Sexual Abuse of Children: Case Finding and Clinical Assessment.
Thomas, J. N. Rogers, C. M.
Children's Hospital National Medical Center, Washington, D.C. Child Protection Center.
Published: March 1981
Nursing Clinics of North America
Vol. 16 , 179-188
Publication Information: W.B. Saunders Co., Philadelphia, PA.
Available from: Bell and Howell Information and Learning
P.O. Box 1346 300 N. Zeeb Rd.
Ann Arbor, MI 48106-1346
Tel: (800) 521-0600 (734) 761-4700
Guidelines for preliminary identification, assessment, and resolution of cases of suspected sexual abuse are provided for use by nurses. Medical indicators of sexual abuse include abrasions in the genital or anal areas; the presence of a sexually transmitted disease; unexplained vaginal or rectal bleeding; inflammations or infections within the genital area; penile swelling or discharge; pain on urination; and pregnancy. Behavioral changes in children that warrant further investigation include manifestations of regression; phobias or fears of apparently sudden onset; running away from home; sudden emergence of sexually-related problems; substance abuse, particularly among adolescents; and extreme depression, hostility, and aggression. If possible, the child and parent(s) should be interviewed separately. The nurse should attempt to elicit an explanation of the problem and its probable or possible cause. Nurses also should be sensitive to evasive answers and to a parent's reluctance to give an adequate history. The nurse's aim should be to provide an adequate basis for suspicion upon which other agencies may act by conducting more thorough investigations. However, it is unwise to conclude that a child is the victim of sexual abuse solely because of behavioral indicators. Preliminary intervention includes assessment and counseling of parents and other family members and assessment and counseling of the victim. The latter involves establishing a rapport with the child and determining the child's feelings about what has happened. 6 references.
sexual abuse; nurses role; medical aspects of child abuse; diagnoses; behavior changes; counseling