NCJ Number
183740
Date Published
1997
Length
16 pages
Annotation
Pediatricians and other health care practitioners have an important role to play in the multidisciplinary examination and evaluation of child sexual abuse.
Abstract
Although clinicians vary in their willingness to consider the diagnosis of child sexual abuse, it is the responsibility of all pediatric care providers to report any suspicions of child sexual abuse. There are many reasons why some clinicians avoid involvement with child sexual abuse cases, including too little time, disruption of office routine, feeling of incompetence regarding assessment, inadequate technical expertise, and lack of specific interviewing skills. Nonetheless, medical evaluation of sexually abused children is necessary. Clinicians who perform the medical assessment of acutely assaulted children should be aware of the particular capabilities of local law enforcement and forensic laboratories that will process the collected materials. Sophisticated forensic techniques are available in many jurisdictions or may be accessed by sending specimens to referral centers. Even in remote areas without specialized referral centers, clinicians can aid the investigation by microscopically inspecting urine samples or wet mounts from vaginal swabs to detect the presence of sperm. Referral of a child who has not been acutely sexually abused to the nearest emergency room for immediate examination should be avoided since the inherently chaotic nature of the emergency room setting is entirely inappropriate for this emotionally charged diagnosis. In cases of suspected child abuse, a careful well-conducted interview is likely to be more even more critical to making the diagnosis than the physical examination. Interview procedures to guide clinicians are described, along with procedures for conducting physical examinations in a manner that provides emotional support to the child during the course of an examination. 42 references, 3 tables, 3 figures, and 2 photographs