Medical evaluation of child sexual abuse : a practical guide / edited by Martin Finkel, Angelo P. Giardino.

Format:

Book

Contributor:

Finkel, Martin.

Giardino, Angelo P.

Language:

English

Subjects (All):

Child sexual abuse--Diagnosis.

Child sexual abuse.

Sexually abused children--Mental health.

Sexually abused children.

Child Abuse, Sexual--diagnosis.

Medical Subjects:

Child Abuse, Sexual--diagnosis.

Physical Description:

xiv, 298 pages : illustrations (some color) ; 29 cm

Edition:

Second edition.

Place of Publication:

Thousand Oaks, Calif. : Sage Publications, 2002.

Summary:

This newly updated edition of the top-selling reference manual for the medical evaluation of suspected child sexual abuse has been expanded to reflect the increasing importance of properly performed, well-documented examinations. Not only does the book cover aspects of the physical examination and diagnosis for sexual abuse, its additional coverage of interviewing children and collecting evidence for criminal investigations makes it an inclusive guidebook for all aspects of the child sexual abuse-evaluation process.

Contents:

1. The Problem / Angelo P. Giardino 1

Definition of Child Sexual Abuse 2

Scope of the Problem: The Numbers 3

Child Sexual Abuse Versus Adult Sexual Assault 10

Categories Included in Sexual Abuse 10

Conceptual Models 11

Characteristics of the Perpetrator 12

Longitudinal Progression of Child Sexual Abuse 12

Preconditions for Child Sexual Abuse 14

Child Sexual Abuse Accommodation Syndrome 14

Traumagenic Dynamics Model 15

Rape Trauma Syndrome 17

Sexual Behaviors in Children 18

Impact of Sexual Abuse 20

Practical Implications for the Health Care Professional 22

2. The Evaluation / Martin A. Finkel 23

Making the Diagnosis: The Medical Model 24

Approach to the Evaluation of Sexual Abuse 29

The Medical History 34

The Dynamics of Sexual Abuse: Predicting Physical Findings 35

Laboratory Studies in Brief 36

Documentation in Brief 36

3. Physical Examination / Martin A. Finkel 39

Genital Anatomy 40

Basic Anatomy and Development 40

Assessment of Pubertal Development 41

Estrogen Effect on Female Genitalia: Huffman Stages 41

Outward Sexual Development: Tanner Stages 41

Terminology 45

Normal Female Genitalia 46

Male Anatomy 51

Anal Anatomy 53

The Physical Examination 54

Preparing for the Physical Examination of the Child 54

Tools of the Physical Examination 56

Method of Evaluation 57

Genital and Anal Examination 58

Examining the External and Internal Structures 61

Presence or Absence of Diagnostic Findings 66

Spectrum of Diagnostic Findings in Sexual Abuse 68

Degree of Physical Contact 68

Fondling and Digital Penetration 69

Oral-Genital Contact 71

Penile Contact With Genitalia Without Vaginal Penetration 71

Penile Vaginal Penetration 72

Intragluteal Coitus 74

Penile, Digital, and/ or Foreign Body Contact With Anus 74

Extragenital Trauma 75

Genital Findings in Males 76

Summary of Findings Following Sexual Contact 77

Accidental Trauma 78

Laboratory and Forensic Specimen Collection 79

Appendix When Sexual Abuse Is Suspected: Common Concerns About the Medical Examination 81

4. Documentation of Physical Evidence in Child Sexual Abuse / Lawrence R. Ricci 99

Photography 100

Colpophotography 103

Video and Digital Imaging 104

Photographing Children 107

Legal Issues 108

5. Outline of STDs in Child and Adolescent Sexual Abuse / Deborah C. Stewart 111

Prepubertal Children 113

Adolescents 115

Medicolegal Aspects of STDs 116

Prevalence 117

Methods of Detection: The Use of the Laboratory in Child Sexual Assault 118

Chain of Evidence: STD Specimens 119

Organisms 119

6. Forensic Evidence Collection / Cindy W. Christian, Angelo P. Giardino 131

Types of Assault 132

Forensic Evidence Collection in Child Sexual Abuse 133

Evidentiary Identification and Collection 136

Rape Kits 140

Evidence Collection 141

7. Unique Needs of Adolescent Patients / Deborah E. Lowen 147

Adolescent Issues 148

Medical History 149

The Physical Examination 151

Laboratory Evaluation 154

Interpretation of Findings 155

Treatment 157

8. The Anogenital Exam: Diagnostic Dilemmas, Mimics of Abuse / Lori D. Frasier 159

Infectious Processes Localized to the Anogenital Tract 160

Vulvovaginitis and Other Anogenital Bacterial Infections 164

Anogenital Conditions Presenting With Primary Anogenital Involvement 167

Anogenital Conditions That May Have Systemic or Extragenital Involvement 171

Anogenital Conditions That Have Primary Systemic or Extragenital Involvement 176

Neoplasms 178

Acquired Structural Abnormalities 179

Nonabusive Trauma 180

9. Nursing Issues Related to Child Sexual Abuse Evaluations / Eileen R. Giardino, Jamie Ferrell 183

Prevention of Abuse 184

Nursing Role in Detection of Abuse 185

Emergency Department Triage 186

Evaluation of Victims of Sexual Abuse in Clinical Settings 187

The Role of the Nurse in Child Sexual Abuse 189

Collaboration With Other Health Care Professionals 190

Collecting Data: Sexual Assault Tools 191

Pregnancy and Abuse 192

10. Psychological Issues / Julie Lippmann 193

The Case for Mental Health Involvement 193

The Psychological Impact of Sexual Abuse on Children 194

The Multiple Roles of Mental Health Professionals in Cases of Suspected Sexual Abuse 197

The Evaluation Process 200

Investigative Interviewing of Children 203

Child-Centered, Developmentally Sensitive Interviewing 206

Helping Children Relate Their Experiences Accurately and Completely 209

Reporting Evaluation Conclusions and Recommendations 211

11. Interdisciplinary Approaches to Child Maltreatment: Accessing Community Resources / Angelo P. Giardino, Stephen Ludwig 215

Interdisciplinary Approaches 216

Team Approach to Work in Child Maltreatment 216

The Health Care Setting: Roles and Responsibilities of Clinicians 220

Roles and Responsibilities of Agencies and Services 221

Creating Services Where None Exists 228

12. Legal Issues in the Medical Evaluation of Child Sexual Abuse / John E. B. Myers 233

Reporting Child Abuse 234

Confidentiality and the Duty to Report 235

Liability of Reporters 235

General Guidelines Regarding Reporting 236

Verbal Evidence of Abuse 237

The Importance of Documentation 241

Confidentiality 241

Testifying in Court 243

The Difference Between Lay Fact Witnesses and Expert Witnesses 244

The Qualification Process to Testify as an Expert 244

Direct and Cross-Examination 245

The Form of Expert Testimony 246

Permissible and Impermissible Topics for Expert Testimony in Child Sexual Abuse Cases 249

13. Documentation, Report Formulation, and Conclusions / Martin A. Finkel 251

Detail of the Medical Record 251

Stating the Purpose of the Medical Examination 252

Medical History Documentation 254

Components of the Medical Record 255

Review of Systems 256

Recording the Physical Examination Findings 257

Describing the Physical Examination 258

Putting It All Together: Formulating a Diagnosis 259.

Notes:

Includes bibliographical references and index.

ISBN:

076192082X

OCLC:

47849378