A study of more than two hundred children using Rawley Silver's draw a story test showed a strong correlation between aggression or depression and certain types of artistic narratives; meanwhile, unbeknownst to Silver, a pair of Russian therapists were using Silver's assessment tests in a similar fashion with Russian children and achieving similar results.

Aggression and Depression Assessed Through Art: Using Draw-A-Story to Identify Children and Adolescents at Risk came about as a result of these studies, but the book's scope goes beyond the numbers to investigate the connections between a child's expression through drawing and his violent behavior. The text, written mostly by Silver but with chapters contributed by therapists from both the United States and Russia, compares drawings by children who have already exhibited violent behavior with those who have not, thus exploring the potential of the test for use as an early identifier of children and adolescents at risk for depression or inappropriate aggression. Other chapters examine the changes in emotional state revealed by a child's responses to standard art assessment tests, as well as the cross-cultural applications of Silver's tests. Silver is recognized as one of the earliest developers of art therapy in the United States, and by providing mental health professionals with a tool to help identify and treat disturbed children this book represents yet another of her major contributions to the field.