Suspected Sexual Abuse Research Articles

Postmortem Changes of Female External Genitalia and Their Importance in Suspected Sexual Abuse.

Examination of the female external genitalia to assess for sexual abuse is performed in living individuals, and the interpretation of the findings is based on evidence-based studies. However, in the deceased, no such studies are available, and postmortem changes could present as suspicious findings that can be mistaken for trauma. Patches of discoloration in the hymen were reported previously in one case as hypostasis (i.e., livor and lividity), and based on this finding, it was listed as a finding that is not associated with trauma. This was a retrospective study that was conducted in the Center of Forensic and Legal Medicine in Dammam, Saudi Arabia over a 4-year period. The study included 30 deceased women in whom photographic documentation of their external genitalia was assessed for postmortem changes. The postmortem interval ranged from less than 24 h to more than 100 days, and the ages of these deceased women were in the 20-40 year-old age group. In cases where the hymen, vagina, and/or fossa navicularis were clearly visible, none of these areas showed any hypostatic discoloration. A comparison between antemortem and postmortem appearance of the hymen in one case clearly showed the absence of hypostatic changes in the hymen. In conclusion, any discoloration of the external genitalia that is detected in a female decedent requires serious consideration.

A Systematic Review of Instruments used to Assess Nonverbal Emotional Signs in Children during an Investigative Interview for Suspected Sexual Abuse

Sexually abused young people often display few or no physical symptoms, and delay of verbal disclosure is common. Based on previous research, we assume that sexually abused children and adolescents may display nonverbal emotional signs, which can be assessed during an investigative interview for suspected child sexual abuse (CSA). We aim to present an overview of reported instruments for the assessment of children's and adolescents' nonverbal emotional signs by medical, psychological and forensic professionals during an investigative interview for suspected CSA. Structured search strategies were developed for MEDLINE (OvidSP), Embase (OvidSP) and PsychINFO (OvidSP). Two reviewers independently performed study selection and data extraction. The search yielded 6711 studies, of which nine were included. All included studies had different study aims and reported a variety of purposes for the assessment of nonverbal emotional signs. Eight different, newly developed instruments were used. Although all studies reported the measurement properties of the instruments, insufficient information was provided for analysis of their reliability and validity. This indicates the need for one reliable, validated instrument for the assessment of nonverbal emotional signs. Standardised, generally approved methods to collect uniform and comparable information during the investigative interview for suspected CSA are essential to enhance the knowledge base in this field.‘An overview of reported instruments for the assessment of children's and adolescents' nonverbal emotional signs… during an investigative interview for suspected CSA’Key Practitioner Messages The evidence base in the field of suspected CSA would be improved if professionals worldwide used standardised and generally approved methods for the collection of uniform, comparable information. Further research is required to explore the additional value of the assessment of nonverbal emotional signs in children and adolescents during the investigative interview for suspected CSA. To warrant the sustainable and harmonised collection of relevant nonverbal emotional signs, a valid and reliable assessment instrument needs to be developed.

Caring for a Child with Suspected Sexual Abuse

Caring for a Child with Suspected Sexual Abuse

Investigative Interviewing of Aboriginal Children in Cases of Suspected Sexual Abuse

ABSTRACTThis study examined the investigative interviewing of Australian Aboriginal children in cases of alleged sexual abuse, with a focus on three commonly included components of interview protocols: ground rules, practice narrative, and substantive phase. Analysis of 70 field transcripts revealed that the overall delivery and practice of ground rules at the beginning of the interview was positively associated with the spontaneous usage of rules in children’s narratives of abuse. When specifically examining the “don’t know” rule, however, only practice had an effect of children’s usage of the rule (as opposed to simple delivery or no delivery at all). Children spoke more words overall, and interviewers used more open-ended prompts during the substantive phase when the interviews contained a practice narrative. Children most often disclosed sexual abuse in response to an open-ended prompt; however, they produced the most words in response to suggestive prompts. This article concludes with a discussion of the effectiveness of ground rules, practice narratives, and questioning with Aboriginal children.

The Psychological Support for Family Reunification to the Suspected Sexual Abuse Case of a Junior High School Girl: Focusing on the Approach to a Child at the Temporary Shelter of a Child Guidance Center

The Psychological Support for Family Reunification to the Suspected Sexual Abuse Case of a Junior High School Girl: Focusing on the Approach to a Child at the Temporary Shelter of a Child Guidance Center

Prevalence of Sexting, Online Solicitations, and Offline Meetings Among Adolescents of a Large Child Advocacy Center With Suspected Sexual Abuse

Prevalence of Sexting, Online Solicitations, and Offline Meetings Among Adolescents of a Large Child Advocacy Center With Suspected Sexual Abuse

Children's Requests for Clarification in Investigative Interviews About Suspected Sexual Abuse

SummaryIn investigative interviews, it is vital that children request clarification when necessary so that crucial legal decisions can take into account the most accurate and detailed information. In the present study, 91 investigative interview transcripts about suspected child sexual abuse were coded to answer these research questions: (i) How often and how do children request clarification in investigative interviews? (ii) What factors (age, alleged abuse frequency, interviewer prompt type) are associated with children's requests? and (iii) How do interviewers respond to clarification requests, and are these interventions associated with relevant responses from children? Children rarely requested clarification, although, as expected, older children made more requests. Most requests were explicit (e.g., What do you mean?) and in response to invitation prompts. Question ‘rephrasing’ was the most common interviewer intervention regardless of child age. Results have implications for interviewing children in various contexts and for advancing our understanding of children's cognitive and communicative development. Copyright © 2015 John Wiley & Sons, Ltd.

The Process of Play Therapy for a Girl with Suspected Sexual Abuse

The Process of Play Therapy for a Girl with Suspected Sexual Abuse

Conferencing When Therapy is Stuck

Abstract Retributive approaches to confronting harmful acts like suspected sexual abuse (SSA) have often been the norm in contemporary Western cultures. Alternative restorative approaches partly inspired by indigenous traditions are growing. Conferencing, one of these restorative approaches, is the focus of our conceptual exploration in this paper. We concentrate on cases of how conferencing may be useful when traditional therapeutic approaches fail. In conferencing, it is typically the case that the person responsible for harmful acts acknowledges this. For SSA, however, we argue that the focus should rather be on the victim's suffering and alleviation of her/his harm, especially for the children. Martin Buber's I-It vs. I-Thou conceptual ideas serve as useful constructs for describing how conferencing invites a holistic approach in difficult and highly conflictual situations where conventional retributive and therapeutic approaches may fail.

Predictors of Disclosure During Medical Evaluation for Suspected Sexual Abuse

ABSTRACT The extent and nature of a child's disclosure of sexual abuse is an important component of the medical diagnosis. This study examined the frequency of disclosure of abuse by (he alleged victim, as well as the child, examiner, and case characteristics that might influence disclosure. One goal was to understand how our medical examination protocol might impede or encourage the child to disclose victimization. All records for 179 children who received an examination for sexual abuse during the period from July 1, 1991 through June 30, 1992 were reviewed. Data were abstracted about demographics, interviewer identity, the alleged acts, the alleged perpetrator, and family characteristics. The overall disclosure rate was 47%. Factors associated with child disclosure were child age, siblings in the home, perpetrator other than a biological parent, alleged oral-genital contact or penetration, previous disclosure, and interview conducted by the physician. The factors significant in regression analysis were: prior disclosure, age greater than four years, and interview by the physician rather than by a social worker or psychologist. The findings related to disclosure to the physician may be confounded by child age. Nevertheless, the findings suggest the need to consider the advantages the physician might bring to the conduct of the sexual abuse interview.

Genital Findings in Adolescent Girls Referred for Suspected Sexual Abuse

Sexual abuse is a common problem affecting adolescent girls, but the frequency of medical findings in this population has not been specifically described. To describe the frequency of specific genital findings in a group of pubertal girls who had experienced probable or definite sexual abuse. Patient series, medical chart and photograph review. Specialty referral clinic for abused children. PATIENTS AND SELECTION: Referred sample of female patients, examined between January 1, 1987, and June 30, 1994, with Tanner genital stages 3, 4, or 5, who reported a history of penile-vaginal penetration, had colposcopic photographs taken, and were determined, by means of a previously described classification system, to have experienced probable or definite abuse. None. The study included 204 girls, aged 9 to 17 years (mean, 13 years); race or ethnicity was Mexican American in 57%, white in 34%, and other in 9%. Abnormal genital findings were documented in 32% of patients overall but were more common when the girls had reported bleeding at the time of the assault (50% vs 26%; P = .004, chi 2 analysis), or when the examination occurred within 72 hours of the last episode of abuse (69% vs 26%; P < .001, chi 2 analysis). Transections of the hymen were unusual (8%), but notches in the hymen were more common (25%). Normal or nonspecific results of genital examinations are commonly found in adolescents who have been sexually abused, unless the abuse was very recent. Further studies are needed to document the healing of genital injuries in victims of acute assault and the frequency of hymenal findings in nonabused, non-sexually active adolescents.

Suspected sexual abuse in a 10-year-old girl

A white girl, 9 years and 10 months old, was brought to me at the Kinderhospital, Osnabrück, by her mother who had noticed bruises of variable shapes and sizes on her daughter's vulva over the previous 4 months. Ointments had not improved the situation. On examination, there was a sharply delineated, 10·30 mm blue-reddish area on the right labium major, extending to the introitus and looking very much like a bruise (figure). The rest of the introitus was normal; the hymen was intact. There were four pubic hairs, but no other signs of puberty.

How children perceive the medical evaluation for suspected sexual abuse

This study investigated how 99 children who were examined for suspected sexual abuse (SSA) perceived their own medical evaluation experiences. Each child was interviewed about the degree of pain and fear associated with the experience, the kindness of the doctor, general fear of doctor visits, and degree of fear associated with a hypothetical second examination. The majority of children did not perceive their SSA examination to be strongly negative. However children did report greater fear associated with the SSA evaluation compared to an ordinary doctor visit. Using multiple regression, general fear of doctor visits and fear and pain associated with the SSA examination contributed to the prediction of intensity of fear about a hypothetical second SSA evaluation. Perceived kindness of the doctor, patient sex and age, and physician sex and age did not contribute to the regression equation. The relatively low reported rate of intense distress associated with medical evaluation of SSA suggests that fear and pain can be minimized and effectively managed for many children. The results of the regression analysis suggest that previous negative medical experiences may play an important role in determining how a child interprets the experience of an SSA medical evaluation.

Interviewing Elders for Suspected Sexual Abuse:

There is little professional literature, research, or training regarding edler sexual abuse, despite the fact that cases are being identified in many locales. This article presents guidelines and techniques for identifying and interviewing possible elder victims of sexual abuse. Specific techniques are illustrated for working with non-verbal elders. Intervention strategies are suggested for cases in which sexual abuse has been substantiated.

Significance of Medical Findings in Suspected Sexual Abuse

No abstract available for this article.

Commentary on the Medical Evaluation of Suspected Sexual Abuse Revisited

No abstract available for this article.

Chlamydia and Suspected Sexual Abuse

In Reply.— We thank Dr Hammerschlag for her thoughtful comments. We wholeheartedly agree with her about the use of cultures in the setting of suspected sexual abuse. As other studies have indicated, the sensitivity and specificity of the direct fluorescent antibody test are too low in a population with low prevalence rates such as a population with suspected child abuse. We also agree with Dr Hammerschlag about the possibility of perinatal infection in a young child.

Chlamydia and Suspected Sexual Abuse

To the Editor.— I read with interest the study by Fuster and Neinstein.1 However, I wish to address several aspects of the report regarding the significance of genital infection with Chlamydia trachomatis in children, clinical findings, and diagnosis. The question of whether genital infection with C trachomatis in a prepubertal child is an indicator of sexual abuse is still controversial. Although it has been demonstrated that an abused child can acquire the infection after rape,2 the organism can also be present as the result of persistent perinatal infection.