Advanced issues in the medical evaluation of the child alleged to have been sexually abused

This workshop will provide a detailed overview of the “How to” of conducting a comprehensive medical evaluation of the child who is alleged to been sexually abused. Participants will learn both foundational and advanced... [ view full abstract ]

This workshop will provide a detailed overview of the “How to” of conducting a comprehensive medical evaluation of the child who is alleged to been sexually abused. Participants will learn both foundational and advanced issues that will benefit health care professionals new to the field and those with significant experience.

Health care professionals have primarily focused their concerns over the last 30 years on the interpretation of physical findings that are found in less than
5% of child sexual abuse cases. Many clinicians are uncomfortable talking to children about their victimization and thus limit their ability to formulate a defensible diagnosis. This workshop will help educate clinicians how to obtain medical histories of sexual victimization that are forensically defensible. The presenter will provide examples of ways to comfortably engage children in conversation to obtain the idiosyncratic details that reflect sexual victimization.

In addition to developing skills to evaluate sexual abuse from a medical history perspective the following topical areas will be addressed as well. 1) preparation of the child for and discussion of specific examination techniques, 2) video-colposcopy and photo documentation, 3) normal anatomic variants commonly confused with residual to trauma, 4) differential diagnosis of genital findings and diagnostic challenges, 5) understanding the healing chronology of ano-genital trauma and the difficulties in the retrospective interpretation of the residual to acute ano-genital trauma, 6) the transverse hymenal diameter debacle, 7) differentiating “in from on” to address the discrepancy between a child’s perception of their experience and physical examination findings, 8) forensic evidence, 9) sexually transmitted diseases, and 10) formulation of a defensible medical diagnostic report. Although this workshop will be focused on medical issues it will be of value to child protective services, law enforcement and mental health professionals, enhancing their understanding of the what to expect from medical colleagues.