Child Sexual Abuse Guidelines

Updated: Nov 29, 2021
  • Author: Angelo P Giardino, MD, PhD, MPH, FAAP; Chief Editor: Caroly Pataki, MD  more...
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Guidelines Summary

American Academy of Pedatrics

The 2013 update of the AAP guideline for the evaluation of sexual abuse in children states that the medical assessment of suspected child sexual abuse should include obtaining a history, performing a physical examination, and obtaining appropriate laboratory tests. The role of the physician includes determining the need to report suspected sexual abuse; assessing the physical, emotional, and behavioral consequences of sexual abuse; providing information to parents about how to support their child; and coordinating with other professionals to provide comprehensive treatment and follow-up of children exposed to child sexual abuse. [20]

Whenever the issue of possible child sexual abuse arises in the office setting, 5 important issues should be addressed.

  1. The child's safety - The health care provider must determine whether the child is at any risk for additional harm if he or she returns home.
  2. Reporting to authorities - In the absence of imminent risk, the physician needs to determine if there is evidence of suspected abuse that would require him or her to contact law enforcement or child protection.
  3. The child's mental health - The child should be assessed for possible mental health problems (e.g., PTSD, depression). If any are identified, appropriate emergency mental health care should be sought.
  4. Need for physical examination - The physician should perform a thorough physical examination to determine whether the child has been injured, particularly if a child is reporting genital or anal pain or bleeding.
  5. Need for forensic evidence collection - If the abuse was recent and involved exchange of bodily fluids, the child should be immediately referred to those capable of gathering forensic evidence.