This paper reviews a body of research on the author's Silver Drawing Test (SDT) and Draw A Story (DAS) art-based 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 may be at risk for depression. (Contains 1 figure.)