Management of sexually abused children by non-forensic sexual abuse examiners

Physicians who do not intend to examine children suspected of having been sexually abused still need information about the disorder and its management. A history from the caretaker and child is vital to determine the safety of the child from further abuse and the urgency of a physical evaluation for health and forensic purposes. The disclosure interview of a young child in Arkansas generally should be by an agency investigator to avoid multiple interviews, after a legally mandated report to the Child Abuse Hotline. The physical evaluation can be delayed when the conditions listed in the Table are met, and a referral to a secondary or tertiary level examiner would follow. Otherwise, immediate referral likely will be to a primary level examiner, such as in an emergency department; the child will receive an examination and tests for acute findings and possible referral to a secondary or tertiary level examiner for a more thorough examination. The child and frequently an adult family member should be referred for counseling.