Children who engaged in interpersonal problematic sexual behaviors.

Background: Over one-third of inappropriate sexual contact experienced by children is initiated by other children. Many studies examined child initiators (CIs) of interpersonal problematic sexual behaviors (IPSBs). This study uniquely links CI information with types of sexual contact as described by children they engaged in IPSBs.

Urogenital symptoms after sexual abuse vs irritant contact in premenarchal girls.

Objectives: Sexually abused (SA) girls report urogenital symptoms temporally related to inappropriate genital contact. Since girls also experience symptoms following genital irritant exposure and mostly all girls are exposed to genital irritants, we describe overall symptoms reported by girls that disclosed SA compared to those that did not and we compare how girls describe symptoms following a specific episode of contact SA vs a genital irritant exposure.

Design: Cross-sectional study.

Diagnostic accuracy in child sexual abuse medical evaluation: role of experience, training, and expert case review.

Objectives: (1) The purpose of this study was to assess the ability of clinicians who examine children for suspected sexual abuse to recognize and interpret normal and abnormal ano-genital findings in magnified photographs using an online survey format. (2) Determine which factors in education, clinical practice, and case review correlate with correct responses to the survey questions.

Methods: Between July and December 2007, medical professionals participated in a web-based survey.

Putting it all together.

The most available form of evidence in child sexual abuse cases is what the child has to say about his or her alleged experience. The most difficult skill for clinicians to develop is the "how tos" of talking to children in a developmentally appropriate, nonjudgmental, facilitative, and empathetic manner. This manuscript provides insight into obtaining historical details about a child's experience and guidance regarding how to incorporate those details when formulating a balanced and defensible opinion.

Urogenital symptoms in premenarchal girls: parents' and girls' perceptions and associations with irritants.

Objectives: Premenarchal girls commonly seek care for urogenital symptoms, yet little is published about parents' and girls' perceived causes of symptoms or associations with irritant exposures. We sought to describe urogenital symptoms, perceived causes, and associations between symptoms and genital irritant exposures.

Design: Descriptive study.

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.

Girls who disclose sexual abuse: urogenital symptoms and signs after genital contact.

Background: Little information is available about idiosyncratic historical details provided by sexually abused girls, yet this information can help medical professionals diagnose sexual abuse.

Objectives: Our goals were to describe types and frequencies of urogenital symptoms/signs reported by girls who disclosed direct genital contact and to explore factors associated with this reporting.

Methods: We reviewed 161 medical charts of 3- to 18-year-old girls who disclosed sexual abuse by direct genital contact for urogenital symptoms/signs, type of genital contact (oral, object, digital, or genital), time interval between last perpetrator contact and physical examination, age and sexual maturity at the time of last perpetrator contact, genital findings, and other medical diagnoses.

Guidelines for medical care of children who may have been sexually abused.

Background: Children who may have been sexually abused are examined in many different settings by medical providers with variable levels of education and experience in this special area of practice. Therefore, there is a need for a consistent evidence-based approach that is agreed upon by medical experts.

Objectives: To develop and provide guidelines and recommendations for performing and interpreting findings of the medical evaluation of children referred for sexual abuse medical evaluations, and to provide guidelines for the education, oversight, and peer review process for clinicians who provide assessments for suspected child sexual abuse.

Funding of child abuse evaluations: survey of child abuse evaluation programs.

This article delineates the current fiscal management and reimbursement for child abuse examinations. These financial issues are high priority for child abuse programs because most programs lack the revenues to meet the demands for service, education, advocacy and research. Programs may share medical protocols and standards but have yet to share management solutions.

Evaluating child sexual abuse.

We have learned much about the medical evaluation of suspected child sexual abuse during the past 2 decades. The physical examination still holds an important place in the evaluation but is secondary to a well-performed history. As the evolving literature increases our understanding, the relevance of various anatomic appearances of the prepubertal and pubertal genital examination will certainly become even clearer.

Adolescents' responses to sexual abuse evaluation including the use of video colposcopy.

Purpose: To examine adolescents' responses to a medical examination, which included the use of video colposcopy, conducted during an investigation of possible child sexual abuse.

Methods: Girls aged 11 to 18 years, referred for evaluation and treatment of sexual abuse at an academic medical center were eligible to participate. Demographic data and information regarding the alleged sexual abuse event(s) were obtained by medical record review.