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Evaluating the child for sexual abuse
S L Lahoti1, N McClain, R Girardet
1Department of Pediatrics, University of Texas Medical School at Houston, USA. slahoti@cac.co.haris.tx.us
American Family Physician
|March 23, 2001
Summary
Detecting child sexual abuse requires careful medical evaluation. While physical signs can be subtle, a child
Area of Science:
- Pediatrics
- Forensic Medicine
- Child Psychology
Background:
- Child sexual abuse (CSA) can manifest with varied physical and behavioral symptoms.
- Many physical findings in CSA cases are nonspecific or within normal limits.
- The child's disclosure is crucial due to the often subtle nature of physical evidence.
Purpose of the Study:
- To outline the medical evaluation of child sexual abuse victims.
- To emphasize the importance of thorough history taking and physical examination.
- To guide physicians on interpreting findings and utilizing diagnostic tools.
Main Methods:
- Detailed medical history collection from the child.
- Comprehensive physical examination, including anogenital assessment.
- Consideration of laboratory tests and forensic evidence collection when indicated.
Main Results:
- Physical findings may include anogenital issues, enuresis, or encopresis.
- Behavioral changes can encompass aggression, depression, and regression.
- Physician familiarity with normal variants and abuse indicators is vital for accurate diagnosis.
Conclusions:
- Physician documentation of history and examination is critical for legal proceedings.
- Individualized treatment plans, including laboratory tests and therapy, are recommended.
- Referral to psychological services is essential for managing long-term mental health impacts like PTSD.