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Chapter 1 The Medical Response to Child Sexual Abuse: An Historical Overview |
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1 | (10) |
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1 | (1) |
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1 | (1) |
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From the Dawn of Civilization |
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1 | (1) |
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The Early Medical Response |
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2 | (2) |
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4 | (2) |
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The Role of Law Enforcement |
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5 | (1) |
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6 | (1) |
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Medical Care of the Child Abuse Victim: Now and Beyond |
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6 | (1) |
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7 | (1) |
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7 | (4) |
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Chapter 2 Basic Anatomy of the Genitalia and Anus |
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11 | (34) |
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11 | (2) |
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13 | (3) |
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16 | (5) |
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16 | (3) |
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19 | (1) |
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20 | (1) |
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21 | (2) |
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22 | (1) |
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23 | (1) |
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23 | (1) |
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23 | (1) |
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Appendix 2-1 Features of Genital and Anal Anatomy |
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23 | (19) |
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42 | (3) |
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Chapter 3 The Medical Evaluation of a Suspected Childhood Sexual Abuse Victim |
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45 | (20) |
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45 | (1) |
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Presentations for Care of Suspected Child Sexual Abuse |
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46 | (1) |
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Sources of Information in Suspected Sexual Abuse Cases |
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46 | (1) |
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Talking to Children and Adolescents About Sexual Abuse |
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47 | (1) |
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Purpose of the Medical Examination |
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48 | (1) |
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Components of the Medical History in Cases of Suspected Sexual Abuse |
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49 | (1) |
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50 | (1) |
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Screening for Trauma Symptoms |
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51 | (1) |
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Preparing Caregiver and Child for the Physical Examination |
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51 | (1) |
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Conducting the Physical Examination |
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52 | (1) |
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After the Examination: Anticipatory Guidance on Personal Space and Safety |
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53 | (1) |
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Addressing the Psychological Impact of Sexual Abuse |
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54 | (1) |
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Trauma-Focused Cognitive Behavioral Therapy |
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54 | (1) |
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54 | (1) |
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Medical Record Documentation in Cases of Suspected Child Sexual Abuse |
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54 | (2) |
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Special Medicolegal Considerations for Medical Record Documentation |
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56 | (1) |
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56 | (4) |
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60 | (1) |
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60 | (5) |
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Chapter 4 The Medical Evaluation of Acute Sexual Abuse or Assault in Children and Adolescents |
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65 | (46) |
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65 | (1) |
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Medical Evaluation Process |
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65 | (12) |
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65 | (2) |
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67 | (2) |
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Forensic Evidence Collection |
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69 | (1) |
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Steps in Collecting and Documenting Forensic Evidence |
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70 | (3) |
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Alternative Light Source Illumination |
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73 | (1) |
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Recommended Testing for Sexually Transmitted Infections and Pregnancy |
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74 | (2) |
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Drug-Facilitated Sexual Assault |
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76 | (1) |
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Findings and Interpretation |
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77 | (13) |
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Physical Injury Interpretation |
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77 | (1) |
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77 | (5) |
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82 | (1) |
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82 | (1) |
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83 | (1) |
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83 | (1) |
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Physical Injury in Prepubertal Children |
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84 | (1) |
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Examination Findings Indicative of Abuse |
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85 | (3) |
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88 | (2) |
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Forensic Evidence Interpretations |
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90 | (10) |
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90 | (1) |
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Prostatic Acid Phosphatase and Other Seminal Fluid Markers |
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91 | (1) |
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92 | (1) |
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93 | (1) |
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93 | (1) |
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Role of Forensic Evidence in Proving the Identity of the Perpetrator |
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93 | (2) |
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Forensic Evidence in Children |
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95 | (3) |
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Relationship of Physical and Forensic Evidence to Successful Prosecution |
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98 | (2) |
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Medical Management Considerations |
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100 | (2) |
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102 | (1) |
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103 | (8) |
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Chapter 5 The Sexual Abuse Postexamination Conference With Families |
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111 | (16) |
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Characteristics and Goals of the Postexamination Conference |
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111 | (1) |
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111 | (1) |
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112 | (9) |
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112 | (2) |
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Psychosocial Aspects and Crisis Intervention |
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114 | (1) |
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Disclosure and Its Reliability |
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115 | (1) |
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115 | (1) |
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116 | (1) |
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116 | (1) |
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117 | (1) |
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117 | (1) |
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Evaluation of the Child's Psychological Distress |
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118 | (1) |
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119 | (1) |
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Adverse Childhood Experiences |
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120 | (1) |
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Intimate Partner Violence |
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120 | (1) |
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120 | (1) |
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121 | (1) |
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Prevention of Conference Problems |
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121 | (1) |
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121 | (1) |
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122 | (1) |
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122 | (1) |
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122 | (5) |
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Chapter 6 Non-Emergent Medical Examination Procedures and Techniques |
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127 | (12) |
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127 | (1) |
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Indications for Medical Assessment |
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127 | (1) |
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The Medical Examination: Setting the Scene |
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128 | (2) |
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Examination Positions and Techniques |
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130 | (7) |
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130 | (1) |
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130 | (1) |
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Supine Lithotomy Position |
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130 | (1) |
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Prone Knee-Chest Position |
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130 | (1) |
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Supine Knee-Chest Position |
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131 | (1) |
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Lateral Decubitus Position |
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131 | (1) |
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131 | (6) |
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137 | (1) |
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Methods of Photodocumentation |
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137 | (1) |
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Discussion of Findings With Children and Parents |
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138 | (1) |
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138 | (1) |
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138 | (1) |
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Chapter 7 Evidence-Based Approach to Child Sexual Abuse Examination Findings |
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139 | (14) |
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139 | (1) |
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Methodology Soundness and Result Validity |
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139 | (3) |
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140 | (1) |
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140 | (1) |
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Case Reports and Case Series |
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141 | (1) |
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Review Articles and Summary Reports |
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141 | (1) |
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141 | (1) |
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Regarding Study Population |
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141 | (1) |
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Regarding Study Methodology |
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142 | (1) |
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Useful Patient Differentiation |
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142 | (5) |
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Applying Study Results to Patient Care |
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147 | (1) |
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Reviewing the Literature Regarding Child Sexual Abuse Examination Findings |
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147 | (3) |
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Review of Cross-Sectional Study |
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147 | (1) |
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147 | (1) |
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147 | (1) |
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148 | (1) |
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Review of Case-Control Study |
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148 | (1) |
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148 | (1) |
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149 | (1) |
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149 | (1) |
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150 | (1) |
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150 | (1) |
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150 | (1) |
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150 | (1) |
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150 | (3) |
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Chapter 8 Interpretation of Genital and Anal Findings in Children and Adolescents With Suspected Sexual Abuse: State of the Science |
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153 | (32) |
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153 | (1) |
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153 | (1) |
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Studies in Genital and Anal Findings in Children and Adolescents With Suspected Sexual Abuse |
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153 | (1) |
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154 | (9) |
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159 | (1) |
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Sexually Transmitted Infections |
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160 | (1) |
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161 | (1) |
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161 | (1) |
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162 | (1) |
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163 | (1) |
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Appendix 8-1 Normal Variations and Forensic Photography |
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164 | (17) |
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181 | (4) |
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Chapter 9 Medical Conditions That Mimic Sexual Abuse |
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185 | (22) |
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185 | (1) |
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Medical Mimics of Child Sexual Abuse |
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185 | (17) |
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Genital Irritation/Erythema |
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185 | (1) |
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186 | (1) |
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186 | (2) |
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Hemangiomas/Vascular Malformations |
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188 | (1) |
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Purpura as a Mimic of Bruising |
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189 | (1) |
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Accidental Genital Injuries |
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190 | (1) |
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Skin Discolorations from Dyes, Surgical Adjuncts, and Plants |
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191 | (1) |
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191 | (1) |
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191 | (1) |
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Maceration with Irritant Contact |
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191 | (1) |
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192 | (1) |
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192 | (1) |
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Group A P-hemolytic Streptococci |
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192 | (1) |
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192 | (1) |
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193 | (1) |
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193 | (1) |
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Newborn Withdrawal Bleeding |
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193 | (1) |
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194 | (1) |
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194 | (1) |
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195 | (1) |
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196 | (1) |
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Bleeding of Gastrointestinal Origin |
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197 | (1) |
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197 | (1) |
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197 | (1) |
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198 | (1) |
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199 | (1) |
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Papules, Macules, and Nodules |
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200 | (1) |
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200 | (1) |
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200 | (1) |
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Perianal Pseudoverrucous Papules and Nodules |
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200 | (1) |
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201 | (1) |
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202 | (1) |
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203 | (4) |
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Chapter 10 Sexually Transmitted Infections |
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207 | (40) |
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207 | (2) |
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Considerations for Sexually Transmitted Infection Testing |
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209 | (1) |
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Neisseria Gonorrhoeae and Chlamydia Trachomatis |
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210 | (5) |
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215 | (7) |
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222 | (2) |
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224 | (5) |
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Syphilis (Treponema Pallidum) |
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229 | (3) |
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Human Immunodeficiency Virus |
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232 | (2) |
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234 | (1) |
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235 | (2) |
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237 | (1) |
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237 | (10) |
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Chapter 11 Collection and Testing of DNA Evidence |
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247 | (38) |
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247 | (1) |
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248 | (7) |
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253 | (1) |
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254 | (1) |
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Serological Laboratory Analysis |
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255 | (7) |
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257 | (2) |
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259 | (1) |
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260 | (2) |
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262 | (1) |
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Untested Sexual Assault Kits |
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262 | (1) |
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Forensic DNA Testing Procedure |
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263 | (13) |
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263 | (2) |
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Polymerase Chain Reaction/Amplification |
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265 | (1) |
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266 | (1) |
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Interpretation of Quantitation Results |
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267 | (1) |
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Autosomal Short Tandem Repeat Multiplex |
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268 | (2) |
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270 | (1) |
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270 | (3) |
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Combined DNA Index System |
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273 | (1) |
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Y Chromosome STR Multiplex |
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274 | (2) |
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Mitochondrial DNA Testing |
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276 | (1) |
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276 | (1) |
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277 | (1) |
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277 | (1) |
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278 | (7) |
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Chapter 12 Child Sexual Abuse Medical Examiners |
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285 | (12) |
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Importance of the Sexual Abuse Evaluation |
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285 | (1) |
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Knowledge and Reliability of Examiners About Sexual Abuse |
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285 | (2) |
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Purpose of the Medical Evaluation of Sexual Abuse |
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287 | (2) |
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Collection of Evidence and Protection of the Child |
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287 | (1) |
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288 | (1) |
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288 | (1) |
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Collaboration Between Health Professionals |
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289 | (1) |
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Who Examines Children for Sexual Abuse? |
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290 | (3) |
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293 | (1) |
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293 | (1) |
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294 | (1) |
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294 | (1) |
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295 | (2) |
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Chapter 13 The Multidisciplinary Team and Child Sexual Abuse |
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297 | (6) |
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297 | (1) |
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Members of the Multidisciplinary Team |
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297 | (4) |
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Child Protective Services |
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297 | (1) |
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298 | (1) |
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299 | (1) |
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299 | (1) |
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300 | (1) |
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Multidisciplinary Team Function |
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301 | (1) |
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301 | (1) |
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301 | (2) |
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Chapter 14 Child Sexual Abuse: An International Perspective |
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303 | (26) |
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Introduction: Commercial Sexual Exploitation of Children |
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303 | (1) |
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303 | (2) |
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303 | (1) |
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303 | (1) |
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303 | (1) |
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Slavery: Forced Labor, Serfdom, and Debt Bondage |
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304 | (1) |
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304 | (1) |
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Commercial Sexual Exploitation |
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304 | (1) |
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Sexual Exploitation of Children in Travel and Tourism |
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305 | (1) |
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Sexual Exploitation of Children in/for Prostitution |
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305 | (1) |
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Use of Children for Sexual Performances |
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305 | (1) |
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305 | (1) |
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305 | (2) |
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305 | (1) |
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Child Labor, Trafficking, and Sexual Exploitation |
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306 | (1) |
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307 | (6) |
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307 | (1) |
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Age, Gender, and Other Individual Factors |
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308 | (1) |
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309 | (1) |
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310 | (1) |
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311 | (1) |
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311 | (1) |
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312 | (1) |
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Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome |
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313 | (1) |
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Getting Involved in Commercial Sexual Exploitation of Children |
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313 | (1) |
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314 | (1) |
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314 | (2) |
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316 | (5) |
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321 | (1) |
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321 | (8) |
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Chapter 15 Adolescent Issues in Sexual Abuse and Assault |
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329 | (20) |
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329 | (1) |
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Definitions and Victim Perceptions of Abuse Experiences |
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330 | (1) |
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331 | (2) |
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333 | (12) |
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334 | (1) |
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334 | (1) |
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334 | (1) |
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335 | (1) |
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Family History, Support by Nonabusive Parent, Protection of Abuser, or Concern for Integrity of Family |
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335 | (1) |
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335 | (1) |
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335 | (1) |
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336 | (1) |
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336 | (1) |
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336 | (1) |
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Assess for Body and Oral, Genital, and Anal Injuries |
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337 | (3) |
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Lessen Embarrassment and Anxiety by Keeping Parts of Body Not Being Examined Draped |
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340 | (1) |
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Testing for STIs, Pregnancy, Drugs, and Alcohol |
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341 | (1) |
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341 | (1) |
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342 | (1) |
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342 | (3) |
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345 | (1) |
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345 | (1) |
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Appendix 15-1 The CRAFFT Interview |
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346 | (1) |
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347 | (2) |
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Chapter 16 Child Sexual Exploitation |
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349 | (18) |
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349 | (1) |
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Types of Child Sexual Exploitation |
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349 | (8) |
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349 | (3) |
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Child Exploitation in Prostitution |
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352 | (1) |
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Child Sexual Exploitation Materials (Formerly "Child Pornography") |
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353 | (1) |
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Solicitation of a Child for Sexual Purposes ("Grooming") |
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354 | (3) |
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Exploitation in Context of Travel or Tourism (Formerly "Sex Tourism") |
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357 | (2) |
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Live Sexual Performances (Online Child Sexual Exploitation or Live Performances in Sexually Oriented Businesses) |
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358 | (1) |
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Adverse Effects of Child Sexual Exploitation |
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359 | (1) |
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Prevention of Child Sexual Exploitation |
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360 | (1) |
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360 | (1) |
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361 | (6) |
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Chapter 17 Child Sexual Abuse of Children With Disabilities |
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367 | (34) |
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367 | (2) |
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369 | (1) |
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369 | (1) |
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370 | (3) |
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Clinical Presentation of Child Sexual Abuse |
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373 | (3) |
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373 | (1) |
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Physical Signs and Symptoms |
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374 | (1) |
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374 | (2) |
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376 | (5) |
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376 | (2) |
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378 | (1) |
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379 | (1) |
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380 | (1) |
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380 | (1) |
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Autism Spectrum Disorders |
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380 | (1) |
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Communication Disabilities and Augmentative and Alternative Communication |
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381 | (1) |
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381 | (2) |
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382 | (1) |
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383 | (1) |
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383 | (1) |
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Standard Procedure and Documentation |
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383 | (4) |
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383 | (1) |
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384 | (1) |
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Multidisciplinary Team Evaluation |
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385 | (2) |
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387 | (1) |
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Psychological Post-Trauma Treatment |
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387 | (1) |
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387 | (1) |
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Societal Reponses to the Abuse of Children and Adults With Disabilities |
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388 | (1) |
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388 | (1) |
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388 | (1) |
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Appendix 17-1 Recommended Language Use When Discussing or Writing About People With Disabilities or Those Who are Deaf or Hard of Hearing |
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389 | (6) |
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389 | (2) |
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Meeting and Interacting With Persons With Disabilities |
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391 | (1) |
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Persons With Physical and/or Mobility Disabilities |
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392 | (1) |
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Persons Who are Blind or Have Visual Disabilities |
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392 | (1) |
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Persons With Speech and/or Communication Disabilities |
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393 | (1) |
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Persons Who are Deaf or Hard of Hearing |
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393 | (1) |
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Persons With Learning Disabilities |
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394 | (1) |
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Persons Who Have Developmental or Intellectual Disabilities |
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394 | (1) |
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Persons Who Have Acquired/Traumatic Brain Injury |
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394 | (1) |
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Persons With Mental Health or Psychiatric Disabilities |
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394 | (1) |
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Persons With Hidden Disabilities |
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395 | (1) |
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395 | (3) |
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Additional Reading and Resources |
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398 | (3) |
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Chapter 18 The Medical Professional's Guide to Court Process and Procedures |
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401 | (6) |
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401 | (1) |
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401 | (1) |
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A Practical Guide to Testifying in Court |
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402 | (4) |
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402 | (1) |
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403 | (3) |
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406 | (1) |
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Chapter 19 The Adverse Effects of Sexual Abuse |
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407 | (18) |
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407 | (1) |
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408 | (5) |
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408 | (2) |
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410 | (3) |
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413 | (4) |
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417 | (2) |
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Adverse Childhood Experiences (ACEs) |
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419 | (1) |
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420 | (1) |
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421 | (4) |
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Chapter 20 Therapy for the Child Sexual Abuse Victim |
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425 | (30) |
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425 | (1) |
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Sequelae of Child Sexual Abuse |
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425 | (3) |
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427 | (1) |
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427 | (1) |
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428 | (1) |
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428 | (1) |
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Engagement of Families in Therapy |
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428 | (2) |
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Responsibilities of Referring Practitioners and Families |
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429 | (1) |
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Responsibilities of Mental Health Practitioners |
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429 | (1) |
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Clinical and Empirical Literature on the Treatment of CSA |
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430 | (10) |
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Empirical Reviews of Efficacious Treatments for Sexual Abuse |
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431 | (2) |
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Treatment Description of TF-CBT and Its Components |
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433 | (1) |
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Psychoeducation and Parenting Skills |
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434 | (1) |
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434 | (1) |
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Application of Psychoeducation |
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434 | (1) |
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Goals of Parenting Skills |
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435 | (1) |
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Application of Parenting Skills |
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435 | (1) |
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Relaxation and Stress Management Skills |
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435 | (1) |
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435 | (1) |
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435 | (1) |
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Affective Expression and Modulation Skills |
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436 | (1) |
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436 | (1) |
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436 | (1) |
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Cognitive Coping and Processing Skills: the Cognitive Triangle |
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436 | (1) |
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436 | (1) |
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437 | (1) |
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Trauma Narration and Processing |
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437 | (1) |
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437 | (1) |
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437 | (1) |
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Sharing the Trauma Narration with the Parenr |
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438 | (1) |
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In Vivo Mastery of Trauma Reminders |
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438 | (1) |
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438 | (1) |
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439 | (1) |
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Conjoint Parent-Child Sessions |
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439 | (1) |
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439 | (1) |
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439 | (1) |
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Enhancing Future Safety and Development |
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439 | (1) |
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439 | (1) |
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440 | (1) |
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440 | (1) |
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440 | (15) |
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Chapter 21 The Path to Prevention |
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455 | (24) |
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455 | (1) |
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The Problem of Child Sexual Abuse and the Importance of Prevention |
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455 | (1) |
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456 | (1) |
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Risk and Protective Factors |
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457 | (1) |
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Some Key Points to Understand About Sexual Abuse of Children |
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458 | (2) |
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Discovery of Child Sexual Abuse: More of a Process Than an Event |
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458 | (1) |
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Children React in a Wide Variety of Ways After Victimization |
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459 | (1) |
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Parents Are Central for Both Successful Prevention and Intervention |
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459 | (1) |
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Some Children Are More Vulnerable to Child Sexual Abuse |
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459 | (1) |
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History of Child Sexual Abuse Prevention Efforts |
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460 | (1) |
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Educational Efforts Targeting Children |
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460 | (1) |
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Educational Efforts Targeting Adults |
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461 | (1) |
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Concerns About Sexual Abuse Prevention Efforts |
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461 | (2) |
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Prevention Today: Trends and Future Directions |
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463 | (5) |
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Set Standards and Use Best Practices |
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463 | (1) |
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Meaningfully Involve Parents |
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463 | (1) |
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Broaden the Targets of Prevention Messages |
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464 | (1) |
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Support Quality Education of Children |
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464 | (1) |
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Create Diverse Approaches for Diverse Communities |
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465 | (1) |
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Address the Internet and Media |
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465 | (1) |
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Organizational Interventions |
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466 | (1) |
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Involve Health Professionals in Prevention Efforts |
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466 | (2) |
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Ten Steps Health Care Professionals Can Take to Prevent Child Sexual Abuse |
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468 | (2) |
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470 | (1) |
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470 | (9) |
| Index |
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479 | |
