Medical Evaluation

Most child sexual abuse reports are belated.  Which means the child does not tell right away.  Children have a lot of worries about their bodies.  The medical evaluator at the Center checks for any injuries or infections and more importantly allows  the child to know they are okay.
At the Center, our physicians have advanced training on the medical evaluation of the sexually abused child.

The physician uses a colposcope which is a very expensive magnifying tool and allows the physician to magnify the genitalia 15-30 times what the human eye can see.  The colposcope is non-invasive which means nothing is inserted into your child.  It primarily looks at the surface of the rectum and genitalia including the hymeneal opening.

Unlike your private physician, medical exams at the Center must be requested by law enforcement or child protective services as part of their investigation.

Families are not responsible for the cost of the medical evaluation.

A medical evaluation is typically indicated if the sexual assault occurred within 72 hours, there is a report of possible penetration or there is pain or bleeding from the rectum or genitalia.

It is important to remember that children often do not disclose the complete history.  The child’s emotional status, their behaviors, the chronic nature of the abuse and the interviewer’s instincts may also prompt a referral for a medical evaluation.  Other times, a private physician may see something suspicious during a routine exam and refer the child to the Center for a colposcopic examination.

Remember, even if the officer or caseworker determine that a medical exam is not necessary for purposes of their investigation, that does not prevent you as a parent from having your child seen by your private physician for a complete check up.

During the medical exam at the Center, the physician will want to meet with you first to obtain a medical history about your child.  Please feel free to ask the physician any questions you might have.

The physician will also want to visit with your child privately about what has happened and to answer any questions they might have.

When it comes time for the actual genital exam, we will ask the child if they want a parent in the room with them.  Some do and some don’t.   Some of our parents are simply too upset about what might have happened to their child.  When the child senses that their parents are upset, they too become anxious and concerned that something terrible is wrong with them.  In those situations, it is better that the parent not be in the exam room.

Our physicians are very patient.  They take their time with your child.  The exam should not be a traumatic experience for your child.  If the exam becomes too upsetting for the child, we simply end the exam.  We will not force a child to do something they are uncomfortable with.

Some mothers are concerned that a speculum will be used.  It has a lot to do with our own experiences.  Speculums are not used in children who have not started menstruation.

There have been cases where a foreign object is suspected or found in the vaginal opening.  In all of those cases, the child was referred to a hospital setting where the object can be removed using anesthesia.

We are able to test for gonorrhea and chlamydia at the Center using cultures or a urine screen.  We do not have needles at the Center (something most kids are glad to know), so if we need additional blood work done we will refer to our lab for assistance with this.

We respect your child’s medical right to privacy.  Information is shared with law enforcement, child protective services and the prosecuting attorney as part of a child abuse investigation.  If you want the results of the examination shared with your child’s private physician, be sure to sign a release form.

At the completion of the exam, the physician will discuss the findings with you, answer any questions you might have and make recommendations for further follow-up.
 

REMEMBER, that in over 85% of the cases, there are no medical findings.  That does not mean the abuse did not happen.