As health-related research on children shifts from seeking information about children to seeking information directly from them, researchers recognize the need for developmentally appropriate methods such as drawing to help children communicate their experiences. This international study sought to (a) explore and compare the nature of stressors of everyday life and disease that children with cancer in the United Kingdom and the United States experience, (b) explore and compare the coping measures they use to manage these stressors, and (c) examine the use of drawing to enhance communication. Participants included 22 children ages 7 to 18 years, 13 boys and 9 girls receiving treatment for cancer in the United Kingdom and the United States. Quantitative and qualitative methods were used within a grounded theory approach and included drawing to accompany the traditional grounded theory methods of interview and observation. Findings indicate that children, regardless of their ethnicity and other cultural components, respond to the childhood cancer experience in a similar manner. The use of drawing enhanced communication through direct visual expression and/or through verbal expression via the “campfire effect.”
Architectural Association of Ireland. ‘Beara in the night’ the Walker family home. Retrieved August 27, 2002 from http://www.irisharchitecture.com/aai/journal/six/beara.html
2.
Bach, S. (1966). Spontaneous paintings of severely ill patients. Acta Psychosomatica, 8, 1-66.
3.
Bach, S. (1975). Spontaneous pictures of leukemic children as an expression of the total personality, mind and body. Acta Paedopsychiatrica, 4, 86-104.
4.
Bach, S. (1990). Life paints its own span. Einsiedeln, Switzerland: Daimon Verlag.
5.
Bellamy, C. (2003). The state of the world’s children 2003. New York: UNICEF.
6.
Bentley, T. (1989). Talking pictures. Nursing Times, 85(31), 58-59.
7.
Burns, R., & Kaufman, S. (1972). Actions, styles, and symbols in kinetic family drawings: An interpretive manual. New York: Brunner-Routledge.
8.
Carter, B. (2002). Chronic pain in childhood and the medical encounter: Professional ventriloquism and hidden voices. Qualitative Health Research, 12(1), 28-41.
9.
Collins, S., & Kuck, K. (1991). Music therapy in the neonatal intensive care unit. Neonatal Network, 9(6), 23-26.
10.
Compas, B. (1987). Coping with stress during childhood and adolescence. Psychology Bulletin, 101, 393-403.
11.
Compas, B. (2001). Coping and attention: Implications for child health and pediatric conditions. Journal of Developmental & Behavioral Pediatrics, 22, 323-333.
12.
Compas, B., Connor-Smith, J., Saltzman, H., Thomsen, A. H., & Wadsworth, M. E. (2001). Coping with stress during childhood and adolescence: Problems, progress, and potential in theory and research. Psychology Bulletin, 127, 87-127.
13.
Councill, T. (1993). Art therapy with pediatric cancer patients: Helping normal children cope with abnormal circumstances. Art Therapy, Journal of the American Art Therapy Association, 10(2), 78-87.
14.
Councill, T. (1999). Art therapy with pediatric cancer patients. In C. Malchiodi (Ed.), Medical art therapy with children (pp. 75-93). London and Philadelphia: Jessica Kingsley.
15.
Cox, C. (1993). The volcano drawing: A technique for assessing levels of affective tension (Cassette Recording No. 16-143). Denver, CO: National Audio-Video.
16.
Dalley, T., Case, C., & Schaverien, J. (1987). Images of art therapy. London: Tavistock.
17.
Docherty, S., & Sandelowski, M. (1999). Interviewing children. Research in Nursing and Health, 22(2), 177-185.
18.
Furth, G. (1988). The secret world of drawings: Healing through art. Boston: Sigo Press.
19.
Gantt, L. (1990). A validity study of the Formal Elements of an Art Therapy Scale for diagnostic information in patients’ drawings. Unpublished doctoral dissertation, University of Pittsburgh.
20.
Gantt, L., & Tabone, C. (1998). Formal elements art therapy scale: The rating manual. Morgantown, WV: Gargoyle Press.
21.
Glaser, B. G., & Strauss, A. C. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine.
22.
Goldstein, A. (1980). Thrills in response to music and other stimuli. Physiological Psychology, 8(1), 126-129.
23.
Golomb, C. (1992). The child’s creation of a pictorial world. Berkeley: University of California Press.
24.
Guilford, J., & Fruchter, B. (1978). Fundamental statistics in education and psychology (6th ed.). New York: McGraw-Hill.
25.
Hays, R., & Lyons, S. (1981). The bridge drawing: A projective technique for assessment in art therapy. The Arts in Psychotherapy, 8, 207-217.
26.
Instone, S. (2000). Perceptions of children with HIV infection when not told for so long: Implications for diagnosis disclosure. Journal of Pediatric Health Care, 14, 235-243.
27.
Keene, N., Hobbie, W., & Ruccione, K. (2000). Childhood cancer survivors: A practical guide to your future. Sebastopol, CA: O’Reilley & Associates.
28.
Kramer, E. (1971). Art as therapy with children. New York: Schocken Books.
29.
Kubler-Ross, E. (1983). On children and death. New York: Macmillan.
30.
Lambert, R., & Lambert, N. (1995). The effects of humor on secretory immunoglobulin A levels in school-aged children. Pediatric Nursing, 21, 16-19.
31.
Lane, D. (1990). The effect of a single music therapy session on hospitalized children as measured by salivary immunoglobulin A, speech pause time, and a patient opinion Likert scale. Unpublished doctoral dissertation, Case Western Reserve University, Cleveland, OH.
32.
Lighting News. Retrieved August 27, 2002, from http://www.lampsplus.com/htms/ightingnews/dimmers.asp.
33.
LoBiondo-Wood, G., & Haber, J. (1998). Nursing research: Methods, critical appraisal, and utilization (4th ed.). St. Louis, MO: Mosby.
34.
Lowenfeld, V. (1939). The nature of creative activity. New York: Harcourt, Brace.
35.
Lowenfeld, V. (1957). Creative and mental growth (3rd ed.). New York: Macmillan.
36.
Machover, K. (1949). Personality projection in the drawings of the human figure. Springfield, IL: Charles C. Thomas.
37.
Malchiodi, C. (1998). Understanding children’s drawings. New York: Guilford.
38.
Malchiodi, C. (1999). Understanding somatic and spiritual aspects of children’s art expressions. In C. Malchiodi (Ed.), Medical art therapy with children (pp. 173-196). London and Philadelphia: Jessica Kingsley.
39.
Naumburg, M. (1966). Dynamically oriented art therapy: Its principles and practices. Chicago: Magnolia Street.
40.
Oakley, A., Bendelow, G., Barnes, J., Buchanan, M., & Husain, O. (1995). Health and cancer prevention: Knowledge and beliefs of children and young people. British Medical Journal, 310, 1029-1033.
41.
Perkins, C. (1977). The art of life-threatened children: A preliminary study. In R. Showemaker & S. Gonick-Barris (Eds.), Creativity and the art therapist’s identity: The Proceedings of the Seventh Annual Conference of the American Art Therapy Association. Baltimore: American Art Therapy Association.
42.
Phipps, S., Fairclough, D., & Mulhern, R. (1995). Avoidant coping in children with cancer. Journal of Pediatric Psychology, 20, 217-232.
43.
Polit, D., Beck, C., & Hungler, B. (2001). Essentials of nursing research: Methods, appraisal, and utilization (5th ed.). Philadelphia: Lippincott.
44.
Pridmore, P., & Lansdown, R. (1997). Exploring children’s perceptions of health: Does drawing really break down barriers?Health Education Journal, 56, 219-230.
45.
Qvortrup, J. (1997). A voice for children in statistical and social accounting: A plea for children’s rights to be heard. In A. James & A. Prout (Eds.), Constructing and reconstructing childhood: Contemporary issues in the sociological study of childhood (pp. 85-106). London: Falmer.
46.
Rae, W. A. (1991). Analyzing drawings of children who are physically ill and hospitalized, using the ipsative method. Children’s Health Care, 20, 198-207.
47.
Reaman, G. (2004). Pediatric cancer research from past successes through collaboration to future transdisciplinary research. Journal of Pediatric Oncology Nursing, 21, 123-127.
48.
Rollins, J. (1990). Childhood cancer: Siblings draw and tell. Pediatric Nursing, 16, 21-27.
49.
Rollins, J. (2003). A comparison of stress and coping for children with cancer in the United Kingdom and the United States. Unpublished doctoral dissertation. DeMontfort University, Leicester, England. (British Library: DXN064479)
50.
Rubin, J. (1984). Child art therapy: Understanding and helping children grow through art (2nd ed.). New York: Van Nostrand Reinhold.
51.
Shepley, M., Fournier, M., & McDougal, K. (1998). Healthcare environments for children and their families. Dubuque, IA: Kendall/Hunt.
52.
Sourkes, B. (1995). Armfuls of time: The psychological experience of the child with a life-threatening illness. Pittsburgh: University of Pittsburgh Press.
53.
Sourkes, B. (1999). Art techniques with pediatric oncology patients. In S. Bertman (Ed.), Grief and the healing arts: Creativity as therapy (pp. 119-125). Amityville, NY: Baywood.
54.
Spinetta, J., McLaren, H., Fox, R., & Sparta, S. (1981). The kinetic family drawing in childhood cancer: A revised application of an age-independent measure. In J. Spinetta & P. Deasy-Spinetta (Eds.), Living with childhood cancer (pp. 86-120). St. Louis: Mosby.
55.
Spouse, J. (2000). An impossible dream? Images of nursing held by pre-registration students and their effect on sustaining motivation to become nurses. Journal of Advanced Nursing, 32, 730-739.
56.
Standley, J., & Moore, R. (1995). Therapeutic effects of music and mother’s voice on premature infants. Pediatric Nursing, 21, 509-512, 574-574.
57.
Sturner, R., Rothbaum, F., Visintainer, M., & Wolfer, J. (1980). The effects of stress on children’s human figure drawings. Journal of Clinical Psychology, 36, 324-331.
58.
Ulman, E. (1992). Art therapy: Problems of definition. American Journal of Art Therapy, 30, 70-74.
59.
Ulman, E., Kramer, E., & Kwiatkowska, H. (1977). Art therapy in the United States. Craftsbury Common, VT: Art Therapy.
60.
United Nations. (1989). Convention on the Rights of the Child. Geneva: United Nations.
61.
Welsh, J., & Instone, S. (2000). Use of drawings by children in the pediatric office. In S. Dixon & M. Stein (Eds.), Encounters with children: Pediatric behavior and development (pp. 571-589). St. Louis: Mosby.
62.
Winnicott, D. (1971). Playing and reality. New York: Basic Books.
