Child sexual abuse at the outpatient department - Comparison of two years of alleged childhood sexual abuse at the outpatient department

Introduction: Diagnosing childhood sexual abuse (CSA) in children is difficult because of lack of disclosures, absence of symptoms or non-specific symptoms only. It is debatable how systematic and objective the evaluation of... [ view full abstract ]

Introduction: Diagnosing childhood sexual abuse (CSA) in children is difficult because of lack of disclosures, absence of symptoms or non-specific symptoms only. It is debatable how systematic and objective the evaluation of suspected CSA is by multidisciplinary child abuse and neglect (CAN) teams. We aim to evaluate: 1- reasons for suspecting CSA; 2- used diagnostics during evaluations and the outcomes; 3- conclusions of a multidisciplinary CAN-team; 4- and to compare these with predefined categories to classify CSA suspicions (no suspicion to proven CSA). 

Methods: retrospective chart analysis of all cases of CSA in 2012 and 2016 in our hospital.

Results: We included 111 children (2012: n=56, 2016: n=55; median age: 6 years (range 1-16), 79.3% female), parents were separated in 60.45%. Main reason for suspecting CSA was “disclosure to family member” (43%) and most often the mother was the first to suspect CSA (51%) and the father the suspected perpetrator (32%). Mother suspects father of CSA in 21.6% (2012: 33%, 2016: 67%). In 59% there were signals of CSA in the case history, in one case genital examination showed signs of penetrative trauma, deviant behavioral reactions were observed in 16% during the examination. Pregnancy test was positive in one case, and in 4 children a sexual transmitted infection were found. In 38 cases (34%) there was agreement between the CAN-team and conclusions based on our predefined criteria.

Discussion: Clinicians are confronted with high conflict divorces more often. In these cases it is most important that conclusions are objective and systematic. Based on the preliminary results (2012 and 2016) there was agreement between the conclusions of multidisciplinary CAN-team and our predefined criteria  in a minority of cases. During the conference we will present additional data on 2013-2015.