The study examined the impact of Children’s Advocacy Centers (CACs) and other factors, such as child’s age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse.
Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims. Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables; 48 percent of children at the CACs had a forensic medical exam compared to 21 percent of children at comparison communities. More females, younger children, white children, children with reported penetration, and victims who were physically injured while being abused were more likely to have exams. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of all exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professionals. Receipt of a medical exam was not associated with offenders being charged. More information is needed about how community structures, resources, and philosophical belief systems of professionals enhance or deter receipt of exams. Some communities have multidisciplinary teams and child abuse diagnostic centers that may be quite effective given geographic areas and limited resources. CACs are one model of service delivery. They are currently the only multidisciplinary investigation model that has a national membership board and a formal accreditation process. CACs should participate actively in the inquiry about developing national benchmarks or standards about referral criteria for forensic medical exams. Tables, references