Child Abuse and Neglect

Table of Contents

1. Child Abuse and Neglect
2. What is Child Abuse and Neglect?
3. Physical Abuse
4. Sexual Abuse
   1. Behavioral indicators of sexual abuse
   2. Evaluation of suspected sexual abuse
   3. Physical findings in sexual abuse examinations
   4. Evaluation of acute sexual assault
   5. Sequelae of sexual abuse
5. Child Neglect
6. When you suspect abuse or neglect
7. Domestic Violence and Children
8. Preventing Child Abuse
9. References

Evaluation of acute sexual assault

If the most recent sexual contact occurred within the previous 96 hours, the standard practice is to perform a forensic sexual assault examination, which includes procedures to collect materials (e.g., semen or hair) that may contain the DNA of the perpetrator.

In most communities, acute sexual assault examinations are carried out in hospital emergency departments by specially trained Forensic Nurse Examiners or Sexual Assault Nurse Examiners.

Another reason for examining victims of acute sexual assault in a hospital setting is that these patients are at higher risk of having acute bodily injuries that may require urgent treatment. Complete physical examination including inspection of all body surfaces is an essential part of the examination of a sexual assault victim.

Menstruating girls and women should always be offered pregnancy prophylaxis and presumptive treatment for gonorrhea and Chlamydia. Prophylactic treatment for trichomonas and bacterial vaginosis is also available, as is initial Hepatitis B immunization for unvaccinated victims.

When to offer or provide post-exposure HIV prophylaxis is a complex topic beyond the range of this discussion. The most recent guidelines from the American Academy of Pediatrics and the Centers for Disease Control should be reviewed, in consultation with local HIV medical experts.