Use of Drawing in Disability Research

I just read an interesting article on the use of drawings as a way to understand the personal experience of persons with spinal cord injuries.  The drawings were part of a larger study focused on the community integration and participation of adults with spinal cord injury. 

But, first some facts and figures on spinal cord injuries (SCI) from the National Spinal Cord Injury Statistical Center:

  • A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the spinalcord1moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don’t completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.
  • There is an estimated 10,000 – 12,000 spinal cord injuries every year in the US.  
  • A quarter of a million Americans are currently living with spinal cord injuries.
  • Costs: The average yearly health care and living expenses and the estimated lifetime costs that are directly attributable to SCI vary greatly according to severity of injury.


  • Since 2005, the most common cause of all spinal cord injuries are due to car accidents followed by falls (27%) followed by violent encounters sci(gunshot wounds). The rest are due to sporting accidents, and work-related accidents.  Interestingly, the proportion of injuries due to sports decreased over time while the proportion of injuries due to falls has increased. Acts of violence caused 13.3% of spinal cord injuries prior to 1980, and peaked between 1990 and 1999 at 24.8% before declining to only 15.3% since 2005.
  • The average age at injury is 39.5 years.
  • Since 2000, over 75% (77.8%) spinal cord injuries reported to the national database have occurred among males.

(Source: Facts and Figures at a Glance, updated February 2009. National Spinal Cord Injury Statistical Center)

  Now, back to the article…

The research project titled, ‘Images of self and spinal cord injury: exploring drawing as a visual method in disability research,’ (VCross K, Kabel A, Lysack C. Visual Studies, Vol.21, No.2, Oct 2006, p183-193)used drawings by persons with SCI which provided unique insights into the personal meanings of spinal cord injury and how this injury is understood and represented to others.  The purpose of the study was to use paticipants’ own drawings as a useful adjunct to the traditional narrative approach.   The 2 specific questions to elicit drawings were “Draw your self.” and “Draw how you see spinal cord injury in your mind.”

Drawings of ‘Self’

The drawings fell into 3 categories: 1) drawings that included a wheelchair; 2) drawings that didn’t include a wheelchair, 3) drawings where ‘the self’ was depicted as a head or a head and torso only, with no reference to paralyzed limbs.  Below are the social researchers’ analyses of the drawings:

  • depth and intensity of mhand_bodymindsoulemotionparticipants’ feelings went unrecognized until the drawing task.  I am not surprised by this at all…engaging in the creative process allows the spirit/soul to assume control and communicates with the body, mind and emotions via complex biochemical pathways.  See my diagram to the right ->
  • Participants didn’t deny that their body had deficits, they did not consider those deficits important or relevant to ‘who they really were.’
  • Physical disabilites invites misperceptions by non-disabled persons as ‘not normal,’ based on their appearance rather than on ‘who they really are.’ 
  • Participants with SCI recognized that ultimately they need to adjust their own impressions and perceptions of disabled persons.

Drawings of “Spinal Cord Injury”

One of the goals of the study was to understand how individuals disabled by SCI understood the injury.  The majority of drawings fell into 3 groups: 1) anatomical drawings, 2) metaphorical drawings, and 3) abstract drawings. Here are the findings:

  • SCI represented a literal ‘break’ of the bones and  nerves
  • Feelings of powerlessness to change or reshape  social interactions and negative social attitudes about disability.
  • Abled-body persons more accepting if persons with SCI downplayed their disabilities.  There is pressure to conform to non-disabled societal expectations and views of ‘normal’


Of interest…

The U-M Model Spinal Cord Injury Care System, part of the University of Michigan Health System, is one of the 14 institutions to be classified as a Model Spinal Cord Injury Center by the National Institute on Disability and Rehabilitation Research (NIDRR).  Interestingly, University of Michigan Health System has a comprehensive arts-in-healthcare program titled “Gifts of Art.”  On their website is this description:

“During times of stress and illness, the arts have the power to nurture and engage. Gifts of Art programs utilize the arts to assist and enhance the healing process, reduce stress, support human dignity and renew the spirit.”

If one of the purposes of healthcare is promoting health, wellness and recovery – why aren’t there more health systems, including public health systems, more open-minded and holistic like University of Michigan Health System?  Healing and caring for people is more than attending to the physical body…it’s addressing the whole person – body, mind, spirit, emotions.

12 responses to “Use of Drawing in Disability Research

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