Finds Children's Art Helpful in Determining Anxiety, Self-Esteem
Issues Linked to Their Appearance
Evaluating children's artwork helps plastic surgeons determine
their patients' emotions associated with having plastic surgery
to correct congenital, traumatic and aesthetic conditions, reports
the May issue of Plastic and Reconstructive Surgery®, the
official medical journal of the American Society of Plastic Surgeons
Non-verbal communication with art
is a time-tested tool in understanding and interpreting the feelings
of children under stress. Frederick Lukash, MD, assistant clinical
professor of surgery at Albert Einstein College of Medicine in
New York, authored the study and has been a strong proponent of
the tool for more than 25 years. The study includes evaluations
by child psychiatrist Robert Dicker, MD, and art therapist Joan
Alpers, MPS, ATR-BC, CCLS, of 200 drawings that were obtained
from Dr. Lukash's pediatric patients before and after plastic
surgery. The drawings showed marked changes in the self-concept
and body image of the children who drew them. This is the first
study of its kind as it relates to plastic surgery, according
to Dr. Lukash.
"Children typically have difficulty
communicating their emotions to adults," said Dr. Lukash.
"Since 1973, I have encouraged my pediatric patients (aged
4 to 13) to provide me with color drawings before and after surgery.
Their pictures clearly demonstrate very strong emotions around
The 200 drawings evaluated could
be placed into distinct patterns. Before surgery, children often
used exaggerated body parts, faces with tears, dark imagery with
clouds and rain and visual or written expressions of fear regarding
their anxiety and sadness. After surgery, drawings were more colorful,
with frequent use of the sun and body parts appearing more normal.
Overall, boys tended to use the exaggerated body part image more
than girls, who tended to draw themselves as sad and isolated.
The evaluations found clear indications
of low self-esteem, isolation, unhappiness and fear in pre-surgical
drawings. In contrast, the post-surgical art revealed improved
self-esteem, happiness and increased socialization.
"The pictures provide a valuable
opportunity to dialogue with patients and their parents about
feelings and fears and to build relationships based on trust,"
said Dr. Lukash. "For older kids, the use of poems and short
stories can be just as valuable as a picture in identifying their
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