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. 2017 Jan-Mar;10(1):24-28.
doi: 10.5005/jp-journals-10005-1401. Epub 2017 Feb 27.

Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale

Jyoti Mathur  1 , Amish Diwanji  2 , Bhumi Sarvaiya  3 , Dipal Sharma  4
Affiliations

Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale

Jyoti Mathur et al. Int J Clin Pediatr Dent. 2017 Jan-Mar.

Abstract

Aim: To develop a simple method to assess the level of anxiety by using children's drawings and correlating them with Frankl's behavior rating scale.

Materials and methods: A total of 178 patients aged of 3 to 14 years were handed out two-page forms which contained three sections on coloring and drawing, along with general information, and Frankl's behavior rating scale for the visit. The three types of drawing exercises given to the patients were geometric copy drawings, coloring a nonthreatening figure, and an empty sheet for freehand drawing.

Results: Out of 178 patients, 60 showed definitely positive behavior, 73 exhibited positive behavior, 37 showed negative behavior, and 8 were definitely negative on Frankl's behavior rating scale; 133 children had none or, 1 stress marker and 45 exhibited 2 or 3 stress markers in their drawings. Chi-square (χ2) analysis was done with a 2 × 2 contingency table. Observed χ2 value was 46.166, which at 1 degree of freedom was much greater than that at 0.995 percentile. Therefore, the result was highly significant.

Conclusion: Children requiring specialized behavioral techniques can be identified by the presence of stress markers in their drawings. This nonverbal activity by itself can have an overall positive effect on the behavior displayed in the dental clinic.

How to cite this article: Mathur J, Diwanji A, Sarvaiya B, Sharma D. Identifying Dental Anxiety in Children's Drawings and correlating It with Frankl's Behavior Rating Scale. Int J Clin Pediatr Dent 2017;10(1):24-28.

Keywords: Children’s drawings; Dental treatment anxiety; Stress markers..

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1:
Fig. 1:
Freehand drawing of a natural scene showing mountains and trees done by an 11-year-old patient in the presence of mother showing “cookie cutter” images typical of children in an overcontrolled environment. Incidentally, this patient was “positive” on Frankl’s behavior rating scale
Figs 2A to C:
Figs 2A to C:
(A) Geometric copy drawings done by a 9-year-old female patient displaying Frankl’s negative behavior during dental treatment. These are at the level of copy drawing expected from 41/- to 51/-year age group; (B) coloring task left incomplete by the same patient as in 2A; and (C) no clarity of thought, disjointed figures, and no resemblance to any object in freehand pencil drawings done by the same patient who has drawn in 2A and 2B
Figs 3A to C:
Figs 3A to C:
(A) Geometric copy drawings done by a 9-year-old female patient displaying Frankl’s positive behavior during dental treatment, showing clear, bold, age-appropriate pattern; (B) neatly completed coloring task using multiple colors by the same patients as in 3A; and (C) clarity of thought and proportion in detailing with multiple human figures drawn by the same patient as in 3A and 3B
See this image and copyright information in PMC

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