Trauma, Stress, and Memory After Sexual Assault

When someone comes forward with a case of assault, it can be difficult for others to fully understand the experience of the survivor. We have touched before on related topics, like how to help victims, the barriers some face, and how damaging abuse like this can be. This blog post will look into the mental disruptions sexual assault causes and how sexual assault is categorized as a traumatic event. Read More »

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Signs of Abuse for Mandated Reporters

Mandated reporters interact with children at places like daycare, school, doctor offices, and activity centers and act as a pivotal player in protecting children from abuse. However, if mandated reporters don’t know what they’re looking for, taking the appropriate actions for children becomes difficult. Read More »

Infant Child Abuse – Claire’s Story

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Claire, a 6-month-old female, presents to the local child advocacy center (CAC) accompanied by a Child Protective Services (CPS) social worker. The social worker picked up Claire from daycare earlier today after law enforcement found child pornography on a home computer belonging to Claire’s father. The uncovered pornography includes many photographs of unidentifiable infants and very young children positioned in explicit sex acts, including photographs of adult men fondling infants. The local police department is assisting the Federal Bureau of Investigation (FBI) in investigating the case.

After finding the child pornography, law enforcement picked up Claire’s mother from work and took her to the police station for questioning, before she had the chance to speak with Claire’s father. With permission from law enforcement, Claire’s mother calls the CAC and gives verbal consent for a medical forensic examination to the forensic nurse, with the CPS social worker on hand to witness the verbal consent. Claire’s mother provides the forensic nurse with her identifying social security information and birthdate as well as a brief medical history of her child. Both the forensic nurse and social worker sign a consent form, testifying to the provision of verbal consent and identifying information. The social worker informs Claire’s mother that she will contact her after the medical forensic evaluation to answer questions.

Claire’s health history is negative for recent illness or injury, hospitalization, or surgery. According to her mother, she had an ear infection at “somewhere between 4 and 5 months old” and received treatment, which she completed. Claire is up to date on her immunizations schedule and had a well-child visit when she turned 6 months old. Her next visit is planned for her 9-month checkup. Claire’s mother relates that neither she nor Claire’s pediatrician has any concerns related to Claire’s growth and development. She reports that she bathed Claire last night and “only rinses [her] privates.” The mother also reports that she is currently under treatment for severe depression and posttraumatic stress disorder (PTSD), which manifested after she delivered Claire. When asked if she ever leaves Claire unattended, she says, “Only with her father, especially when I feel sad.” It should be noted that Claire’s mother and father are teenagers. After speaking with the forensic nurse at the CAC, law enforcement requests a kit collection from the patient’s mouth, anus, and vulva.

To learn more about how to help children in Claire’s situation, please click here to visit our site and help us stop child abuse together.

 

Pediatric Nonfatal Strangulation Photodocumentation Protocol

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There are many resources available in Child Abuse Sexual Assault Assessment. The Appendices in Section III contain five useful sections, including photodocumentation protocol with information on kid-friendly communication in a medical setting. Helpful tips include:

1. Talk with the child and use their name. This helps the child feel that you care.

2. Smile and say something positive to the child (eg, “Your hair looks cute today.”). Kids like friendly adults and will respond better.

3. Sit or squat lower than the child. This gives them some feeling of control over the situation. This will help calm their nerves, fears, and anxieties, thus increasing their level of cooperation.

4. Phrase your instructions as “helping” (eg, “I need you to help me by placing your hands in your lap. Let me show you.”).

5. Reassure and praise when it is due (eg, “You are doing such a good job!”).

6. Give the child a helping role. Children like to help, and playing a role in their own examination gets their mind off being apprehensive or fearful.

7. Distraction is your friend in pediatric care. Have child-friendly toys or coloring books for them to play with as well.

Mastering the Lingo: What Kids Hear When You Say…

1. Young children do not get abstract ideas. They are concrete, so be specific with the task. Instead of saying “relax,” say “Please place your hand on your lap.”

2. Use open-ended questions allowing them to talk. Be patient and listen.

3. Trauma-informed care and interviews work better when you ask children questions that will make them use any of their 5 senses (eg, “Tell me everything about what you smelled.”).

4. Children respond better to friendly adults who smile and listen.

 

For more information on Pediatric Nonfatal Strangulation Photodocumentation Protocol. please visit our Web site.

 

Non-Emergent Examination Procedures and Techniques

When sexual abuse is first reported, medical staff should determine when and where the medical evaluation should be conducted. Some communities have a single program or facility that provides evaluations for all victims regardless of when the abuse occurred, whereas other communities have one program for victims with recent or acute injuries and another for victims who were abused several days or more prior to their clinical presentation.

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Evidence Collection in Sexual Assault

In the aftermath of a sexual assault or rape, evidence is collected from the victim by a forensic nurse for a number of reasons. It can confirm sexual contact, confirm that force or coercion was used, and identify the suspect through DNA. Ideally, the evidence collected can help catch the criminal responsible in a timely manner to prevent further crime. As outlined in our Medical Response to Adult Sexual Assault, this post explores what evidence is collected and injuries that are documented from SANE/SAFE personnel. Read More »