DAP:I~ Female 0 Male 0

Transcription

1 Sectin I. Identifying Infrmatin Name DAP:I~ Female 0 Male 0 Draw-a-Persn Intellectual Ability Test fr Children, Adlescents, and Adults Administratin/Scring Frm Schl Date f Testing Date f Birth Test Age Grade Year Mnth Day Referred by Reasn fr Referral Examiner Sectin II. Recrd f Scres Raw Scre IQ Percentile Qualitative Descriptr ( ) Manual Table 3.1 (page 12) Sectin III. Testing Cnditins A. Place tested I. Other knwn impairments B. Setting 0 Individual Grup Interfering Nt Interfering J. Ntes and ther cnsideratins C. Nise level D. In terru ptins E. Distractins F. Light G. Temperature H. Knwn mtr prblems Sectin IV. Directins Individual Directins: Place the Drawing Frm in the prtrait rientatin in frnt f the examinee alng with a pencil with an eraser. Say, I want yu t draw a picture f yurself. Be sure t draw yur whle bdy, nt just yur head, and draw hw yu lk frm the frnt, nt frm the side. D nt draw a cartn r stick figure. Draw the very best picture f yurself that yu can. Take yur time and wrk carefully. G ahead. If the examinee draws a side view r nly a head, repeat the instructins. A new Drawing Frm may be prvided if needed r requested. The examinee may erase as needed, but d nt prmpt the examinee t d s Hwever, if the examinee asks if it is kay t erase, respnd in the affirmative. Grup Directins: Pass ut the Drawing Frms t all examinees and demnstrate placement f the sheet in a prtrait rientatin. Be sure each examinee has a pencil with an eraser. Say, I want yu t draw a picture f yurself. Be sure t draw yur whle bdy, nt just yur head, and draw hw yu lk frm the frnt, nt frm the side. D nt draw a cartn r stick figure. Draw the very best picture f yurself that yu can. Take yur time and wrk carefull y. Nw g ahead. Raise yur hand if yu have a questin r when yu cmplete yur drawing. Be sure t walk amng the grup and in spect the drawings. If an examinee is bserved t draw a side view r nly a head, repeat the instructins sftly t the examinee. A new Drawing Frm may be prvided if needed r requested. Examinees may erase as needed, but d nt prmpt them t d s. Hwever, if an examinee asks if it is kay t erase, respnd in the affirmative. Once an examinee cmpletes the draw ing, be sure the name r ID number is OnAh t> [{rawing Frm, then cllect the drawing. D nt wait t cllect all the drawings at nce.

2 Scre Sectin V. Scring 1. Head N recgnizable head 1 Any shape recgnizable as a head 2 Oval shaped head, smaller than trunk in height 3 Meets criteria fr 2 pts., IS attached t trs, and has at least 1 feature Nne present 1 Hair present 2 Hair present, placement apprpriate t gender f drawing 3 Meets 2 pts., shws attempt at styling (includes n hair if examinee has shaved head r is bald), and is neatly drawn 3. Eyes Nne present 1 2 eyes present 2 2 val shaped eyes with pupils 2. Hair Meets 2 pts., are prprtinately placed n tp f face, and are grssly symmetrical Nne r present n 1 eye Present n bth eyes 4. Eyelashes Nne r 1 present Present abve bth eyes 5. Eyebrws 6. Nse Nne present 1 Any recgnizable nse 2 Nse is depicted as having at least 2 dimensins (e.g., width, height, depth) and is apprximately centered n the face 3 Meets 2 pts. and clearly shws 2 nstrils I 3,,;},. \ 7. Muth Nne present 1 Any mark recgnizable r intended as a muth 2 Muth IS essentially crrectly placed 3 Tw lips are shwn 4 Meets criteria fr 2 pts. and shws sme attempt at expressin Chin 0 Nne present 1 Any recgnizable chin 2 Chin shws dimensin and is clearly distinct frm neck and trs 9. Ears 0 Nne r ne present (includes lng hair with n ears evident) 1 2 ears are shwn 2 Ears are crrectly placed n sides f head relative t ther features [i: I CJ2 ~J. ;,r " - ~., ~,! ~ Neck 0 Nne present 1 Any Ime recgnizable as a neck is present 2 Neck shws dimensins (ie, nt single stick), but nt cntmuus with trs 3 Neck shws dimensin and is drawn cntmuusly with trs 11. Shu Iders 0 Nne r ne present 1 2 shulders shwing dimensin are present 2 Meets criteria fr 1 pi. and is placed crrectly r nearly crrectly n the bdy; arms are present DAPIQ 2

3 Scre 12. Arms Nne r 1 shwn 1 2 arms are present 2 Arms shw dimensin and are attached at r near where shulders wuld be crrectly lcated Nne r 1 present Elbws shwn n bth arms 13. Elbws 14. Hands Nne r 1 present 1 Tw hands are shwn 2 Tw hands with fingers 3 Tw hands shwing dimensin, with fingers and distinct thumb 15. Trs Nne present r n shape distinguishable frm head and neck 1 Any shape belw and distinguishable frm head and neck 2 Shape at least 2 times the length f head, belw head, and n mre than 5 times the length f the head 16. Waist Nne present Apparent narrwing r divisin f trs at apprximate midline r Just belw midline (may be shwn by clth ing) Nne r 1 present Recgnizable hips present 17. Hips 18. Legs Nne r 1 leg present 2 legs present 2 Legs shw dimensin and are attached t lwer trs at r near bttm f hips Nne r 1 present Knees present n bth legs 19. Knees 20. Ankles Nne r 1 present ~~ Bth an kles present ~~ 21. Feet Nne r 1 present 1 Any shape recgnizable fr 2 feet present 2 2 feet With tes (r shes) present 3 Meets criteria fr 2 pts. and has 10 tes (r shes with at least 2 details) 22. Clthing Nne present 1 Any article f clthing present 2 Clthing with any details present (e.g., buttns, zippers, pckets, lgs) 3 Meets 2 pts., and there are n transparencies unless required by style f clthing Accessries Nne present Any accessries present Mre than 3 accessries present (accessr ies may inc lude extraneus articles, such as Jewelry, purses, backpacks, CD players, bicycles, watches, skates r ther sprts equ ipment, flwers, birds, etc.) " 3 D Raw Scre (frm pages 2 and 3) DAPIQ 3

4 Name r ID number: Drawing Frm Additinal cpies f this frm (# 10698) may be purchased frm 2004 by PRO-EO, PRO-ED, 8700 Shal Creek Blvd, Austin, TX / , Fax , www,predinccm

5 DRAW-A-PERS[]N Name r ID number: ~~~ ~~~ ~~~L-~~ L-+--L~-L-L 2004 by PRO-ED, Inc Additinal cpies f this frm (# ) may be purchased frm PRO-ED, 8700 Shal Creek Blvd, Austin, TX / , Fax 800/ ,

6 DRAW-A-PERSON t \V1. G- 3 rd Drawing Frm Name r ID number: g-j.---d.l.=.::'..(:!.</~c;"_ii_b-\:::;i--'--_~ 1 I q ' q _ Additinal cpies f this frm (#10698) may be purchased frm 2004 by PRO-EO, Inc. PRO-EO, 8700 Shal Creek Blvd., Austin, TX / , Fax 800/ ,

7 DRAW-A-PERSON Additinal cpies f this frm (#10698) may be purchased frm 2004 by PRO-ED, Inc. PRO-ED, 8700 Shal Creek Blvd., Austin, TX / , Fax 800/ ,

8 DRAW-A-PERSON Dr~wing Frm l.lh~u~ C)'..L. Lf----L-+h Name r ID '-'1J'----'n~~f...!.L2._ number: I' " U"' 6v ~-'-!.) I_""'bL:Ke_'_ ' r~2x)...t_"'_i()q Additinal cpies f this frm (#10698) may be purchased frm 2004 by PRO-ED, Inc. PRO-ED, 8700 Shal Creek Blvd, Austin, TX / , Fax 800/ , vvvvw.predinc.cm

9 DRAW-A-PERSON Drawing Frm Name r ID number: D'w \.gq J b, b Additinal cpies f this frm (#10698) may be purchased frm 2004 by PRO-EO, Inc. PRO-EO, 8700 Shal Creek Blvd, Austin, TX / , Fax 800/ , wwwpredinc.cm

10 Drawing Frm NamerlDnumber: Additinal cpies f this frm (# 10698) may be purchased frm 2004 by PRO-ED, Inc. PRO-ED, 8700 Shal Creek Blvd, Austin, TX / , Fa x 800/ ,