A Practical Guide to the Evaluation of Sexual Abuse in the Prepubertal Child

Carefully developed and thoroughly field tested, this volume is a guide to aid practitioners in the identification, evaluation and documentation of suspected sexual abuse of children. It will be invaluable to a broad range of professionals, including paediatricians, doctors, nurses, health care and child protection workers, clinical social workers and psychologists. Including over 45 medical illustrations, the manual reassures caregiving professionals in their role as health care provider and/or child advocate. It provides a solid reference showing how to proceed with medical and psychological assessment and gives practical guidelines for doing physical and genital examinations, pertinent laboratory studies and proper documentation.

Table of Contents:
Foreword - Suzanne M Sgroi The Problem The Evaluation Interview and History Physical Examination and Laboratory Specimens Differential Diagnosis of Anogenital Findings Sexually Transmitted Diseases (STDs) Mental Health Evaluation - Julie Lippmann and Ester Deblinger-Sosland Documentation and Conclusions Foreword - Extended Contents Suzanne M Sgroi Definition - Chapter One: The Problem Scope of the Problem Incidence and Prevalence Categories Included in Sexual Abuse Conceptual Models Preconditions for Sexual Abuse Characteristics of the Perpetrator Longitudinal Progression of Sexual Abuse Child Sexual Abuse Accommodation Syndrome Long-Term Effects of Sexual Abuse Issues of Power and Control Brief Approach to Evaluation of Sexual Abuse - Chapter Two: The Evaluation Emergent Evaluation History Physical Examination Laboratory Studies Documentation Brief Interview as Diagnostic and Therapeutic - Chapter Three: Interview and History The Interview Process Compliance with Legal Responsibilities Brief Physical Examination - Chapter Four: Physical Examination and Laboratory Specimens Familiarity with the Prepubertal Examination Laboratory Findings Lack of Evidence Basic Anatomy and Development Estrogen Effect on Female Genitalia Huffman Stages Outward Sexual Development Tanner Stages Normal Female Genitalia Male Anatomy Anal Anatomy Variables Affecting Physical Evidence Findings in Sexual Abuse Degree of Physical Contact Extragenital Trauma Fondling and Digital Penetration Male Abusive Findings Anal Examination Findings Penile Contact with Genitalia and Anus Oral-Genital Contact Penile Penetration Summary of Abuse Findings Accidental Trauma Preparing for the Physical Examination with the Child Genital and Perianal Examination Examining the External and Internal Structures Collection of the Specimens Forensic Evidence Brief Framework for Consideration - Chapter Five: Differential Diagnosis of Anogenital Findings Anogenital Erythema, Excoriation, Pruritus Anogenital Bruising Anogenital Bleeding and/or Bloody Vaginal Discharge Nonbloody Vaginal Discharge usual Anatomic Appearance Gonorrhea - Chapter Six: Sexually Transmitted Diseases Chlamydia Trachomatis Syphilis Condyloma Acuminata Trichomoniasis Herpes Genitalis HIV Pediculosis Pubis Gardnerella Vaginalis Chancroid and Granuloma Inguinale Candida Brief Referrals - Chapter Seven: Julie Lippmann and Ester Deblinger-Sosland: Mental Health Evaluation Purpose of the Mental Health Evaluation Interviewing the Child Aspects of Validation Assessment of Emotional Impact Interviewing Other Family Members Feedback and Recommendations for Treatment Prognosis eatment Detail of the Medical Record - Chapter Eight: Documentation and Conclusions Recording the History Recording the Physical Examination Court Testimony Conclusion In Brief