Guidelines for Medical Care of Children Who May Have Been Sexually Abused

Adams, Joyce A.; Kaplan, Rich A.; Starling, Suzanne P.; Mehta, Neha H.; Finkel, Martin A.; Botash, Ann S.; Kellogg, Nancy D.; Shapiro, Robert A.

doi:10.1016/j.jpag.2006.10.001

« Previous Next »Journal of Pediatric and Adolescent Gynecology
Volume 20, Issue 3 , Pages 163-172, June 2007

Guidelines for Medical Care of Children Who May Have Been Sexually Abused

Joyce A. Adams, MD
- University of California, San Diego School of Medicine, San Diego, California
- Address correspondence to: Joyce A. Adams, MD, University of California, San Diego Medical Center, 200 W. Arbor Drive, San Diego, CA 92103-8449
Rich A. Kaplan, MD
- Midwest Children's Resource Center, Children's Hospitals and Clinics of Minnesota, St. Paul, Minnesota
Suzanne P. Starling, MD
- Child Abuse Program, Children's Hospital of the Kings Daughters, Eastern Virginia Medical School, Norfolk, Virginia
Neha H. Mehta, MD
- Sunrise Children's Hospital, Las Vegas, Nevada
Martin A. Finkel, DO
- Child Abuse Research, Education and Service Institute, University of Medicine and Dentistry of New Jersey, Stratford, New Jersey
Ann S. Botash, MD
- SUNY Upstate Medical University, Syracuse, New York
Nancy D. Kellogg, MD
- University of Texas Health Science Center, San Antonio, San Antonio, Texas
Robert A. Shapiro, MD
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

Abstract

Background

Children who may have been sexually abused are examined in many different settings by medical providers with variable levels of education and experience in this special area of practice. Therefore, there is a need for a consistent evidence-based approach that is agreed upon by medical experts.

Objectives

To develop and provide guidelines and recommendations for performing and interpreting findings of the medical evaluation of children referred for sexual abuse medical evaluations, and to provide guidelines for the education, oversight, and peer review process for clinicians who provide assessments for suspected child sexual abuse.

Methods

Participation from medical providers was solicited through postings on the Internet listserves administered by Cornell University (Special Interest Group in Child Abuse), and by the Ray E. Helfer Society, an honorary society for physician specialists in child abuse diagnosis and treatment. The guidelines were developed through review and critique of published research studies, discussions in focus group meetings at child abuse medical conferences, and ongoing communication leading to revision of draft documents.

Results

Groups of 10 to 40 physician experts met at child abuse conferences between January 2002 and January 2005 to revise the table summarizing the interpretation of physical and laboratory findings in suspected child sexual abuse and to develop guidelines for medical care for sexually abused children. Between January and December 2005, the guidelines were expanded and revised.

Conclusions

The guidelines presented here reflect the current knowledge, recommended clinical approaches, and required competencies in the field of child sexual abuse medical evaluation.

Key Words: Child sexual abuse, medical evaluation, guidelines