judges. Most of the disagreement between the judges occurred when X-ray houses were drawn only in a part of the page and did not involve all of the paper. The discrepancy between reliability results attract our attention on this Taiwanese feature and raise the question if these X-ray houses may be considered as compartimentalization or not. We wonder if our definition of the variable compartimentalization includes two different features. This question is all the more interesting since the interpretation of the variable compartmentalization, proposed by Burns and Kaufman (1972), is debated. Some authors agree with them: Reynolds (1978) defined it as a sign of inhibition of strong emotions; isolation; inability to communicate openly. Other authors suggested another definition; for example, McPhee and Wegner (1976) concluded in their study that

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WEGMANN AND LUSEBRINK Compartimentalization seemed to appear repeatedly in those drawings (both adjusted and disturbed) depicting the family members engaged in roles associated with the typical American household. Perhaps in an effort to impose clarity and order on this assortment of activities, the subjects employed the use of lines to separate the various figuresthus producing the style defined as Compartmentalization. (p. 490) in Swiss drawings then in American or Taiwanese drawings. The reliability results for the variable incomplete body are intriguing as they differ from one figure to the other. For the self figure, the reliability is good whereas for the father figure it is insufficient. For these two figures there are no significant differences between the three samples. On the other hand, for the mother figure, the Taiwanese reliability result is significantly statistically lower with an insufficient percentage of agreement between the jugges, while the reliability result is good for the two other populations. We have no hypothesis for the reason for the discrepancies of the results. However, we suppose that the disagreements between judges are related to the way children at these ages draw hands and feet. Often these features are suggested and not clearly drawn. We assume that if we had defined more clearly this variable, especially the minimum features needed for hands and feet, it would have improved the reliability results. The result of this variable for other non-major figures is not reliable. A drawing could contain together complete and incomplete other figures. The scoring of the other figures is debatable because they must be scored all together as complete or incomplete. Figure ascendance also attained intriguing results. The American sample had significantly statistically higher agreement between the judges when the self figure was rated. For the mother and the father figures, this variable did not show significant difference between the populations. We have no hypothesis for this inconsistency between the figures results. We obtained low reliability results for akinesis except with the Swiss children. The scoring sheets show that one judge scored akinesis on only one drawing. The other judge scored this variable many times, especially with the Taiwanese and American drawings. This leads to more disagreement about these cultures than the Swiss culture. The definition of this variable is not clear as it was obviously understood differently by each judge. Nevertheless, it would be interesting to clarify the definition to find out if this variable is actually distributed differently in the three cultures. The variable activity level, obtained a low reliability result for all samples. We made the hypothesis that the variables definition was not accurate enough. During the schematic stage, at least in the early phase, children have a poor ability to draw figures in a clearly recognizable activity. Hence the poor results

Hence, comparison with other variables that give information about family member interactions and activities might help us to better interpret this variable: Does it indicate separation and/or lack of communication; or, does it indicate a tendency to organize, structure space and roles of family members? With the barrier variable we reached an overall reliability result near 80%. The Taiwanese drawings had a better reliability result than the Swiss and American ones, with a statistically significant difference for the pair mother/father (2 16) and for the pair self/mother (2 4.7). If we calculate the reliability for the American and Swiss drawings only, the results will be below 80% (77% for self/mother; 77% for self/father and 66% for mother/father). As the Taiwanese drawings more often contained compartmentalization, the barriers between the pairs of figures were more obvious. Thus it led to a higher percentage of identical answers between judges. Studying the American and Swiss drawings that got different scores for this variable, we noticed that most divergences occurred when an object or another figure only partially separated the pair of figures. We can improve our definition if we take partial separation into account. In addition, it would be useful to separate barrier from the lines of compartmentalization as these two variables might indicate different features. The good reliability result of the facing variable is misleading. Only the result of the Swiss drawings for the self/mother pair of figures was insufficient. Actually, the variable was not present at all in the American drawings and only rarely in the Taiwanese, but it was present a few times in the Swiss drawings. The Swiss children tried, more often than the others, to represent figures facing each other. The way the variable is defined does not allow for the ambiguity of the drawing done by children that do not master the skill to draw figures in profile. Studies would be useful to confirm if this variable is actually more often present

KFD SCORING METHOD of activity level can be attributed to the developmental level of the children of the study. The judges probably had to guess the type of action drawn, thus adding an important subjectivity to the result. It was probably difficult for them to decide if the figure was simply standing or actually doing something. The majority of disagreements were between the categories of answers standing and doing. If we combine these two categories together and keep as multiple choices: moving, standing, sitting and laying, the result is good with no significant difference with the Chi-square test among the cultures (Self: 82%, 2 0.9; Mother: 91%, 2 0.3; Father: 87%, 2 2.7). We obtained an insufficient percentage of agreement between judges for the sexual differentiation variable with the Swiss and American children but not with the Taiwanese. For this variable, all the figures of the drawing were scored together. The drawings showing partial differentiation got arguable scoring. The Swiss and American drawings often contained figures that were sexually recognizable and some that were not. In the Taiwanese drawings, most of the figures present a sexual differentiation and reach a 83% of identical answers between the judges. We assume that if we had proposed a third possibility, partial differentiation, or if the major figures were scored separately, we would have had a better reliability result. Conclusion To analyze drawings from children of different cultural backgrounds, we propose a revised scoring method for the KFD test. We verified the reliability of the method and demonstrated the importance of clearly defined variables and the necessity to test the reliability of the variables with each cultural sample. We demonstrate that clinicians must be very carefull when applying the KFD test with children from another cultural background than the one it was designed for. Indeed, a variable may be reliable with one cultural sample, but not necessarily with another. Many variables obtained statistically significant different reliability results from one population to the other. Most of the time these differences were due to a different distribution of the variable between the samples. If a variable is more frequent in one population and if its definition is not clear, then we may have more disagreement between the judges for this population than for the others. A more interesting reason for variations in the

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reliability results among the populations is when a variable was defined so that two different features were scored together. For instance, the Taiwanese children often drew X-ray houses with the rooms laid out over the whole page. This feature looked like compartmentalization and was scored as such. Disagreement occurred when X-ray houses were not spread over the whole page. This leads us to wonder if these X-ray houses are to be considered as compartmentalization or some other feature. This brings a new argument to the debate of the interpretation to be given to this variable: does it indicate a lack of communication or a tendency to structure and organize. Additional studies are needed to answer the question whether the different distribution of the variables between populations is a consequence of an insufficient variable definition, or a sign of cultural influence on the personality. Before this method could be applied with confidence in clinics, further studies are needed to learn if the variables can predict phenomena of clinical importance. The purpose of this article is the description and the verification of the applicability of this scoring method for cross-cultural studies, thus we focused on the cultural differences in the reliability of the variables. We did not analyse here the differences of the distribution of the variables among the populations. Such analysis and the discussion of their clinical implications will help to verify the relevance of this method in clinics. It will be the topic of a future article. In addition to finding cultural differences in the reliability of the variables, this study shows that the contribution of cross-cultural studies is to question and thus to clarify the definitions and interpretations of the KFD variables. Cross-cultural studies of the test improve our understanding and use of it by challenging us to verify the validity of the definition of the different variables, even when the test is used with population for whom it was designed.
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