![]() Questions are encouraged and breaks can be taken whenever needed. If the child expresses an interest, exam equipment can be demonstrated. The health care provider will explain what is happening during the different steps of the examination. The child is in control of what happens during the examination.The images will be securely stored at the health care facility and access to them is controlled. Photographic images will be taken to document the physical findings and ensure the accuracy of the interpretation of these findings.Sedation or anesthesia is necessary only in rare situations in which there are concerns of significant anogenital bleeding or injury, a mass, or a foreign body. Generally speaking, a speculum will not be used. It will include an examination of the genital and anal area. The examination is typically painless.The health care provider evaluating the child is someone who has expertise with children who have been sexually abused.The examination is a thorough physical evaluation, similar to an annual pediatric well-check visit.Consent for Care ) Convey the following (drawn from Sanford Health Dakota Children’s Advocacy Center, 2014): Photo-Documentation )Įxplain the overall examination to the child and caregiver prior to the examination, as well as specific procedures during the examination. ![]() Documentation serves both medical and evidentiary purposes. Evidence Collection ) In both acute and nonacute cases, exam findings should be documented-in writing, on body maps and diagrams, and through photography, as per jurisdictional and facility policies. In acute cases, pediatric examiners must be prepared to incorporate forensic sample collection into the physical and anogenital examination as it proceeds. ![]() Recognize that medical components of the examination cannot be separated from evidentiary components. Principles of Care ), this approach allows examiners to assess for all types of abuse and neglect, not just sexual abuse. Besides being more child-focused, victim-centered, and trauma-informed (see A1. Focus on a full review of systems before moving to the anogenital examination. There are many reasons to perform such an examination, the most important of which is to medically evaluate the child’s health (MD CHAMP, 2008). The medical forensic examination in a prepubescent child sexual abuse case includes a physical examination augmented by an anogenital examination (MD Child Abuse Medical Professionals Network, 2008). Keep the focus of the examination on the entire child. ![]() Members to address misconceptions that children, caregivers, or others may have about the examination and to explain its benefits. It is important that examiners educate the multidisciplinary response team about the positive impact that medical forensic care can have for children and their families. Needs related to safety, justice, and support. The exam process also provides the opportunity to begin to address children’s When findings are abnormal, medical forensic care can facilitate the treatment needed to allow children to regain their health. The vast majority of children who experienced sexual abuse-over 90 percent-have normal examinations (Adams, 2003 Berkoff et al.,Ģ008 Heger et al., 2002 Kellogg, 2005). In many situations, children leave theĮxam room feeling empowered, having learned information about their bodies and been reassured that they are healthy. One of the most invaluable benefits of the medical forensic examination is its power to promote children’s healing. ![]()
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