Evaluating child sexual abuse : education manual for medical professionals /
Saved in:
| Author / Creator: | Botash, Ann S. |
|---|---|
| Imprint: | Baltimore, Md. : Johns Hopkins University Press, 2000. |
| Description: | 1 v. (various pagings) : ill. ; 23 cm. + 1 videocassette. |
| Language: | English |
| Subject: | |
| Format: | Video |
| URL for this record: | http://pi.lib.uchicago.edu/1001/cat/bib/4452919 |
Table of Contents:
- Section I. Decision Points in the Evaluation of Child Sexual Abuse
- Objectives
- Key historical indicators of recent abuse or medical situations requiring early intervention and treatment
- Using the history to determine when to see the child
- Indications for urgent care
- Indications for emergency care
- Historical and behavioral factors for sexual abuse
- Appropriate response to disclosure of abuse
- Common-law emancipation rule for a minor
- Components of the physical examination
- Who should be present during the examination
- When to use a Wood's lamp
- Order of progression through the examination
- When to take photographs
- Indications for sedation and anesthesia
- When to do a pelvic examination
- Determining appropriate equipment
- When to do a speculum examination
- Choosing the appropriate speculum
- Using a colposcope
- Evidence collection
- When to collect evidence
- Handling the evidence
- Dealing with sexually transmitted diseases
- Indications to culture for STDs
- Implications of STDs
- Symptoms of STDs
- Implications of a foul-smelling vaginal discharge
- Indications for STD prophylaxis
- Indications for HIV prophylaxis
- Education and consent for HIV testing
- Handling pregnancy issues
- Indications that need to be reported
- Assessing follow-up needs
- Agencies and their roles
- Summary
- Section II. The Medical History for Child Sexual Abuse
- Objectives
- The goals of a medical history
- Differences between a medical history and an investigative interview
- The three steps in acquiring a medical history
- Obtaining information for the medical history
- Gathering data from other disciplines
- The importance of building rapport
- The order of the visit
- The purpose of the caregiver history
- The process of the caregiver history
- Issues to cover in the caregiver history
- Taking a direct history from the child
- The goals of building rapport
- The process of building rapport
- Assessment opportunities while building rapport
- Ascertaining the concept of truth
- The purpose of the child history
- The process of the child history
- Asking good questions
- The spectrum of open-ended to closed-ended questions
- Using interview aids
- What influences a child's memory
- Ending the child history
- When the caregiver is present during the child history
- Overview of good documentation
- Hearsay evidence
- Factors to document in the medical record
- Appropriate reactions to disclosure
- Why children do not disclose
- Phases of secrecy
- How perpetrators enforce secrecy
- Asking age-appropriate questions
- Preparing an anxious child for the medical examination
- Summary
- Section III. The Medical Examination for Child Sexual Abuse
- Objectives
- Purposes of a medical examination
- Information about general appearance
- Risks of medication for conscious sedation
- Findings of the examination of the skin
- Possible signs of forced oral trauma
- Labeled diagrams of prepubertal genitalia
- Appropriate examination positions
- Visualizing female prepubertal genitalia
- Labial traction
- Visualizing male genitalia
- Hymenal configurations
- Normal crescent hymen
- Technique for the knee-chest position
- Normal annular hymen
- Normal fimbriated hymen
- Normal septate hymen
- Anterior annular hymen
- Berenson's description of annular hymens
- Techniques to visualize the hymen
- Imperforate hymen
- Hymenal bumps, notches, and tags
- Classification of physical findings
- Normal perianal variants
- Adams' classification of physical findings
- Suspicious findings
- Evidence of penetrating trauma
- Diagnosing and describing a laceration
- Treating a laceration
- The use of toluidine blue dye
- Significance of a transection
- Significance of a notch
- Significance of the absence of the hymen
- Anogenital conditions that may be mistaken for sexual abuse
- Documenting findings
- Using standardized documentation forms
- Appropriate documentation
- Documenting findings on a diagram
- Documenting your impression of an examination
- Swabbing techniques and culture guidelines
- Forensic evidence collection
- Collecting evidence for the rape kit
- Collecting other physical evidence
- Maintaining the chain of evidence
- Addressing the concerns of the child and family
- Summary
- Section IV. Medical-Legal Issues in Child Sexual Abuse
- Objectives
- Reporting child sexual abuse
- Reasons not to report and appropriate care
- Reasons to report and appropriate care
- Disclosing information and privileged communication
- Communicating with Child Protective Services
- Access to medical records
- When not to share information
- Immunity from criminal or civil liability
- Preparing for a court appearance
- Steps in preparing for a court appearance
- Difference between a fact and an expert witness
- Factors that form expert opinion
- Qualifications of a medical expert in child sexual abuse
- Common sexual abuse myths
- Journal articles to use in testimony
- Evidence needed for burden of proof
- Presenting testimony
- Role of the health care provider during testimony
- Tips for testifying in court
- Order of evidence
- Answering questions during direct examination
- Answering direct yes or no questions
- Answering questions during cross-examination
- Responding to attempts to discredit expert testimony
- Summary