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Printable Handouts
Navigable Slide Index
- Introduction
- A historical & developmental perspective
- Prevalence of sexual victimization
- New trends
- Child sexual abuse medical literature trends
- Adverse childhood experiences studies
- Genitalia under a microscope
- Definitions of CSA
- Gold standard for the best outcome
- What you need to know but embarrassed to ask
- Clarity and certainty
- Obtaining & preserving medical history
- Why the importance of medical history?
- Principles of realiability of medical history
- Sad child drawing
- Medical examination in suspected CSA
- Medical model of diagnosis:
- Factoid
- Taking the medical history
- The “disease of sexual victimization”
- Engagement
- Engagement: obtaining historical details (1)
- Engagement: obtaining historical details (2)
- Sexual interaction (1)
- Sexual interaction (2)
- Sexual interaction (3)
- Sexual interaction (4)
- Idiosyncratic historical details
- The child poem
- Secrecy phase
- Secrecy: continued
- Bleeding heart drawing
- Types of disclosure
- Disclosure: accidental
- Disclosure: purposeful
- Disclosure: obtaining details
- Cleaning the mind drawing
- Suppression phase
- Physical abuse and sexual abuse
Topics Covered
- Historical and developmental perspectives of recognizing and treating child sexual abuse
- Definitions of child sexual abuse
- The clinical presentation of child sexual victimization
- Purpose of medical examination of potential sexual abuse victims
Talk Citation
Finkel, M.A. (2018, August 28). Suspected child sexual abuse and the role of the health care professional in diagnosis and treatment 1 [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 22, 2024, from https://doi.org/10.69645/WUED9078.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Martin A. Finkel has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Suspected child sexual abuse and the role of the health care professional in diagnosis and treatment 1
Published on August 28, 2018
34 min
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
My name's Martin Finkel.
I'm a pediatrician and Professor of Pediatrics and founder and co-director of
the Child Abuse Research Education and Service Institute
at Rowan University School of Osteopathic Medicine.
It's my pleasure to be able to spend some time with you and present to
you an area of my interests, child sexual victimization.
I'm going to speak to you about the role of the healthcare professional
in diagnosis and treatment of suspected child sexual abuse.
A problem that I've been working on for over 37 years.
The challenges presented themselves at the beginning and they still
continue to bring challenges to all of us as clinicians.
0:36
I like to share with you
a historical and developmental perspective on medicines discovery of this new disease,
the sexual victimization children.
There were a number of forces that were happening at the time that
resulted in society taking on this societal scourge.
The first was a publication of a seminal paper by Dr. C. Henry Kempe 1962,
The Battered Child Syndrome.
In many ways, I guess medicine did not deny the reality that children who presented to
us with injuries that we could actually see with our naked eye, bruises, implement hurts,
burns or things that could be seen through imaging,
broken bones that we can no longer accept in a naive way
that these injuries were incurred by children in the manner that they were described.
We no longer could be so naive to believe that
children entrusted to parents would not harm their children.
Medicine responded, diagnostic criteria,
increase awareness of the issue of child
maltreatment spread throughout the pediatric community.
Doctors became very comfortable,
asking more probative questions and no longer being
so naive and making the diagnosis of child physical abuse.
In 1998, Dr. Kempe published another seminal paper,
The Sexual Abuse Of Children Another Hidden Pediatric Problem.
It's interesting that medicine did not respond with
the same degree of enthusiasm that respond to the physical abuse.
All of the skills the doctors amassed in terms of
their diagnostic skills for physical abuse interestingly
we're not transferable to the issue of child sexual victimization,
in great part, because I would say it was a different disease a different phenomenon,
a different set of historical constructs.
The physical abuse of children
manifested by things we could actually see with our naked eye,
where in sexual victimization as we will learn as we go through this talk,
the most available evidence in
these kids is not things that are seen through the naked eye.
There are parallel developments in social work,
and mental health, the rape crisis movement, and law,
that created an environment that made it much
more reasonable to take on this very difficult issue.
In the United States, the American Academy of Pediatrics actually in only in 1989,
developed the first section on child abuse and neglect.
Yet we know that the child abuse and neglect has been
something that's been going on since time in memorial.
American Board of Pediatrics recognize child abuse as a subspecialty in 2009,
leading to ultimately board certification in this field.
So, how rare is this disease of sexual victimization.
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