In cases of child sexual abuse, a second follow-up exam often finds injuries, trauma or sexually transmitted infections missed on the first evaluation, especially in teens, says a study published by the American Academy of Pediatrics. With 80,000 reports of child sexual abuse in the U.S. annually, doctors say children should be examined at least once more in cases of reported sexual assault. Here are details about child sex abuse and how further medical evaluation might help.
* According to Child Help, in 2009, allegations of abuse were made on about 6 million children. 7.6 percent of those children are sexually abused.
* The Pediatrics study looked at characteristics of children and sexual abuse and how the length of time between reports of abuse and examinations affected diagnosis. Researchers explored how injuries and STIs changed between two examinations and how the experience and qualifications of the examiner affected the treatment children received.
* Nearly 18 percent of children who received follow-up examinations were diagnosed differently. 6.5 percent showed STIs that hadn't appeared on the initial examination. In 23 percent of children who were seen a second time, the findings were different.
* According to Reuters, physicians who conducted the study gave several reasons for different findings. When children are first evaluated, they are often frightened and in pain. It might be difficult to get a clear idea of what happened and the nature of the injuries. Parents might be unwilling or unable to give specific information. Parents might be better able to provide information at follow-up examinations. Additionally, some STIs don't always show up immediately.
* Second examinations showed more variance in diagnosis with adolescents, females and sexually active patients. Also those who experienced genital-to-genital contact, drug-facilitated assault or who had unclear initial examinations had differing diagnoses.
* Along with a second medical examination, the American Academy of Child and Adolescent Psychiatry recommends that in reports of sexual abuse, parents get a psychological examination for their children. They also offer resources for families.
Marilisa Kinney Sachteleben writes about parenting issues from 23 years raising four children and 25 years teaching K-8, special needs, adult education and home-school.
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