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Timing of child sexual abuse examinations

7 May, 08 | by Ian Wacogne

In a series of 331 children examined following allegations of child sexual abuse, examination within 7 days of the alleged abuse was associated with a higher yield of positive examination findings – 50% compared to 30% in children examined after 7 days.  Here.

This is an interesting paper, the lessons from which I find hard to interpret.

What it says in the abstract is that there are implications for clinical practice.  However, although I can see why they drew this conclusion, I’m not sure I can agree.  The 331 children are split into two groups, depending on how long before the examination was made the alleged abuse occurred.  They then find, as I’ve summarised above, that the longer is since the alleged abuse, the less likely there are to be signs.  OK, fair enough.  But the recommendation that we change practice?  Is there any service for CSA which delays examination by more than, say, 24 or 48 hours?  I don’t work in this field, and I’m prepared to be corrected, but I’d be surprised if there were.

Surely, if there is an implication for practice, it is to try to get children to disclose as soon as possible after abuse.  Which is a very big ask indeed.

[Incidentally, bought a copy of the CSA handbook from the RCPCH - not available as a pdf sadly, although given the images, I can quite see why.  So, in this paper it says out soon; that's print lag; it's out.]

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