Collection of Forensic Evidence From Pediatric Victims of Sexual Assault

Girardet, Rebecca G; Bolton, Kelly L.; Lahoti, Sheela L; Mowbray, Hillary; Giardino, Angelo P.; Isaac, Reena; Arnold, William P.; Mead, Breanna; Paes, Nicole

doi:10.1542/peds.2010-3037

Cited by 47 publications

(15 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11,12 Importantly, the presence of significant physical findings does not predict recovery of foreign DNA and should not be the basis for collecting forensic evidence. 10 Additionally, DNA can still be recovered following genital wiping after the event. 12 At this time, forensic evidence collection is recommended for sexual contact that may have resulted in the exchange of biologic material within 24 hours in prepubertal children and within 72 hours in adolescents.…”

Section: Examinationmentioning

confidence: 99%

Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused

Adams

Kellogg

Farst

et al. 2016

Journal of Pediatric and Adolescent Gynecology

156

View full text Add to dashboard Cite

The medical evaluation is an important part of the clinical and legal process when child sexual abuse is suspected. Practitioners who examine children need to be up to date on current recommendations regarding when, how, and by whom these evaluations should be conducted, as well as how the medical findings should be interpreted. A previously published article on guidelines for medical care for sexually abused children has been widely used by physicians, nurses, and nurse practitioners to inform practice guidelines in this field. Since 2007, when the article was published, new research has suggested changes in some of the guidelines and in the table that lists medical and laboratory findings in children evaluated for suspected sexual abuse and suggests how these findings should be interpreted with respect to sexual abuse. A group of specialists in child abuse pediatrics met in person and via online communication from 2011 through 2014 to review published research as well as recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics and to reach consensus on if and how the guidelines and approach to interpretation table should be updated. The revisions are based, when possible, on data from well-designed, unbiased studies published in high-ranking, peer-reviewed, scientific journals that were reviewed and vetted by the authors. When such studies were not available, recommendations were based on expert consensus.

show abstract

Section: Examinationmentioning

confidence: 99%

Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused

Adams

Kellogg

Farst

et al. 2016

Journal of Pediatric and Adolescent Gynecology

156

View full text Add to dashboard Cite

show abstract

“…Interestingly, testing and prophylaxis were not affected by presence of injury. As many pediatric victims of sexual assault will not have evidence of injury on exam, 13, 14 it is important that care not vary based on these findings. In fact, in our population, just over one-third of the patients had injuries noted at the time of the ED visit; higher than what has been previously reported in the literature, which has ranged from 21–24%.…”

Section: Discussionmentioning

confidence: 99%

Enhancing the Emergency Department Approach to Pediatric Sexual Assault Care

Goyal

Mollen

Hayes³

et al. 2013

Pediatric Emergency Care

View full text Add to dashboard Cite

Objective Describe the experience of a novel pediatric Sexual Assault Response Team (SART) program in the first three years of implementation, and compare patient characteristics, evaluation, and treatment among subpopulations of patients. Methods Retrospective chart review of a consecutive sample of patients evaluated at a pediatric ED who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with gender, menarchal status, and presence of injuries were measured using logistic regression. Results One hundred and eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 years (+/− 4.6 years). The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among females (p<0.01), but not by gender. Evidence of acute anogenital injury on physical exam was found in 20.6% of patients. As per the Center for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal females were more likely to undergo testing for sexually transmitted infections (STI) and pregnancy (p<0.01) and to be offered pregnancy, STI, and HIV prophylaxis (p<0.01). Conclusions In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on exam. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault.

show abstract

“…Finally, a study was conducted that determined the relationship between time of sexual assault and the time frame in which the yield of evidence using DNA amplification is valid supported an extended time frame for FEK collection from children [44]. Findings showed that body swabs collected from children beyond 24 hours after assault still yielded evidence.…”

Section: Figure 2cmentioning

confidence: 99%

Back to Basics: The Identification of Genital Anatomic Structures and Forensic Evidence Collection Kits in Cases of Suspected Child Sexual Abuse

Donaruma‐Kwoh¹,

Giardino²,

Giardino³

2016

MEDJ

View full text Add to dashboard Cite

Background: The genitalia examination and collection of forensic evidence are essential components of the medical evaluation when sexual abuse is suspected. In addition to a complete history/interview, the medical visit for a suspected child sexual abuse victim usually includes a detailed examination of external genitalia and anus as well as, if indicated, the collection of forensic evidence. It is important that medical and nursing professionals are able to correctly identify normal genital and anal structures before they can identify abnormal physical findings in either the prepubertal or adolescent patient. Additionally, medical and nursing professionals are expected to accurately collect and preserve forensic evidence when possible. Methods: A topical review of literature that examines: 1) if physicians and nurse practitioners could identify basic anatomic structure of external genitalia, and 2) the timing and yield of forensic evidence collection kits. Results: Physicians vary in their ability to correctly identify prepubertal genital anatomic structures. Over a series of studies, on the same photograph of female prepubertal genitalia, 59 to 64% of physicians correctly identified the hymen from; 76 to 90% correctly identified the labia minora, and 63 to 78%correctly identified the urethra. On a second photo, deemed more clear, 71% of pediatric chief residents correctly labeled the hymen. Pediatric nurse practitioners performed similarly to the physicians correctly identifying the hymen 59%, labia minora 88% and urethra 81%. Looking at photographs of male prepubertal genitalia, 93% of pediatric chief residents correctly identified the basic structures while only 22% correctly recognized hypospadias. Literature reviewed on forensic evidence collection kits support an extended window for evidence collection of up to 96 hours after suspected sexual contact especially of clothing and other non-body surfaces. Conclusion: Medical and advanced practice nursing professions have to improve the educational processes of clinicians who evaluate and treat children suspected of abuse. Physicians and nurse practitioners experienced difficulty in correctly labeling and identifying basic external genital structures on a photograph of a prepubertal child’s genitalia. Additionally, extending the time frame from suspected sexual contact to examination to a window of up to 96-hours post assault may increase the yield of recovering forensic evidence in both pre and post-pubertal patients.

show abstract

Collection of Forensic Evidence From Pediatric Victims of Sexual Assault

Abstract: Body samples should be considered for children beyond 24 hours after assault, although the yield is limited. Physical examination findings do not predict yield of forensic laboratory tests.

Cited by 47 publications

References 15 publications

Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused

Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused

Enhancing the Emergency Department Approach to Pediatric Sexual Assault Care

Back to Basics: The Identification of Genital Anatomic Structures and Forensic Evidence Collection Kits in Cases of Suspected Child Sexual Abuse

Contact Info

Product

Resources

About