Indicators in children's drawings as a tool for identifying sexual abuse.

Children often struggle to verbally express experiences of sexual abuse due to confusion, fear of consequences, or emotional bonds with the abuser; however, they may indirectly reveal aspects of these experiences through drawings. This study employed directed content analysis to examine emotional and behavioral indicators in the drawings of 28 children (13 girls and 15 boys) with confirmed histories of sexual abuse in Iran, the majority of whom (85%) were Afghan immigrants. Children were asked to draw a family picture and describe its features. Three researchers independently coded the drawings using a framework derived from prior studies, and discrepancies were resolved collaboratively. Key visual indicators included floating objects, heavy pencil pressure, asymmetrical arms, one-dimensional forms, frog-like or monstrous figures, unstable feet, and horizontally positioned arms. These features appeared more frequently in drawings by children abused by their father, the mother's partner, or a male family acquaintance. While these visual elements are not diagnostic markers of child sexual abuse, the findings suggest that drawing-based cues may offer clinicians complementary insights into children's emotional states-such as fear, anxiety, insecurity, aggression, or low self-image-particularly when verbal disclosure is difficult. Given the absence of a control group and the cultural specificity of the sample, the results should be interpreted with caution and may not be generalizable to other populations.