Non-Emergent 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. Victims of recent abuse are likely to require forensic evidence collection, photo documentation, or treatment for injuries. Victims of chronic or remote abuse usually do not have emergent medical or forensic needs and their medical evaluations can occur in an outpatient setting. Child advocacy centers and outpatient facilities often provide a child-friendly, calm, safe, and supportive setting for non-emergent medical evaluations, victim assistance, counseling, and other services.

Some experts are questioning the need for a medical examination. The majority of examinations for sexual abuse result in normal findings, especially when the last incident of abuse may have occurred some time previously. There are several reasons why the medical assessment is recommended.

— The child may not provide a full disclosure of the abusive acts and the examination may reveal evidence of penetrative trauma.

— The child and family are often concerned about whether the child’s body is normal, and more specifically, whether the hymen is undamaged.

— Reassuring the child and family that the examination findings are normal may reduce anxiety and make the child feel less stigmatized by the abuse.

— In court proceedings, jurors and judges may perceive the lack of a medical assessment as an incomplete investigation, negating the importance of the victim’s statement.

— Some children are victims of repeated sexual abuse. Examinations with photo-documentation allow for detection and comparison of changes that can occur over time.

— The presence of a previously undiagnosed sexually transmitted infection (STI) such as venereal warts may be detected.

We hope to provide professionals who work with victims of assault and abuse with the most up-to-date information when confronted with abusive situations. Read more about medical examination procedures in Medical Response to Child Sexual Abuse. For more information on what we do, visit our website or subscribe to our newsletter.


Offenders of Child Sexual Exploitation

Child sexual offenders work to gain trust, social status, and control to harm children, noted with the recent news of Larry Nassar who used his prestige as a renown doctor to abuse hundreds of athletes. Although he has been sentenced to life in prison for his crimes, it is important to know what to look out for to prevent future offenses. This post identifies child sexual abuse offender characteristics as well as their process to gain power and control over their victims, as outlined in our Child Sexual Exploitation Quick Reference.Read More »

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 »

Debunking Myths About Child Abuse

Stories of child abuse litter the news on a weekly basis, each one as heartbreaking as the next. Through these stories, and its portrayal in other media, we build assumptions on what the circumstances must be for abuse to happen. However, these assumptions are not entirely accurate and can hinder the credibility of cases that break out of these stereotypes. Outlined in Nursing Approach to the Evaluation of Child Maltreatment 2E, this post explores common myths around child abuse and the truth behind them.Read More »

Prevention of Abusive Head Trauma

Children under the age of five are the most likely to be affected by abusive head trauma, sometimes resulting in long-term injury or death. Fortunately, abusive head trauma is preventable when parents know the right information about infant behavior, the right audiences are addressed with hands-on training, and awareness of the frustrations of care-giving are brought to the surface. Featured in our abusive head trauma titles, here are some ways to prevent abusive head trauma. Read More »