Evaluation Of Child Sexual Abuse Research Articles

The Evaluation of Child Sexual Abuse: Child Advocacy Center Example

The Evaluation of Child Sexual Abuse: Child Advocacy Center Example

A Standardized Peer Review Program Improves Assessment and Documentation of Child Sexual Abuse.

Introduction:The objective was to assess the impact of interventions associated with ongoing expert peer review on the quality of child abuse medical providers’ written and photograph documentation in child sexual abuse cases.Methods:Pediatricians participated in a HIPAA compliant blind peer review process on a web platform developed to provide the American Board of Pediatrics maintenance of certification. Participants submit sequential photograph and written documentation of child sexual abuse examinations over 1 year. Documentation includes genital examination descriptions and interpretation of findings. Reviewers evaluate the photographic quality and written documentation of examination findings utilizing a numerical rating system. Each case cycle is reviewed by one of four experts in child abuse who received training in a uniform evaluation process. Reviewers follow each case throughout three cycles of documentation, selecting from several interventions that have been customized to address the quality issues noted. The third and final cycle includes summary comments from the reviewer.Results:Forty-one participants completed the program at the time these data were collected. A paired t test analysis of the combined scores of the three measures, such as Image Quality, Quality of Written Documentation, and Accuracy of Exam Interpretation, showed a statistically significant improvement (P < 0.001) between the first and last sets. In addition, each of the individual measures was statistically significant between the first and last case sets with a P value of <0.05 for each.Conclusion:Peer review with interventions customized to address quality issues improved the quality of the assessment and documentation of child sexual abuse evaluations.

Medical Evaluation of Child and Adolescent Sexual Abuse by Nancy Kellogg, Joyce Adams and Jordan Greenbaum, Evidentia Publishing, Huizen, The Netherlands, 2019. US$250, abridged version US$99. Available: https://www.evidentiapublishing.com/shop-1

Medical Evaluation of Child and Adolescent Sexual Abuse by Nancy Kellogg, Joyce Adams and Jordan Greenbaum, Evidentia Publishing, Huizen, The Netherlands, 2019. US$250, abridged version US$99. Available: https://www.evidentiapublishing.com/shop-1

Creation of a novel educational module to improve the proficiency of sexual assault evidence collection among pediatric emergency providers

Background: Of all sexual assaults in the US, 44% of them are perpetrated against victims less than 18 years of age. The standard adopted by the Ohio Department of Health is for forensic evidence collection to be performed or supervised only by a physician or nurse practitioner (NP) trained and experienced in the evaluation of child sexual abuse. Timing of evidence collection is essential. In a study of 273 children less than 10 years of age, no swabs collected after 9 hours were positive for semen. …

Role of Child Monitoring Centers in the evaluation of child sexual abuse

РЕЗЮМЕ Роль центров Mониторинга в оценке сексуального насилия против детей Acлы ЯЙЯК Бурсский технический университет, Турция Жестокое обращение с ребенком со стороны взрослого человека с целью его сексуального и психосексуального удовлетворения называется сексуальным насилием над ребенком. Известно, что дети из-за их основных характеристик являются группой, наиболее нуждающейся в защите как физически, так и психологически. В этой статье указанно, что деятельность Центров детского мониторинга, действующих в нашей стране с 2010 года, является основным центром оценки процесса сексуальное эксплуатации над детьми. Центры детского мониторинга - это специализированные центры для получения информации от детей, подозреваемых в сексуальной эксплуатации, посещения их семей и подготовки отчетов о других мероприятиях. В 28 различных регионах Турции, функционируют 31 таких центров. В этих центрах регулярно работают психологи, социальные работники, эксперты по развитию ребенка, врачи, медсестры и детские психологи. Здесь, проводятся судебномедицинские встречи, семейные встречи, судебно-медицинские экспертизы и психиатрические обследования. Ключевые слова: Ребенок, сексуальное эксплуатация, центр детского мониторинга, насилие, эксперт

Child Sexual Abuse: Management and Prevention, and Protection of Children from Sexual Offences (POCSO) Act.

Child Sexual Abuse is an alarming reality and is being increasingly reportedin India as well as globally. Pediatricians and allied medical professionals are often the first point of contact with abused children and their families. They have a key role in detecting Child Sexual Abuse, providing immediate and long-term care and support to the victims and their families. India has adopted the Protection of Children from Sexual Offences Act (POCSO) in 2012. It is a comprehensive law on sexual abuse, which expands the scope and range of forms of sexual offences, makes reporting of abuse mandatory and defines guidelines for the examination of victims. Pediatricians and health care professionals need to acquire necessary expertise for clinical evaluation of child sexual abuse, and its prevention, management and reporting.

Common Beliefs About Child Sexual Abuse and Disclosure: A College Sample

ABSTRACTAdults’ common beliefs about child sexual abuse and disclosure were explored. Participants (N = 670) were questioned about key areas of child sexual abuse that could affect decision-making processes of jurors evaluating child sexual abuse cases. These areas included victim and perpetrator characteristics, medical and behavioral indicators of child sexual abuse, memories for the event, and disclosure of the event. The scientific literature pertaining to these same areas are reviewed. While individual beliefs were consistent with some areas of the scientific literature (e.g., victim and perpetrator characteristics), they strongly contrasted the literature in other important areas (e.g., memories for the event, indicators of child sexual abuse, and the likelihood of denial and recantation). Implications, including the option of providing expert testimony to reduce discrepancies, are discussed.

The evaluation of child sexual abuse in child advocacy center: one year experience of a single center

Objective: Child Advocacy Centers (CAC) are multidisciplinary centers that evaluate child sexual abuse (CSA) cases. In Turkey, CACs, first in Ankara, has been established all around the country. This study is conducted to evaluate the CSA cases’ demographic findings, admission types, diagnosis and outcomes in the first year of Izmir CAC. Methods: The data of 943 cases were evaluated retrospectively and 848 child diagnosed as CSA were accepted as the study group. Descriptive statistical analysis were performed. Results: The mean age of the study group was 14.1±3.3 with female/male ratio 5.73. The most common presentation type was sexual abuse due to peer relations of adolescent girls. The most frequent admission type was by law enforcement while the most common presentation by medical services was from psychiatry clinics. The 60% of the study group defined CSA with contact while 27% defined penetration. The perpetrators were frequently (60%) recognized persons before CSA, most of them were friend/boyfriends and darlings. The frequency of incest cases was 10.7%. The most frequent perpetrator of incest cases were fathers. The 99% of perpetrators were males in the study group while 100% in the incest group. Forty eight percent of the study group required forensic examination but the diagnostic value was 32%. Discussion: CACs are functional centers in evaluating child sexual abuse cases in a multidisciplinary approach. As the most common type of admissions is sexual abuse due to peer relations in adolescents, we suggest that preventive social works should focus on this issue.

Community Characteristics Associated With Seeking Medical Evaluation for Suspected Child Sexual Abuse in Greater Houston.

Child sexual abuse (CSA) affects over 62,000 children annually in the United States. A primary obstacle to the success of a public health prevention strategy is the lack of knowledge around community level risk factors for CSA. We evaluated community level characteristics for children seeking care for suspected CSA in the Greater Houston area for 2009. There was a total incidence rate of medical evaluations for suspected CSA of 5.9/1000 children. We abstracted the medical charts of 1982 (86%) children who sought a medical evaluation for suspected CSA at three main medical systems in the Greater Houston area for 2009. We evaluated 18 community level variables from the American Community Survey for the 396 zip codes these children lived in. The mean number of cases per Greater Houston zip code was 2.77 (range 0-27), with 62% of zip codes not having a case at any of the three sites surveyed. Zip codes with a higher than Houston average rate of vacant houses, never married females and unemployed labor force with high family poverty rate, were associated with an increased rate of children seeking care for suspected CSA. We demonstrated zip codes level characteristics which were associated with an increased rate of children seeking care for suspected CSA. Our modelling process and our data have implications for community based strategies aimed at improved surveillance or prevention of CSA. The process of identifying locally specific community level factors suggests target areas which have particular socioeconomic characteristics which are associated with increased rate of seeking CSA evaluations.

The new model in evaluating Child Sexual Abuse: Child Advocacy Centers

The new model in evaluating Child Sexual Abuse: Child Advocacy Centers

Diagnostic agreement when comparing still and video imaging for the medical evaluation of child sexual abuse

Still photo imaging is often used in medical evaluations of child sexual abuse (CSA) but video imaging may be superior. We aimed to compare still images to videos with respect to diagnostic agreement regarding hymenal deep notches and transections in post-pubertal females. Additionally, we evaluated the role of experience and expertise on agreement. We hypothesized that videos would result in improved diagnostic agreement of multiple evaluators as compared to still photos. This was a prospective quasi-experimental study using imaging modality as the quasi-independent variable. The dependent variable was diagnostic agreement of participants regarding presence/absence of findings indicating penetrative trauma on non-acute post-pubertal genital exams. Participants were medical personnel who regularly perform CSA exams. Diagnostic agreement was evaluated utilizing a retrospective selection of videos and still photos obtained directly from the videos. Videos and still photos were embedded into an on-line survey as sixteen cases. One-hundred sixteen participants completed the study. Participant diagnosis was more likely to agree with study center diagnosis when using video (p<0.01). Use of video resulted in statistically significant changes in diagnosis in four of eight cases. In two cases, the diagnosis of the majority of participants changed from no hymenal transection to transection present. No difference in agreement was found based on experience or expertise. Use of video vs. still images resulted in increased agreement with original examiner and changes in diagnostic impressions in review of CSA exams. Further study is warranted, as video imaging may have significant impacts on diagnosis.

A Retrospective Analysis of Children's Assessment Reports: What Helps Children Tell?

This paper explores a retrospective analysis of children's file data as a research method of gathering information on children's experiences of informal disclosure of child sexual abuse. This study extracted data from files where children were seen for a child sexual abuse evaluation in Ireland and the children were deemed to have given a credible account of abuse by the professionals concerned. A content analysis was conducted using themes identified in previously published research, based on direct interviews with children about their experiences of informal disclosure. The paper discusses the relative merits and limitations of this method, through reporting on the findings of the file analysis and comparing these findings with findings obtained from a smaller sub‐sample of this sample of children, who were interviewed about their experiences of disclosure. It is suggested that this method is worth exploring with a larger sample size which would enable statistical analysis and thus explore the predictive factors influencing early informal disclosure. Frontline services can contribute to the knowledge base on what helps children tell through service‐based research that uses data already collected from evaluation interviews with children, thus eliminating the need to interview children for research purposes. Copyright © 2015 John Wiley &amp; Sons, Ltd.‘A content analysis was conducted using themes identified in previously published research’Key Practitioner Messages Frontline professionals gather useful data on a daily basis on informal disclosures of child sexual abuse. Practitioners can contribute to the knowledge base on informal disclosure by systematically gathering information from service users. We need more information on what helps children tell. We therefore need to explore innovative methods of gathering such information directly from children in ways that do not rely on interviewing children repeatedly yet include the child's voice. ‘We need more information on what helps children tell’

A entrevista de crianças com suspeita de abuso sexual

O presente trabalho tem como objetivo revisar a literatura científica referente às melhores práticas na entrevista de investigação do abuso sexual infantil. Foi realizada uma revisão narrativa da literatura sobre as particularidades da memória e das habilidades de comunicação da criança em situação de entrevista investigativa, bem como as diferentes técnicas que permitem aprimorar a qualidade dos relatos infantis e maximizar a quantidade de informações obtidas. Foram pesquisadas as seguintes bases de dados: MedLine, PsychInfo e SciELO, no período de 1995 a 2012, utilizando-se as palavras-chave "sexual abuse", "children", "interview", "investigative"e "forensic".Foram encontradas 196 referências, das quais 34 foram selecionadas para inclusão neste artigo. Foi encontrado grande número de evidências demonstrando a necessidade de procedimentos cuidadosos para avaliar as suspeitas de abuso sexual. Técnicas específicas são descritas, assim como são discutidas as dificuldades frequentemente encontradas pelos entrevistadores.

A Nationwide Survey of Peer Review Practices in Child Maltreatment Teams

Medical evaluations for suspected child sexual abuse carry a significant medico‐legal burden and are often performed in a variety of clinical settings, by clinicians with different levels of expertise and experience. Peer review or professional practice evaluation is an important component for quality assurance. We surveyed 255 programmes which provided sexual abuse evaluations which were identified through queries with national child abuse professional organisations. We sought information on team composition and setting, patient population characteristics and each site's peer review process. Of the 129 responding programmes, 42 per cent (n = 44) reported having a written peer review process. There were no differences between practice types with regards to having a written peer review process, the percentage of cases reviewed, the documentation type reviewed or the percentage reporting an external review process. The majority of programmes (n = 89, 85%) reported that they review both chart and photo documentation during the peer review process. Our data support that most programmes involved in child maltreatment evaluations undergo some form of peer review, but there exists a large amount of heterogeneity in the process by which it occurs. Copyright © 2014 John Wiley &amp; Sons, Ltd.‘We surveyed 255 programmes which provided sexual abuse evaluations’Key Practitioner Messages: Peer review is an important process to ensure high quality of clinical practice. The majority (80%) of programmes which perform child sexual abuse evaluations reported performing some form of peer review. Most peer review involves both chart and photo documentation reviews. ‘Most peer review involves both chart and photo documentation reviews’

Child sexual abuse research knowledge among child abuse professionals and laypersons

The purposes of this study were to: (1) Assess child abuse professionals’ and nonprofessionals’ knowledge of scientific research findings that are relevant to forensic child sexual abuse (CSA) evaluations and (2) describe associations between child abuse professionals’ levels of research knowledge and their education and experience. An 18-item multiple-choice test was administered to 188 child abuse professionals and 457 nonprofessionals (undergraduate college students) in Brazil and the United States. The nonprofessionals’ average percent correct, M=44%, was not significantly different than what would be expected for random guessing (45%). The professionals’ average percent correct, M=55%, was higher than that of nonprofessionals and random guessing (both ps<.001). The average percent correct score for the US-sample psychologists, M=76%, was higher than the average score of the other professionals, M=51%, p<.001. Professionals’ educational level, as measured by the highest academic degree obtained, was positively associated with percent correct scores, Spearman's ρ=.46, p<.001. Controlling for educational attainment, professional experience, as measured by the total number of CSA evaluations performed, was weakly associated with percent correct scores, partial r=.15, p=.04. Percent correct scores were low for both nonprofessionals and professionals. Most of the participants in this study were uninformed or misinformed about scientific research findings that are important for conducting optimal forensic CSA evaluations and for making accurate judgments about the validity of sexual abuse allegations.

Educating Physicians Internationally in the Diagnosis of Child Sexual Abuse: Evaluation of a Brief Educational Intervention in Malawi

We designed this pilot study to assess physician knowledge and comfort evaluating child sexual abuse in Malawi and to evaluate the feasibility of a brief educational intervention to improve physician knowledge. A survey was administered to 21 physicians before receiving training on child sexual abuse. The survey was administered again, 3 days later, to assess improvement. Prior to the training, 48% correctly identified the hymen in a photograph, and 24% correctly interpreted the photograph as normal. Of the 11 physicians available for the posttest 3 days later, significant improvement was found in their ability to correctly identify the hymen (6 of 11 pretraining and all 11 posttraining, p = 0.011) and to interpret the photograph correctly (1 of 11 correct pretraining, 9 of 11 posttraining, p = 0.001). This study demonstrates the feasibility of designing trainings on child sexual abuse in a low-income country.

Is There a Place for Extended Assessments in Addressing Child Sexual Abuse Allegations? How Sensitivity and Specificity Impact Professional Perspectives

Using data from a survey of perceptions of 932 child welfare professionals about the utility of extended assessments, the researchers constructed a scale to measure respondents' views about sensitivity (ensuring sexually abused children are correctly identified) and specificity (ensuring nonabused children are correctly identified) in child sexual abuse evaluations. On average, respondents scored high (valuing sensitivity) on the sensitivity versus specificity scale. Next, the researchers undertook bivariate analyses to identify independent variables significantly associated with the sensitivity versus specificity scale. Then those variables were entered into a multiple regression. Four independent variables were significantly related to higher sensitivity scores: encountering cases requiring extended assessments, valuing extended assessments among scarce resources, less concern about proving cases in court, and viewing the goal of extended assessments as understanding needs of child and family (adjusted R2 = .34).

Development of standardized clinical training cases for diagnosis of sexual abuse using a secure telehealth application

ObjectivesThe training of physicians, nurse examiners, social workers and other health professional on the evidentiary findings of sexual abuse in children is challenging. Our objective was to develop peer reviewed training cases for medical examiners of child sexual abuse, using a secure web based telehealth application (TeleCAM). MethodsSixty de-identified cases developed by 2 child abuse pediatricians, were stratified by availability of information (minimal, moderate, comprehensive) for both positive and negative child sexual abuse findings. These cases were narrowed to a set of 30 cases through an expert peer review process using pediatricians with extensive expertise in the evaluation of child sexual abuse. A previously studied secure web-based telehealth application TeleCAM which contains a child abuse workflow, was used to develop, disseminate and review cases. A series of Free Margin agreement statistics are used to select those cases with the highest rates of agreement. A final set of 30 cases are stratified equally by availability of information and for both positive and negative findings. Mantel Haenszel Chi-square was used for trend analysis of the ordered categorical variables. ResultsThe highest degrees of inter-rater reliability was found in cases with moderate to comprehensive information. Cases with minimal data had poor kappa agreement indicating that availability of differing levels and types of information contribute to variability in diagnostic findings. ConclusionThese final cases will be further studied with medical examiners in various settings utilizing TeleCAM as the application for dissemination.

Reliability of Professional Judgments in Forensic Child Sexual Abuse Evaluations: Unsettled or Unsettling Science?

In the absence of photographic or DNA evidence, a credible eyewitness, or perpetrator confession, forensic evaluators in cases of alleged child sexual abuse must rely on psychosocial or “soft” evidence, often requiring substantial professional judgment for case determination. This article offers a three-part rebuttal to Herman's (2009) argument that forensic decisions based on psychosocial evidence are fundamentally unreliable and that this conclusion represents settled science. The article also discusses the potentially adverse consequences of Herman's proposed reforms to forensic practice on child protection and prosecution efforts.

Conducting the Medical History

A key portion of the medical evaluation of child sexual abuse is the medical history. This differs from interviews or histories obtained by other professionals in that it is focuses more on the health and well-being of the child. Careful questions should be asked about all aspects of the child's medical history by a skilled, compassionate, nonjudgmental, and objective clinician. Often the diagnosis of sexual abuse is based only on the medical history. The history can be further understood by knowledge of how children are abused and their reactions to it. By addressing the child's and parent's concerns, reassurance can also be provided about what is normal and abnormal with the child's body.