Identifying Children and Adolescents With Depression - Review of the Stimulus Drawing Task and Draw A Story Research

Oct 15, 2026

Uploaded by Grenda

This paper reviews four decades of research on the Silver Drawing Test (SDT) and Draw A Story (DAS), art-based assessments designed to support early identification of depression risk in children and adolescents. It explains the original impetus for the tasks and summarizes studies addressing depression, abuse, aggression, cognitive skills, reliability, normative data, and treatment outcomes across the United States, Thailand, and Russia. Findings indicate strongly negative drawing responses on Emotional Content and Self-Image may signal elevated risk for depression.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Introduction

Stimulus drawing task design

Scoring emotional content and self-image

Review of the Literature

Diagnostic context and prior findings

Development of SDT and DAS

Identifying Children and Adolescents With Depression: Review of the Stimulus Drawing Task and Draw A Story Research Rawley Silver, Sarasota, FL Abstract This paper reviews a body of research on the author’s Silver Drawing Test (SDT) and Draw A Story (DAS) artbased assessments, which span 40 years of development. The original impetus for the assessment is described and studies are reviewed that examined relationships between depression, abuse, and aggression; cognitive skills; interrater and retest reliability; normative data; and treatment outcomes in the United States, Thailand, and Russia. Findings from these studies suggest that drawing responses that are strongly negative (receiving of a score of 1 out of a total possible 5 points) on both the Emotional Content and the Self-Image scales can provide early identification of children and adolescents who maybe at risk for depression. Introduction Making accurate assessments that allow for early identification of depression among children and adolescents, whose condition may be concealed, is a difficult task for clinicians. Among children, symptoms of depression maybe masked by anger, and among adolescents, suicide has become a leading cause of death. This paper reviews a body of research that studied responses to a stimulus drawing task for children and adolescents who were at risk for depression. The art-based assessment tool was found to provide valuable access to participants’ fantasies, thoughts, and feelings. The task involves instructing participants to select two drawings from a series of people, animals, places, and things (referred to as stimulus drawings) and then asking them to imagine something happening between the subjects of the drawings they had chosen and to draw what they imagined. The participants also are asked to add titles or stories to their drawings and to discuss their responses whenever possible, so that the researcher may have a clear understanding of overt and covert meanings. Experience with the stimulus drawing task shows that different participants perceive the same stimulus drawings differently and they tend to choose images associated with Editor’s note: Rawley Silver, EdD, ATR-BC, HLM, is a retired adjunct faculty member of the College of New Rochelle in New York, and grant recipient from the U.S. Office of Education, the New York State Department of Education, and the National Institute of Education. Reproductions of specific drawings described in this article may be found in the Silver Drawing Test and Draw A Story (Silver, 2007) . past experiences—behaviors that reveal perceptions of themselves and relationships with others that can be quantified. Researchers score the drawing responses for emotional content and self-image on two scales that range from strongly negative, such as drawings about suicide or homicide (1 point); to strongly positive, such as those that depict loving relationships or achieving success (5 points) . Moderately negative and positive drawing responses score 2 and 4 points respectively; unclear or ambivalent responses are scored 3 points. In the original study (Silver, 1963) I offered the task to deaf children who could not talk or understand speech. Because I could not communicate with them manually using the means they preferred, I decided to make a quick sketch of my family and gesture an invitation to reply. The children’s responses to my sketch provided clues to their concepts of themselves and others. For example, one girl drew herself isolated from others in her family using the visual barrier of a tree (Silver, 1963) . Subsequently, I offered the stimulus drawing task to adult stroke patients and also to children and adolescents with learning disabilities (Silver, 1973, 1975, 1976, 1989) . Fifty of these stimulus drawings were included in the Stimulus Drawings and Techniques (Silver, 1991), and 15 stimulus drawings were in the Silver Drawing Test of Cognitive and Creative Skills (Silver, 1996

FAQs

What are the SDT and DAS assessments, and what do participants do?

Participants complete art-based tasks that involve selecting stimulus drawings and imagining an event between pictured subjects, then drawing the imagined outcome. They may also add titles or stories to help researchers understand overt and covert meanings.

How are drawing responses scored in relation to depression risk?

Researchers score Emotional Content and Self-Image using a 1–5 scale. Strongly negative responses (such as drawings depicting suicide or homicide) on both scales are suggested as indicators for early identification of children and adolescents at risk for depression.

What does the paper review about reliability, norms, and study settings?

The review covers interrater and retest reliability, normative data, and treatment outcomes, drawing on studies conducted in the United States, Thailand, and Russia.

Oct 15, 2026

Uploaded by Grenda