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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
PubMed
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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.

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  • 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.