The Silver Drawing Test and Draw a Story

Assessing Depression, Aggression, and Cognitive Skills

Rawley Silver

• Publisher: Routledge
• Year: 2010
• Print ISBN: 9780415955348
• eBook ISBN: 9781135916664
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Art can be an invaluable means of communication. It can bypass language and impairment and allow for the expression of thoughts or feelings too difficult to communicate with words. In The Silver Drawing Test and Draw a Story, Rawley Silver draws on her years of experience using therapeutic art with hearing-impaired children, stroke patients, and others with learning disabilities or emotional disturbances. The book's original art assessments use stimulus drawings to elicit responses that provide access to a patient's emotions and attitudes toward themselves and others, while also testing for the ability to solve problems and convey ideas. Offering tools to assess cognitive skills that often escape detection on verbal tests of intelligence or achievement, the book helps in identifying those at risk for violent behavior or masked depression. Thoroughly updated from Silver's earlier works, this new book includes techniques to assess aggression and depression that may lead to violence in schools and suicide among children and adolescents. It also addresses important gender and age differences, incorporating new information and updated studies, and it offers an in-depth look at the developmental procedures involved in these art assessments. As education for mental health professionals now includes art therapy more regularly, Silver has provided an invaluable resource for assessing emotional and cognitive content.

Chapter 1

Introduction

Much has happened since Three Art Assessments was published in 2002. New studies have found that the Draw a Story assessment can be used to identify children and adolescents at risk for violent behavior as well as for depression, and two subgroups of aggression have emerged: predatory and reactive. In addition, there have been new studies of the Silver Drawing Test of Cognitive Skills and Emotion by practitioners in Russia, Thailand, and the United States, and scoring guidelines have been made more precise.

To include these new findings, I streamlined the Draw a Story assessment and the Silver Drawing Test but more had to go—condensing the third assessment, Stimulus Drawings and Techniques, into a single chapter of techniques for developing cognitive skills, and moving its stimulus drawings to appendix C.

The original purpose of the Draw a Story (DAS) assessment was to identify children and adolescents with masked depression. Their responses to the drawing task provided access to thoughts and feelings that were inaccessible through words, and recent studies have found that their responses can serve to identify those who may harm others as well as themselves.

The Silver Drawing Test (SDT) evolved from a theory that drawings might be used to bypass the language deficiencies of deaf children, to evidence that responses to its drawing tasks can be used not only to assess cognitive skills that escape detection on language-oriented tests of intelligence and achievement but also provide access to the fantasies of typical children and adolescents. The SDT has been used to assess emotional as well as cognitive strengths and weaknesses, and has been used with adults as well as children and adolescents.

DAS and the SDT use stimulus and response drawings as the primary channel for receiving and expressing ideas. They are based on the premise that drawings can bypass verbal deficiencies and serve as a language parallel to words, that emotions and cognitive skills can be evident in visual as well as verbal conventions, and that even though traditionally identified and assessed through words, they can also be identified and assessed through images.

The stimulus drawings are line drawings of people, animals, places, and things. Some are explicit, while others are ambiguous in order to elicit personal associations with past experiences. The assessments provide different sets of stimulus drawings but present the same Drawing from Imagination task, which asks respondents to choose two stimulus drawings, imagine something happening between the subjects they choose, draw what they imagine, add titles or stories, and—whenever possible—to discuss their responses so that meanings can be clarified.

Respondents tend to perceive the same stimulus drawings differently, and alter them in subtle ways, intentionally and unintentionally. Some choose subjects that represent themselves or others in disguise. Others use drawings to express fear or anger indirectly or fulfill wishes vicariously, using symbols and metaphors.

Both assessments include 5-point rating scales that range from strongly negative to strongly positive in emotional content, self-image, and use of humor. In addition, the SDT provides 5-point scales for assessing cognitive skills, and includes three tasks: Drawing from Imagination, Predictive Drawing, and Drawing from Observation. Each task has been designed to assess one of the three concepts said to be fundamental in mathematics and reading, as discussed in chapter 6.

Why the Assessments Were Developed and How They Evolved

Initially, the assessments were developed in experimental art classes for children with hearing impairments. My interest in deafness began when I was temporarily deafened myself in midlife. Painting had been my vocation, and, after recovering, I volunteered to provide studio art experiences to deaf students in a school that did not have an art teacher. The children assigned to my class were emotionally disturbed as well as deaf, and since only one could lip-read or speak and I did not know how to sign, we communicated, at first, through pantomime. Then I tried a quick sketch of my family, gesturing an invitation to sketch in reply. A tall girl responded with a sketch of her mother, father, and sister, then added herself isolated by a tree and the smallest in her family. A boy whose father had disappeared drew himself, his siblings, mother, and beside her, a picture on the wall.

Although most of the students loved to draw, a few were reluctant or shy, and I offered them simple line drawings as possible subjects. The sketches they chose most often were offered to others, and eventually became stimulus drawings in the assessments.

The first assessment published was Stimulus Drawings and Techniques in 1981, followed by The Silver Drawing Test in 1983. Most responses to the Drawing from Imagination task expressed thoughts and feelings, but a few were fantasies about suicide. Subsequent studies found that these responses, scoring 1 point, correlated significantly with responses by children and adolescents who had been hospitalized for clinical depression, and Draw a Story: Screening for Depression was published in 1987. The assessments were revised during the 1990s, and in 2002, revised again into a single volume, Three Art Assessments.

Theoretical Background

Neuroscientists, using magnetic resonance imaging scans, have been tracking mirror neurons, a fundamental brain mechanism. The function of mirror neurons may be to detect mental states and empathize with the behaviors of others, enabling one individual to understand the emotions, intentions, and actions of another (Gallese, Keysers, & Rizzolatti, 2004). This mind-reading ability works through feelings, not conceptual reasoning. Our brains have the capacity to link “what I do and I feel” directly with what someone else does and feels. It responds when we experience emotions or purposeful actions, and when we observe the same emotions or actions in others. The empathy circuits light up and the brain internalizes representations of the external world. These mirror neurons could explain why watching media violence may be harmful, why some people like pornography, and why people respond to music and the visual arts (Blakeslee, 2006).

These findings raise questions that relate to the studies reported here: Do stimulus and response drawings activate mirror neurons? Do stimulus drawings prompt respondents to empathize with the subjects they choose and project emotion into their responses? Do their drawings enable us to sense a respondent’s motivation and state of mind?

Other neuroscientists have been examining relationships between the visual brain and the arts. According to Semir Zeki, the preeminent function of the visual brain is to acquire knowledge about the world, and achieves this knowledge by selecting essentials and discarding what is superfluous, whereas artists have the ability to “abstract the essential features of an image and discard redundant information, essentially identical with what the visual areas themselves have evolved to do” (1999, p. 17).

Visual artists have expressed similar ideas. Ching Hao, a painter in tenth-century China, wrote that painters “should disregard the varying minor details, but grasp their essential features,” and try “to fathom the significance of things and to grasp reality” (1948, pp. 84, 92). In addition, Hindu artists spoke of capturing and conveying the “rasa” or essence, according to Ramachandran and Hirstein (1999).

Even though these neuroscientists cite the observations of Hindu artists, they exclude the experiences of practicing artists from their studies, as Amy Ione (2000) points out, and they also fail to provide empirical evidence.

Like mature artists, unskilled children, adolescents, and adults seem to reveal essences in the subjects they choose and the feelings they express in responding to the drawing task, as well as in their use of humor.

How do our brains process humor? Neuroscientists can make patients cry or smile by stimulating particular regions of the brain, but have difficulty making them laugh, and puns are processed in the left hemisphere, nonverbal jokes in the right. Do mirror neurons enable us to perceive and respond to the various kinds of humor—morbid, disparaging, resilient, playful—expressed through drawings?

Other neuroscientists have been studying the relationships between thoughts and feelings. According to LeDoux (1996), cognition and emotion work together rather than separately, and both involve symbolic representations. Lane and Nadel (2000) note that they are linked inextricably; and Damasio (1994) proposes that human reasoning consists of several brain systems working in concert, that emotions are one of the components, and that, contrary to traditional opinion, emotions are involved in decision making and just as cognitive as other percepts.

Psychologists have used drawings to assess emotions and measure intellectual maturity for more than 50 years. The House, Tree, Person Test (Buck, 1948) and Kinetic Family Drawings (Burns & Kaufman, 1972) assess emotional indicators. The Draw-a-Man Test (Goodenough & Harris, 1963) measures intellectual maturity. The Human Figure Drawing Test (Koppitz, 1968) assesses level of intellectual development as well as emotions. The Torrance Test of Creative Thinking (Torrance, 1984) measures fluency, flexibility, originality, and elaboration.

For more than 40 years, art therapists have demonstrated that drawings can be used to assess and enhance emotional well-being. Some art therapists present unstructured tasks to encourage spontaneity whereas others specify what to draw (Cohen, 1986; Gantt & Tabone, 1998; Kramer, 1971; Lachman-Chapin, 1987; Levick, 1989; Malchiodi, 1997, 1998; Rubin, 1987, 1999; Shoemaker, 1977; Ulman, 1987).

Draw a Story and the Silver Drawing Test are based on the premise that limiting choices can stimulate creativity, and that structuring need not inhibit spontaneity. If we offer choices within boundaries, and encourage respondents to feel free to make final decisions, structured tasks can provide emotional support, particularly when drawing is a novel experience. In addition, the assessments are concerned with content rather than form; with meanings rather than colors, shapes, or other physical attributes; with visual and verbal brain functions; and the mysteries of humor.

Quantitative and Qualitative Findings

This volume presents its findings in two forms: quantitative and qualitative. The quantitative findings are based on groups large enough for statistical analyses; they include experimental and control groups, rating scales, normative data, and studies of reliability and validity. The qualitative studies are based on subgroups too small for statistical analysis, and on individuals: the behaviors, histories, and response drawings of particular children, adolescents, young adults, and senior adults.

I believe that both forms are essential. Without both, the wealth of information that emerges about individuals and small groups vanishes within groups large enough for statistical analyses. On the other hand, without empirical evidence, findings remain speculations.

Other observers have recognized and defined the value of both forms of knowledge. Jacob Bronowski (1973), a scientist at the Salk Institute, has suggested that the scientific search for truth and the human search for understanding belong together, that science has a way of formalizing its language so that it can be persuasive and constantly checked, whereas art and literature carry many messages, not one, and speak for our most secret thoughts and feelings.

Fluornoy has noted that the scientific intellect analyzes, abstracts, and generalizes, and when it deals with particular objects, dissolves their particularity; but it is just this individuality that is the exclusive interest of art (in Allen, 1967).

Stern (1965) has distinguished between the analytical and the intuitive; the artist’s knowledge is intuitive, subjective, and poetic, “an immediate beholding of essences” (p. 42). It can be experienced but not explained, and is contrary to the scientist’s knowledge, acquired through objective analysis. Nevertheless, we can study movement both ways, by floating in the stream ourselves or by timing the passage of a stick as it floats past certain points on shore.

How the Book Is Organized

Section I, “Draw a Story: Screening for Depression and Aggression,” consists of four chapters. Chapter 2 includes guidelines for administering and scoring, together with examples of scored responses. Chapter 3 reviews findings of reliability and validity. Chapter 4 reviews new findings about aggression and depression. Chapter 5 concludes this section with ways that various practitioners have used DAS to assess children, adolescents, and adults with and without emotional disturbances, as well as those who experienced abuse, delinquency, brain injuries, or other disorders.

Section II, “The Silver Drawing Test: Drawing What You Predict, What You See, and What You Imagine,” presents similar findings about the SDT, along with the addition of a chapter of normative data. It reviews recent and previous findings of studies that used the assessment for access to the cognitive skills, emotions, and attitudes of individuals and groups with hearing impairments, brain injuries, and learning disabilities, as well as children, adolescents, young adults, and senior adults with no known impairments.

Section III, “The Use of Both Assessments by Practitioners in Florida and Abroad,” presents updated reports by art therapists who have been using both assessments with students in Florida, as well as reports by practitioners in Australia, Brazil, Russia, and Thailand.

Section IV, “Developmental Techniques and Concluding Observations,” includes studio art techniques for developing cognitive skills, and a chapter of discussion and conclusions.

Section V, “Appendices,” provides testing materials for the SDT and DAS assessments in appendixes A and B, and the original 50 stimulus drawings in appendix C.

Section I

Draw a Story: Screening for Depression and Aggression

Chapter 2

Background

There is an urgent need to identify children and adolescents who may harm others or themselves. Suicide has become a leading cause of death, and antisocial behavior is increasing. The aim of the Draw a Story (DAS) assessment is to identify those at risk. After summarizing its background, this chapter presents guidelines for administering its assessment and scoring responses.

Why DAS Was Developed and How It Evolved

A few children drew suicidal fantasies when responding to the Drawing from Imagination task of the Silver Drawing Test (see appendix A), raising questions whether drawings could be more revealing than face-to-face interviews, and whether the task might be useful in screening for masked depression. Because certain stimulus drawings seemed to elicit these negative fantasies, I included them in a new set of stimulus drawings, and presented them first to children in elementary ...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Contents
• List of Figures
• Foreword
• Acknowledgments
• Chapter 1 Introduction
• Section I Draw a Story: Screening for Depression and Aggression
• Section II The Silver Drawing Test: Drawing What You Predict, What You See, and What You Imagine
• Section III The Use of Both Assessments by Practitioners in Florida and Abroad
• Section IV Developmental Techniques and Concluding Observations
• Section V Appendices
• References
• Index