Everyone can draw: An inclusive and transformative activity for conceptualization of topographic anatomy

Anatomical drawing traditionally involves illustration of labeled diagrams on two-dimensional surfaces to represent topographical features. Despite the visual nature of anatomy, many learners perceive that they lack drawing skills and do not engage in art-based learning. Recent advances in the capabilities of technology-enhanced learning have enabled the rapid and inexpensive production of three-dimensional anatomical models. This work describes a "drawing on model" activity in which learners observe and draw specific structures onto three-dimensional models. Sport and exercise sciences (SES, n = 79) and medical (MED, n = 156) students at a United Kingdom medical school completed this activity using heart and femur models, respectively. Learner demographics, their perceptions of anatomy learning approaches, the value of the activity, and their confidence in understanding anatomical features, were obtained via validated questionnaire. Responses to 7-point Likert-type and free-text items were analyzed by descriptive statistics and semi-quantitative content analysis. Learners valued art-based study (SES mean = 5.94 SD ±0.98; MED = 5.92 ± 1.05) and the "drawing on model" activity (SES = 6.33 ± 0.93; MED = 6.21 ± 0.94) and reported enhanced confidence in understanding of cardiac anatomy (5.61 ± 1.11), coronary arteries (6.03 ± 0.83), femur osteology (6.07 ± 1.07), and hip joint muscle actions (5.80 ± 1.20). Perceptions of learners were independent of both their sex and their art-based study preferences (p < 0.05). Themes constructed from free-text responses identified "interactivity," "topography," "transformative," and "visualization," as key elements of the approach, in addition to revealing some limitations. This work will have implications for anatomy educators seeking to engage learners in an inclusive, interactive, and effective learning activity for supporting three-dimensional anatomical understanding.

Characteristics of drawing deficits in people with aphasia: Differences between symbolic and realistic drawn objects

BACKGROUND

Pictures drawn by people with aphasia (PWA) are often more challenging to understand than those drawn by healthy people. There are two types of objects: those that tend to be drawn symbolically (symbolically drawn objects-SOs) and those that are likely to be drawn realistically (realistically drawn objects-ROs).

AIMS

To compare the identification rate and number of misunderstanding types between SOs and ROs drawn by PWA and healthy controls (HCs). To reveal trends in the misunderstandings of drawings by PWA, and to identify the language or cognitive abilities related to the identification rate of pictures drawn by PWA.

METHODS & PROCEDURES

We designed a drawing task involving SOs and ROs. A total of 18 PWA and 30 HCs completed the task, and respondents identified the drawings. The identification rate and number of misunderstandings were analysed with two-way analysis of variance (ANOVA) including group (PWA and HCs) and object type (SOs and ROs). The misunderstandings were divided into four categories varying in semantic and morphological similarity; these ratios were examined with a chi-square test. The relationships of language and cognitive abilities with the identification rate were investigated with multiple regression analyses.

OUTCOMES & RESULTS

There was a significant effect of the interaction between group and object type on the identification rate (F(1.1387) = 3.90, Mean Squared Error (MSE) = 4139.67, p = 0.04): the identification rates for ROs were lower in the PWA than in the HCs. For the number of misunderstanding types, an interaction was observed between group and object type (F(1.56) = 8.26, MSE = 26.93, p < 0.01): the number of misunderstanding types for ROs in the PWA was greater than that in the HCs. The misunderstanding patterns differed between ROs and SOs (χ2(3) = 694.30, p < 0.001, V = 0.37). ROs were semantically related, whereas SOs were morphologically related. The identification rates of ROs and SOs were correlated only with Kanji writing scores (ROs: β = 3.66, p = 0.01; SOs: β = 6.57, p < 0.01).

CONCLUSIONS & IMPLICATIONS

In drawings by the PWA, SOs had a higher identification rate, while ROs had a lower identification rate and a greater variety of misunderstandings. SOs may increase drawing motivation. Interventions to improve the identifiability of SOs and ROs should reflect each character. Identification rates were correlated only with Kanji writing scores. The PWA, whose native language was Japanese and had preserved Kanji writing abilities, and their communication abilities may be increased through drawing.

WHAT THIS PAPER ADDS

What is already known on the subject PWA often have impaired drawing abilities and draw pictures that third parties misinterpret. Some objects tend to be drawn symbolically, and some are drawn realistically. However, it is not clear whether there is a difference between these types of drawings depicted by PWA in identifiability and the tendency to be misunderstood by ordinary people. In addition, the relationships between language or cognitive abilities and the identification rate of drawn pictures are not clear. What this paper adds to the existing knowledge The identification rate differed between SOs and ROs. In drawings by PWA, SOs had a higher identification rate, while ROs had a lower identification rate and the greatest variety of misunderstandings. Approximately half of the misunderstandings were related to the target object. SOs tended to be confused with morphologically related objects, while ROs tended to be confused with semantically related objects. Identification rates were correlated only with Kanji writing scores. What are the potential or actual clinical implications of this work? To motivate PWA's drawing, it is suitable to begin with SOs. Examining drawing ability from the perspective of SOs and ROs increases the chance of identifying drawing ability. PWA whose native language is Japanese and have preserved Kanji writing abilities may be able to increase their communication abilities through drawing.

Toward a theory of perspective perception in pictures

This paper reviews projection models and their perception in realistic pictures, and proposes hypotheses for three-dimensional (3D) shape and space perception in pictures. In these hypotheses, eye fixations, and foveal vision play a central role. Many past theories and experimental studies focus solely on linear perspective. Yet, these theories fail to explain many important perceptual phenomena, including the effectiveness of nonlinear projections. Indeed, few classical paintings strictly obey linear perspective, nor do the best distortion-avoidance techniques for wide-angle computational photography. The hypotheses here employ a two-stage model for 3D human vision. When viewing a picture, the first stage perceives 3D shape for the current gaze. Each fixation has its own perspective projection, but, owing to the nature of foveal and peripheral vision, shape information is obtained primarily for a small region of the picture around the fixation. As a viewer moves their eyes, the second stage continually integrates some of the per-gaze information into an overall interpretation of a picture. The interpretation need not be geometrically stable or consistent over time. It is argued that this framework could explain many disparate pictorial phenomena, including different projection styles throughout art history and computational photography, while being consistent with the constraints of human 3D vision. The paper reviews open questions and suggests new studies to explore these hypotheses.

Associations between screen viewing at 2 and 3.5 years and drawing ability at 3.5 years among children from the French nationwide Elfe birth cohort

The effect of screen viewing on children's cognitive development has been of concern among parents and researchers. This study investigated the association between children screen time, as reported by parents, and drawing ability, and the confounding effects of socioeconomic characteristics (such as parental education, household income, migration status) and children's competing activities (such as drawing practice, extracurricular activity, outdoor time, sleep time, time playing with parents). Participants included 7577 children aged 3.5 years (50% girls) who underwent the Draw-a-person test (McCarthy score [range = 0-12 points]) in the French nationwide Elfe birth cohort, initiated in 2011. Sex-stratified zero-inflated Poisson regression models were used. Increased screen time was associated with a higher likelihood to obtain a null score in boys (OR 1.15, 95% CI 1.07-1.23) and girls (1.13 [1.03-1.24]) and a lower score in girls only (β =  - 0.02, 95% CI - 0.04; - 0.01). After adjusting for SES, associations were no longer observed, indicating that the association between screen time and drawing abilities was confounded by socioeconomic characteristics.

Online comic-based art workshops as an innovative patient and public involvement and engagement approach for people with chronic breathlessness

BACKGROUND

Talking about breathlessness can be emotionally challenging. People can feel a sense of illegitimacy and discomfort in some research contexts. Comic-based illustration (cartooning) offers an opportunity to communicate in a more creative and inclusive way. We used cartooning in patient and public involvement and engagement (PPIE) work to explore symptoms of breathlessness and their impact on peoples' everyday lives.

MAIN BODY

Five, 90-min cartooning workshops were delivered online to members of Breathe Easy Darlington (UK). The workshop series involved 5-10 Breathe Easy members and were facilitated by a professional cartoonist supported by three researchers. The experience of living with breathlessness was represented via illustrations of cartoon characters and ideas explored in subsequent conversations. Cartooning was fun and the majority found it a nostalgic experience. Sharing the experience helped the research team develop new understandings of breathlessness and fostered relationships with the Breathe Easy members. The illustrations showed characters leaning against objects, sweating and sitting down, demonstrating living with the sensation of not being in control.

CONCLUSION

Comic-based art, as a fun and innovative PPIE approach. It facilitated the research team becoming embedded in an existing group who will act as PPIE members on a long-term research programme. Illustrations enabled storytelling and fostered novel insights into the lived experiences of people with breathlessness including sensations of a loss of control, disorientation, and unsteadiness. This will impact on work investigating balance in people with chronic obstructive pulmonary disease. This model has potential to be applied in a range of PPIE and research contexts.

Draw yourself: How culture influences drawings by children between the ages of two and fifteen

The place children live strongly influence how they develop their behavior, this is also true for pictorial expression. This study is based on 958 self-portraits drawn by children aged 2-15 years old from 35 countries across 5 continents. A total of 13 variables were extracted of each drawing allowing us to investigate the differences of individuals and environment representations in these drawings. We used a principal component analysis to understand how drawing characteristics can be combined in pictorial concepts. We analyzed the effect of age, gender, socioeconomic, and cultural factors in terms of complexity and inclusion of social (human figures) and physical (element from Nature and man-made elements) environments, their frequencies, size, and proportions of these elements on each drawing. Our results confirm the existence of cultural variations and the influence of age on self-portrait patterns. We also observed an influence of physical and socio-cultural contexts through the level of urbanization and the degree of individualism of the countries, which have affected the complexity, content and representation of human figures in the drawings studied.

Reimagining Language

Since its inception, the study of language has been a central pillar to Cognitive Science. Despite an "amodal view," where language is thought to "flow into" modalities indiscriminately, speech has always been considered the prototypical form of the linguistic system. However, this view does not hold up to the evidence about language and expressive modalities. While acknowledgment of both the nonvocal modalities and multimodality has grown over the last 40 years in linguistics and psycholinguistics, this has not yet led to a necessary shift in the mainstream linguistic paradigm. Such a shift requires reconfiguring models of language to account for multimodality, and demands a different view on what the linguistic system is and how it works, necessitating a Cognitive Science sensitive to the full richness of human communication.

Curricula Design & Pedagogy for Sketching Within HCI & UX Education

Sketching is recognised as an important tool in the journey of research and practical processes of Human Computer Interaction (HCI) and User Experience Design (UX). However, it is not always included in higher education curriculum, in which HCI and UX is often a single module in one year group amongst more “traditional” approaches in computer science. The benefits of sketching and visualisation practice can be used by students across the board in computing degrees, but especially so within HCI and UX, where novel approaches and ideation are valued and practiced. By the time learners leave higher education, they may or may not have engaged with this valuable skill. HCI has a lot in common with UX, and the two are commonly conflated to be the same thing, though despite this, there is not a focus on practical sketching and visualisation skills. In comparison, within the UX workplace environment, sketching is part of design thinking and vital for the structuring of ideas, storyboards, user journey maps and more. We focus on the incorporation and exploration of sketching as an educational tool, technique and output within HCI, and how this learning is given and received over a number of contexts. This paper outlines case studies where sketching has been included in both formal and informal learning with both undergraduate, postgraduate, and post education populations, and how this knowledge exchange has been both enhanced and changed by the recent compulsory move to online teaching during the COVID-19 pandemic. We discuss practice and learning in the context of four case studies: Data-Sketching in a First Year Minor; Sketching in a 2nd Year HCI Cohort; Sketching as a Foundational Tool for MSc User Experience Design; and, Sketching in HCI for Peer-to-Peer Learning. Further, we make recommendations for incorporating sketching practice and theory into both undergraduate and postgraduate university programs, as well as for peer-to-peer learning in both public and private contexts.

Remarks on Multimodality: Grammatical Interactions in the Parallel Architecture

Language is typically embedded in multimodal communication, yet models of linguistic competence do not often incorporate this complexity. Meanwhile, speech, gesture, and/or pictures are each considered as indivisible components of multimodal messages. Here, we argue that multimodality should not be characterized by whole interacting behaviors, but by interactions of similar substructures which permeate across expressive behaviors. These structures comprise a unified architecture and align within Jackendoff's Parallel Architecture: a modality, meaning, and grammar. Because this tripartite architecture persists across modalities, interactions can manifest within each of these substructures. Interactions between modalities alone create correspondences in time (ex. speech with gesture) or space (ex. writing with pictures) of the sensory signals, while multimodal meaning-making balances how modalities carry "semantic weight" for the gist of the whole expression. Here we focus primarily on interactions between grammars, which contrast across two variables: symmetry, related to the complexity of the grammars, and allocation, related to the relative independence of interacting grammars. While independent allocations keep grammars separate, substitutive allocation inserts expressions from one grammar into those of another. We show that substitution operates in interactions between all three natural modalities (vocal, bodily, graphic), and also in unimodal contexts within and between languages, as in codeswitching. Altogether, we argue that unimodal and multimodal expressions arise as emergent interactive states from a unified cognitive architecture, heralding a reconsideration of the "language faculty" itself.

Neural correlates of sex differences in communicative gestures and speech comprehension: A preliminary study

The goal of this study was to investigate whether the semantic processing of the audiovisual combination of communicative gestures with speech differs between men and women. We recorded event-related brain potentials in women and men during the presentation of communicative gestures that were either congruent or incongruent with the speech.Our results showed that incongruent gestures elicited an N400 effect over frontal sites compared to congruent ones in both groups. Moreover, the females showed an earlier N2 response to incongruent stimuli than congruent ones, while larger sustained negativity and late positivity in response to incongruent stimuli was observed only in males. These results suggest that women rapidly recognize and process audiovisual combinations of communicative gestures and speech (as early as 300 ms) whereas men analyze them at the later stages of the process.

Crossmodal processing of environmental sounds and everyday life actions: An ERP study

To investigate the processing of environmental sounds, previous researchers have compared the semantic processing of words and sounds, yielding mixed results. This study aimed to specifically investigate the electrophysiological mechanism underlying the semantic processing of environmental sounds presented in a naturalistic visual scene. We recorded event-related brain potentials in a group of young adults over the presentation of everyday life actions that were either congruent or incongruent with environmental sounds. Our results showed that incongruent environmental sounds evoked both a P400 and an N400 effect, reflecting sensitivity to physical and semantic violations of environmental sounds’ properties, respectively. In addition, our findings showed an enhanced late positivity in response to incongruous environmental sounds, probably reflecting additional reanalysis costs. In conclusion, these results indicate that the crossmodal processing of the environmental sounds might require the simultaneous involvement of different cognitive processes.

Executive Function, Language, and the Toddler's Discovery of Representational Drawing

Working memory capacity and executive functions play important roles in the early development of drawing and language, but we lack models that specify the relationships among these representational systems and cognitive functions in toddlers. To respond to this need, the present study investigated the relations between drawing and language in very young children, and the role of working memory capacity, inhibition, and shifting in the association between these two representational systems. The participants were 80 children, 25–37 months old. The results revealed that in toddlers (a) all the measures of working memory, inhibition, and shifting loaded on a single factor of general executive functioning; (b) language and drawing are two distinct, but substantially correlated, representational systems; and (c) the development of executive function has a strong impact on language development, which in turn influences the development of drawing.

The electrophysiology of audiovisual processing in visual narratives in adolescents with autism spectrum disorder

We investigated the semantic processing of the multimodal audiovisual combination of visual narratives with auditory descriptive words and auditory sounds in individuals with ASD. To this aim, we recorded ERPs to critical auditory words and sounds associated with events in visual narrative that were either semantically congruent or incongruent with the climactic visual event. A similar N400 effect was found both in adolescents with ASD and neurotypical adolescents (ages 9-16) when accessing different types of auditory information (i.e. words and sounds) into a visual narrative. This result might suggest that verbal information processing in ASD adolescents could be facilitated by direct association with meaningful visual information. In addition, we observed differences in scalp distribution of later brain responses between ASD and neurotypical adolescents. This finding might suggest ASD adolescents differ from neurotypical adolescents during the processing of the multimodal combination of visual narratives with auditory information at later stages of the process. In conclusion, the semantic processing of verbal information, typically impaired in individuals with ASD, can be facilitated when embedded into a meaningful visual information.

New indices to characterize drawing behavior in humans (Homo sapiens) and chimpanzees (Pan troglodytes)

Techniques used in cave art suggest that drawing skills emerged long before the oldest known representative human productions (44,000 years bc). This study seeks to improve our knowledge of the evolutionary origins and the ontogenetic development of drawing behavior by studying drawings of humans (N = 178, 3- to 10-year-old children and adults) and chimpanzees (N = 5). Drawings were characterized with an innovative index based on spatial measures which provides the degree of efficiency for the lines that are drawn. Results showed that this index was lowest in chimpanzees, increased and reached its maximum between 5-year-old and 10-year-old children and decreased in adults, whose drawing efficiency was reduced by the addition of details. Drawings of chimpanzees are not random suggesting that their movements are constrained by cognitive or locomotor aspect and we cannot conclude to the absence of representativeness. We also used indices based on colors and time and asked children about what they drew. These indices can be considered relevant tools to improve our understanding of drawing development and evolution in hominids.

A Brief Drawing Task for the Differential Diagnosis of Semantic Dementia

BACKGROUND

Semantic dementia (SD) is a subtype of frontotemporal lobe degeneration characterized by semantic loss, with other cognitive functions initially preserved. SD requires differential diagnosis with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Semantic knowledge can be evaluated through different tests; however, most of them depend on language.

OBJECTIVE

We describe the development of a brief drawing task that may be helpful for the differential diagnosis of SD.

METHODS

Seventy-two patients, including 32 AD, 19 bvFTD, and 21 SD were asked to draw 12 items with different age of acquisition and familiarity, belonging to four different semantic categories. We employed the drawings of healthy volunteers to build a scoring scheme.

RESULTS

Turtle, strawberry, train, and envelope were the items of each category that best discriminated between groups and were selected for the Brief drawing task. The discriminatory power of the Brief drawing task between SD versus AD and bvFTD patients, estimated through the area under the curve was 0.84 (95% CI = 0.72-0.96, p = 0.000007). In a logistic model, the Brief drawing task (p = 0.003) and VOSP "number location" subtest (p = 0.016) were significant predictors of the diagnosis of SD versus AD and bvFTD after adjustment by the main covariates. The Brief drawing task provided clinically useful qualitative information. SD drawings were characterized by loss of the distinctive features, intrusions, tendency to prototype, and answers like "I don't know what this is".

CONCLUSION

The Brief drawing task appears to reveal deficits in semantic knowledge among patients with SD that may assist in the differential diagnosis with other neurodegenerative diseases.

Visual narrative comprehension: Universal or not?

Visual narratives of sequential images - as found in comics, picture stories, and storyboards - are often thought to provide a fairly universal and transparent message that requires minimal learning to decode. This perceived transparency has led to frequent use of sequential images as experimental stimuli in the cognitive and psychological sciences to explore a wide range of topics. In addition, it underlines efforts to use visual narratives in science and health communication and as educational materials in both classroom settings and across developmental, clinical, and non-literate populations. Yet, combined with recent studies from the linguistic and cognitive sciences, decades of research suggest that visual narratives involve greater complexity and decoding than widely assumed. This review synthesizes observations from cross-cultural and developmental research on the comprehension and creation of visual narrative sequences, as well as findings from clinical psychology (e.g., autism, developmental language disorder, aphasia). Altogether, this work suggests that understanding the visual languages found in comics and visual narratives requires a fluency that is contingent on exposure and practice with a graphic system.

Editors’ Introduction and Review: Visual Narrative Research: An Emerging Field in Cognitive Science

Drawn sequences of images are among our oldest records of human intelligence, appearing on cave paintings, wall carvings, and ancient pottery, and they pervade across cultures from instruction manuals to comics. They also appear prevalently as stimuli across Cognitive Science, for studies of temporal cognition, event structure, social cognition, discourse, and basic intelligence. Yet, despite this fundamental place in human expression and research on cognition, the study of visual narratives themselves has only recently gained traction in Cognitive Science. This work has suggested that visual narrative comprehension requires cultural exposure across a developmental trajectory and engages with domain‐general processing mechanisms shared by visual perception, attention, event cognition, and language, among others. Here, we review the relevance of such research for the broader Cognitive Science community, and make the case for why researchers should join the scholarship of this ubiquitous but understudied aspect of human expression.

Drawn sequences of images, like those in comics and picture stories, are a pervasive and fundamental way that humans have communicated for millennia. Yet, the study of visual narratives has only recently gained traction in Cognitive Science. Here we explore what has held back the study of the cognition of visual narratives, and why researchers should join in scholarship of this ubiquitous aspect of expression.

The grammar of emoji? Constraints on communicative pictorial sequencing

Emoji have become a prominent part of interactive digital communication. Here, we ask the questions: does a grammatical system govern the way people use emoji; and how do emoji interact with the grammar of written text? We conducted two experiments that asked participants to have a digital conversation with each other using only emoji (Experiment 1) or to substitute at least one emoji for a word in the sentences (Experiment 2). First, we found that the emoji-only utterances of participants remained at simplistic levels of patterning, primarily appearing as one-unit utterances (as formulaic expressions or responsive emotions) or as linear sequencing (for example, repeating the same emoji or providing an unordered list of semantically related emoji). Emoji playing grammatical roles (i.e., 'parts-of-speech') were minimal, and showed little consistency in 'word order'. Second, emoji were substituted more for nouns and adjectives than verbs, while also typically conveying nonredundant information to the sentences. These findings suggest that, while emoji may follow tendencies in their interactions with grammatical structure in multimodal text-emoji productions, they lack grammatical structure on their own.

The Role of Shape in Semantic Memory Organization of Objects: An Experimental Study Using PI-Release

Visual information contributes fundamentally to the process of object categorization. The present study investigated whether the degree of activation of visual information in this process is dependent on the contextual relevance of this information. We used the Proactive Interference (PI-release) paradigm. In four experiments, we manipulated the information by which objects could be categorized and subsequently be retrieved from memory. The pattern of PI-release showed that if objects could be stored and retrieved both by (non-perceptual) semantic and (perceptual) shape information, then shape information was overruled by semantic information. If, however, semantic information could not be (satisfactorily) used to store and retrieve objects, then objects were stored in memory in terms of their shape. The latter effect was found to be strongest for objects from identical semantic categories.

The grammar of visual narrative: Neural evidence for constituent structure in sequential image comprehension

Constituent structure has long been established as a central feature of human language. Analogous to how syntax organizes words in sentences, a narrative grammar organizes sequential images into hierarchic constituents. Here we show that the brain draws upon this constituent structure to comprehend wordless visual narratives. We recorded neural responses as participants viewed sequences of visual images (comics strips) in which blank images either disrupted individual narrative constituents or fell at natural constituent boundaries. A disruption of either the first or the second narrative constituent produced a left-lateralized anterior negativity effect between 500 and 700ms. Disruption of the second constituent also elicited a posteriorly-distributed positivity (P600) effect. These neural responses are similar to those associated with structural violations in language and music. These findings provide evidence that comprehenders use a narrative structure to comprehend visual sequences and that the brain engages similar neurocognitive mechanisms to build structure across multiple domains.

Framing “I can’t draw”: The influence of cultural frames on the development of drawing

Why is it that many people feel that they “can’t draw”? In a recent article Cohn, 2012 , I put forth a new theory that compared the cognitive structure of drawing to the cognitive structure of language. Like language, drawing uses schemas that combine in innumerable novel ways, and thus children learning to draw must acquire these schemas from the drawings in their environment. However, while most people in the United States and Europe “can’t draw,” Japanese children have far greater proficiency in drawing. This paper explores reasons for this cultural disparity in graphic fluency originating in the structure of the drawing systems in those respective cultures and the beliefs that frame ideas about drawing and art education. In particular, I explore the intriguing possibility that cultural assumptions admonishing imitation of other people’s drawings prohibits the acquisition of graphic schemas, thereby leading to people feeling that they “can’t draw.”