This paper reviews current knowledge of medical evaluations of young victims of alleged sexual abuse. The several purposes and the value of these examinations are discussed. The evaluation of physical findings is reviewed with emphasis on recent progress in improving the reliability and validity of such examinations. The complexities of the identification and interpretation of sexually transmitted diseases are reviewed. Areas in which additional progress is expected in the 1990s are identified.
Get full access to this article
View all access options for this article.
References
1.
American Academy of Dermatology Task Force on Pediatric Dermatology (1984) Genital warts and sexual abuse in children. J. Amer. Acad. Dermatol.11, 529–30.
2.
American Academy of Pediatrics Committee on Early Childhood, Adoption, and Dependent Care (1983) Gonorrhoea in prepubertal children. Pediatrics, 71, 553.
3.
AlexanderE. R. (1988) Misidentification of sexually transmitted organisms in children: Medicolegal implications. Pediat. Infect. Dis. J.7, 1–2.
4.
BartleyD. L.MorganL.RimszaM. E. (1987) Gardnerella vaginalis in prepubertal girls. Am. J. Diseases of Children141, 1014–17.
5.
BellT. A.StammW. E.KuoC.C.HolmesK. K.GraysonJ. T. (1986) Chronic Chlamydia Trachomatis infections in infants. In: OrielJ. D.RidgwayG.SchachterJ.RobinsonD. TaylorWandM. (eds) Chlamydia Infections. Cambridge, Cambridge University Press, pp. 305–308.
6.
ChadwickD.BerkowitzC. D.KernsD.McCannJ.ReinhartM. A.StricklandS. (1989) Color Atlas of Child Sexual Abuse. Chicago, Yearbook Medical Publishers.
7.
EmmonsS. J.WoodsE. R.FlaggN. T.FreemanA. (1987) Genital findings in sexually abused, symptomatic, and asymptomatic girls. Pediatrics79, 778–85.
8.
FinkelM. A. (1989) Anogenital trauma in sexually abused children. Pediatrics, 84, 317–22.
9.
HammerschlagM. R.ChandlerJ. W.AlexanderE. R.EnglishM.KoutskyL. (1982) Longitudinal studies on chlamydial infections in the first year of life. Pediat. Infect. Dis. J.1, 395–401.
10.
JennyC. (1989) Vaginal colonization with Gardnerella vaginalis in sexually abused female children and adolescents. Presented at the Ambulatory Pediatric Association Regional Meeting, Carmel, California, 6 February 1989.
11.
JoyeN.ReinhartM.RoehrM. (1986) Sexual Abuse of Children. Garden Grove, Medcom Inc.
12.
KempeC. H. (1978) Sexual abuse, another hidden pediatric problem. Pediatrics, 62, 382–9.
13.
LadsonS.JohnsonC. F.DotyR. E. (1987) Do physicians recognize sexual abuse?A. J. D. C.141, 411–15.
14.
McCannJ.VorisJ.SimonM.WellsR. (1989) Perianal findings in prepubertal children selected for nonabuse: A descriptive study. Child Abuse and Neglect, 13, 179–93.
15.
McCannJ.WellsR.SimonM.VorisJ. (1990) Genital findings in prepubertal girls selected for non-abuse: A descriptive study. Pediatrics86, 428–39.
16.
MorrisJ. L.JohnsonC. F.ClasenM. (1985) To report or not to report, physicians' attitudes toward discipline and child abuse. A. J. D. C.139, 194–7.
17.
MuramD. (1989) Child sexual abuse: Relationship between sexual acts and genital findings. Child Abuse and Neglect, 13, 211–16.
18.
PokornyS. F.KozinetzC. A. (1988) Configuration and other anatomic details of the prepubertal hymnen. Pediatric and Adolescent Gynecology, 1, 97–103.
19.
PollakJ.LevyS. (1989) Countertransference and failure to report child abuse and neglect. Child Abuse and Neglect, 13, 515–22.
