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.


OBJECTIVE
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.


METHODS
Participation from medical providers was solicited through postings on the Internet list-serves administered by Cornell University (Special Interest Group in Child Abuse), and by the Ray E. Helfer Society, an honorary society for physician specialists in child abuse diagnosis and treatment. The guidelines were developed through review and critique of published research studies, discussions in focus group meetings at child abuse medical conferences, and ongoing communication leading to revision of draft documents.


RESULTS
Groups of 10 to 40 physician experts met at child abuse conferences between January 2002 and January 2005 to revise the table summarizing the interpretation of physical and laboratory findings in suspected child sexual abuse and to develop guidelines for medical care for sexually abused children. Between January and December 2005, the guidelines were expanded and revised.


CONCLUSIONS
The guidelines presented here reflect the current knowledge, recommended clinical approaches, and required competencies in the field of child sexual abuse medical evaluation.
Adams
Joyce A
JA
University of California, San Diego School of Medicine, San Diego, California 92103, USA. jadams@ucsd.edu
Kaplan
Rich A
RA
Starling
Suzanne P
SP
Mehta
Neha H
NH
Finkel
Martin A
MA
Botash
Ann S
AS
Kellogg
Nancy D
ND
Shapiro
Robert A
RA
D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000331:legislation & jurisprudence / Q000628:therapy*; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D010808:Physical Examination / Q000379:methods; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D012749:Sexually Transmitted Diseases / Q000175:diagnosis