■ The dynamics of child sexual abuse differ from those of adult sexual abuse. In particular,
children rarely disclose sexual abuse immediately after the event. Moreover, disclosure tends to
be a process rather than a single episode and is often initiated following a physical complaint or
a change in behaviour.
■ The evaluation of children requires special skills and techniques in history taking, forensic
interviewing and examination; the examiner may also need to address specific issues related to
consent and reporting of child sexual abuse.
■ Definitive signs of genital trauma are seldom seen in cases of child sexual abuse, as physical
force is rarely involved. The accurate interpretation of genital findings in children requires specialist
training and wherever possible, experts in this field should be consulted.
■ Decisions about STI testing in children should be made on a case-by-case basis. If testing is
warranted, age-appropriate diagnostic tests should be used. Presumptive treatment of children
for STIs is not generally recommended.
■ A follow-up consultation is strongly recommended. Although a physical examination may not
be necessary, a follow-up consultation provides an opportunity to assess any psychological
problems that may have since arisen and to ensure that the child and his/her caregiver are
receiving adequate social support and counselling
■ The dynamics of child sexual abuse differ from those of adult sexual abuse. In particular,children rarely disclose sexual abuse immediately after the event. Moreover, disclosure tends tobe a process rather than a single episode and is often initiated following a physical complaint ora change in behaviour.■ The evaluation of children requires special skills and techniques in history taking, forensicinterviewing and examination; the examiner may also need to address specific issues related toconsent and reporting of child sexual abuse.■ Definitive signs of genital trauma are seldom seen in cases of child sexual abuse, as physicalforce is rarely involved. The accurate interpretation of genital findings in children requires specialisttraining and wherever possible, experts in this field should be consulted.■ Decisions about STI testing in children should be made on a case-by-case basis. If testing iswarranted, age-appropriate diagnostic tests should be used. Presumptive treatment of childrenfor STIs is not generally recommended.■ A follow-up consultation is strongly recommended. Although a physical examination may notbe necessary, a follow-up consultation provides an opportunity to assess any psychologicalproblems that may have since arisen and to ensure that the child and his/her caregiver arereceiving adequate social support and counselling
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