During the second half of the presentation,
we'll provide an opportunity to understand a little bit more about
our approach to the medical and actual physical examination, and
interpretation of findings, as well as the formulation of
a diagnostic impression, including recommendations for treatment and follow-up.
We're going to examine a child and these are some of the preliminaries.
We obtain historical details of the alleged event.
Those details may be obtained from child protective services,
from the non-offending parent;
we clarify additional details that we believe need to be obtained,
we develop rapport and trust with the child when we meet them.
We explain to the child the purpose of examination,
we tell the child what is going to happen.
When I first meet children in our lobby,
the first thing I say to them is that there are no shots,
and no needles, and they have sighs of relief.
When we're engaging in conversation with a child about what happened,
we use the child's names that they use for their body parts,
we encourage the child to ask questions,
we assess the cooperativeness of the child,
we allow the child to select the adult ally to be present during the examination,
and we always encourage the child to participate in a complete head-to-toe examination.
The reason that we do a head-to-toe examination, and
not just a genital or anal examination when sexual abuse is
concerned, is that we want to give a message to children that all parts
of their body are important, and we will look at every part of their body.
So what are the criteria for immediate examination?
Any age inappropriate sexual contact within 72 hours,
genital trauma within 72 hours,
and these windows can actually go out further, particularly
in pubertal children, depending upon the level of sexual contact,
possibility of sexually transmitted disease
and possibility of pregnancy.