Suspected child sexual abuse and the role of the health care professional in diagnosis and treatment 1

Published on August 28, 2018   34 min

Other Talks in the Category: Diseases, Disorders & Treatments

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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.
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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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Suspected child sexual abuse and the role of the health care professional in diagnosis and treatment 1

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