Professionals' attitudes towards suspected cases of child sexual abuse in Saudi Arabia

Objectives: Medical evaluation of children for concerns of child sexual abuse (CSA) requires specialized skills and training including forensic interview skills. The aim of this study is to determine whether three forensic... [ view full abstract ]

Objectives: Medical evaluation of children for concerns of child sexual abuse (CSA) requires specialized skills and training including forensic interview skills. The aim of this study is to determine whether three forensic attitudes (sensitivity, specificity, and skepticism) influence professional’s judgments and contribute to disagreements in conclusion of assessment of CSA cases.

Methods: The cross-sectional study, approved by the ethical committee of King Abdullah International Medical Research Center (KAIMRC) was conducted at law enforcement and prosecutor’s offices, hospital based child protection centers, and educational institutions throughout Saudi Arabia. Sample (N=327) was selected randomly from National Family Safety Program (NFSP) database of professionals in the fields of healthcare, social service, law enforcement, medical examiner, and education who were involved with suspected cases of CSA as part of their job or were in a profession that puts them in contact with such cases. Computer based survey was used for data collection.

Results: More than half of the participants were ≤40 years and male. Twenty five percent were doctor/nurse, social worker (24%), therapist/psychiatrist (20%), educational (17%), law enforcement (9%), and medical examiner (5%). High specificity towards professional’s judgment in assessment of CSA cases was found in sensitivity/specificity analysis. There were significant differences in attitude subscale scores by age (≤40 vs. >40 years), gender, number of training courses (>5 sessions vs. ≤5 sessions), and specialty of the participants with social workers more concerned about undercalling abuse than other professionals (p<0.05).

Conclusions: Strategies can be implemented to control the influence of subjective factors; these are highlighted including self-awareness of personal biases and team approaches of assessment.