NCJ Number
145423
Journal
Child Abuse and Neglect Volume: 17 Issue: 5 Dated: (September-October 1993) Pages: 663-676
Date Published
1993
Length
14 pages
Annotation
The extent to which medical examiners agree about whether children being examined for possible child sexual abuse have normal genitalia was studied using a sample of 170 medical examiners, 82 percent of whom were pediatricians.
Abstract
The participants were shown preselected colposcopic photographs of the anogenital area of 16 children, but were not told the history of any child. Seven children had not experienced abuse; the other nine had been referred to a California medical center for evaluation for child sexual abuse. Results revealed that the characteristics most often considered suggestive of child sexual abuse were immediate anal dilatation with no stool present, hymenal transection, marked narrowing of the hymenal rim with notching, and posterior fourchette scar. The participants and the experts agreed 81 percent of the time on abnormal cases, compared to 71 percent of the normal findings. Findings indicated the need for consensus development for the definition of findings that should be considered specific for sexual abuse or penetrating injury. Also needed are more research documentation of variations in normal anatomy and more education of medical examiners regarding characteristics of abused and nonabused children. Finally, the history from the child remains the most important factor in determining whether sexual molestation has occurred. Tables, photographs, and 16 references