INTRODUCTION
METHOD AND PROCEDURE
RESULTS AND DISCUSSION
CONCLUSION
RECOMMENDATIONS
BIBLIOGRAPHY
 

EMOTIONAL PROBLEM OF PHYSICALLY HANDICAPPED CHILDREN IN NORTH WEST FRONTIER PROVINCE (N.W.F.P.), PAKISTAN
Asghar Ali Shah and Maher Bano

From the Department of Psychology, University of Peshawar, Peshawar, N.W.F.P., Pakistan. Address reprint requests to: Syed Asghar Ali Shah, S-3,4, 2nd Floor Bilour Plaza, Saddar Road, Peshawar Cantt, Pakistan.

A sample of 70 physically handicapped children were taken from schools for special education from North West Frontier Province (N.W.F.P.) of Pakistan. Human Figure Drawing test (HFD) was administered and scored according to koppitz's method. It was found that physically handicapped children faced some emotional problems like immaturity, poor adjustment, tendency to withdraw, aggression and anxieties.

Key Words: Physically Handicapped Children, Emotional Problems, Pakistan

INTRODUCTION :
          The term physically impaired includes people who are orthopedically impaired, who have traumatic brain injury or any other illness which limits their physical abilities.
          Physically impaired means a severe skeletal, muscular, or neuromuscular impairment which adversely affects a child's educational performance, and includes impairments resulting from congenital anomaly, disease and other causes. A disabled person runs the risk of isolation in the community and segregation from other people. The most encouraging factor for the disabled is to receive full support, so that he can live as normal a life as possible in the community. He must also be encouraged to take interest in his abilities rather than his disabilities. He is a person with different abilities compared to those of normal people, but that doesn't mean, he lacks abilities. The social and psychological situation of the disabled will be better if those who meet them take interest in their abilities only. The only way of achieving the right attitude towards the disabled is to accept him as a collaborator and fellow member of the community. Many disabled people are anxious and ask for a social system with complete security.
          The physical restrictions and social impoverishment which the handicapped children have, would have an important psychological impact on them and would be reflected in their expressions of personal inadequacy and uncertainty.
          On coming in contact with other children, the handicapped child may use his assistive device or special diet to gain prestige, but he may meet rejection, fear and disgust and do not find acceptance. He may instead focus on his body and its short-comings and feel that he is ugly, useless and is in need of care from his mother rather than face competition with his father and other children.
          Shaffer¹ has described the too cohesive family, where the whole family becomes excessively centered on the handicapped child to the detriment of the emotional growth and functioning of the family unit. This appears to be a way of avoiding damaging conflict and tension.
          Genetic counseling, like blaming the parents to convince the handicapped child that he is always right, maintain his ideas of omnipotence and egocentricity and prevent the development of an empathic appreciation for the feelings and needs of others. Frustration is reacted with justified aggressive outburst. Alternately, with the urge to make sure of his own state of existence, his pain, discomfort, clumsiness, stiffness of failure to comprehend or to be understood, he may attribute his difficulties to actions of parents and other children in the family rather than his handicap. This may lead to a variety of symptoms of aggressiveness, fears and obsessionality.
          It is particularly difficult for handicapped adolescents to discover exactly who they are and perhaps more importantly to discover what sort of men and women they are going to be in adult life.

METHOD AND PROCEDURE :
Sample
          A sample of 70 physically handicapped children was selected randomly from different schools for physically handicapped children (Special Education) aged 5 to 15 years.

Material
          A paper and pencil were used for the purpose of drawings. A manual for interpretation and a list of emotional indicators by Koppitz² were used.

Administration of the test
          The human figure drawing test (HFD) was administered individually as well as in a group form. The children were instructed to draw a complete human figure, without erasing. No fixed time was given but complete drawings were encouraged.

Scoring
          According to the list of emotional indicators given by Koppitz, the number of the indicators were pointed out and the total results of all the group were found in percentages.

RESULTS AND DISCUSSION :
          The results are shown in Table 1. They show that the dominant emotional indicators are "no neck" 58% "short arms" 44% "teeth": 37 and "poor integration of parts" 34%. Shading of face and body is 26%. Machover³ found that omission of the neck on HFD is the indicator of immaturity. She hypothesizes that failure to draw the neck reveals a lack of rational control and poor coordination of impulses and behavior. It did not become a clinically
 

valid emotional indicator until age 9 for girls and age 10 for boys. But the children who have some adjustment problem can also make such drawings. This indicator seems to be a sign of good inner control over their impulses and actions. It is concluded that omission of the neck seems to be a valid indicator for immaturity and adjustment problems of physically handicapped children.
          Short arms (44%) seems to reflect the child's difficulties in reaching out into the world and toward others. They seem to be associated with the tendency to withdraw, to turn inward toward one's self and try to inhibit one's impulses. The attitude of the family and the community may be the source of such feelings.
          37% children drew teeth which have an interpretive value along with other emotional indicators. Koppitz² found it as a sign of overtly aggressive children, not only of oral aggression. Hammer⁴ suggests that the presence of teeth may indicate not only oral aggression but also sadistic tendencies on the drawings of adults. Machover³ hypothesized that the drawings of teeth on a HFD reveals infantile oral aggression and is frequently found on drawings of simple schizophrenics, emotionally flat adults, hysterics and low-grade defective adults.
          34% children drew poor integration of parts of figure. According to Koppitz², it seems to be an indicator of immaturity, over aggression, poor school beginners, brain injured youngsters, a poorly integrated personality or poor coordination. Reznikoff et.al⁵ found that poor inte-gration of figure drawings was associated with organic dysfunction in adults. Hammer⁴ attributes poor synthesis of HFDs to emotional disturbances.
          26% children have shown shading on face on HFD and 26% shading of body. It seems to be an indicator of anxiety.

CONCLUSION :
          It is concluded that the physically handicapped children seem to be immature, have poor adjustment, difficulties in reaching out to the world and towards others, tendency to withdraw, are overtly aggressive and have anxieties.

RECOMMENDATIONS :
          If the physically handicapped children are to be accepted as normal members of the family and community and treated in a positive way, their feelings of insecurity and withdrawal should be reduced. They should be encouraged to participate fully in all activities of life. This will act as a good psychotherapeutic measure. A group of normal children should be taken as control and tested for comparison to assess the emotional status of handicapped children. Sex differences in the handicapped children and type of handicap - congenital, or acquired should be seperately assessed.

BIBLIOGRAPHY :

1. Shaffer HR: Internal Journal of Social Psychiatry. 1964, 10 p.266.

2. Koppitz EM: Psychological Evaluation of Children's Human Figure Drawings. Grune & Stration New York. 1969

3. Machover K: Personality Projection in the Drawing of the Human Figur: A method of Personality investigation. Springfield Thomas. 1965

4. Hammer EF: Clinical Application of Projective drawings. Spring field, Thomas. 1963

5. Reznikoof NA and Reznikoff HR: The family drawing test. Psychiat. Quart, 1964;38:488-503.