NCJ Number
106590
Date Published
1987
Length
11 pages
Annotation
Techniques of conducting medical assessments of child victims of sexual abuse are described, based on the author's involvement in about 300 assessments at the Sexual Assault Referral Center (SARC) in South Australia.
Abstract
All professionals involved in medical examinations of abused children must be guided by the statement, 'First, do no harm.' They should also try to make the medical assessment a positive experience that helps the child progress toward emotional well-being. SARC's staff consist of doctors, a nurse coordinator, social workers, and a secretary. Appointments for most cases are made in advance, allowing staff time to establish a good relationship with the mother and to clarify expectations. The medical assessment has four components: (1) allowing the child to divulge the extent of the sexual abuse, (2) assessing the injuries and collecting any necessary forensic specimens, (3) determining the impact of the abuse and planning future therapy, and (4) providing liaison with other agencies to protect the child. Assessment starts with a meeting with the child and supportive parent in pleasant surroundings. The doctor then talks to the child with the nurse and social worker but, if possible, without the parent present. They use drawings and dolls and try to check the child's allegations during the history taking and the physical examination. The doctor also voices positive messages that the child's body has not been damaged and is not bad. Children receive continued reassurances that they are believed, that they are not to blame, that they are not permanently harmed, and that they are worthwhile persons deserving of protection and continued help to feel better about themselves. The social worker counsel the mother and emphasizes that the offender's taking responsibilities for the actions is an important first step in the child's recovery. Most children and adolescents are referred to a local hospital for ongoing therapy. 2 figures.