Sexual abuse evaluations in the emergency department: Is the history reliable?

Gordon, Stacy; Jaudes, Paula Kienberger

doi:10.1016/0145-2134(96)88716-3

Cited by 32 publications

(19 citation statements)

References 11 publications

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“…In this section, we review 16 articles that were published since 1990 that contained statistics on the frequency of denial. These are listed in We do not report Gordon and Jaudes's (1996) "recantation" rate because the child was not interviewed under the same clinical watch, but rather the first interview was a brief medical screening. Also, the authors include parents' disclosures (i.e., as historian) in the base rate.…”

Section: Rates Of Disclosure (Denial)mentioning

confidence: 99%

Disclosure of Child Sexual Abuse: What Does the Research Tell Us About the Ways That Children Tell?

London¹,

Bruck²,

Ceci³

et al. 2005

Psychology, Public Policy, and Law

494

419

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The empirical basis for the child sexual abuse accommodation syndrome (CSAAS), a theoretical model that posits that sexually abused children frequently display secrecy, tentative disclosures, and retractions of abuse statements was reviewed. Two data sources were evaluated: retrospective studies of adults' reports of having been abused as children and concurrent or chart-review studies of children undergoing evaluation or treatment for sexual abuse. The evidence indicates that the majority of abused children do not reveal abuse during childhood. However, the evidence fails to support the notion that denials, tentative disclosures, and recantations characterize the disclosure patterns of children with validated histories of sexual abuse. These results are discussed in terms of their implications governing the admissibility of expert testimony on CSAAS. Although it is widely acknowledged that the sexual assault of children is a major societal concern, it is not known how many children are victims of sexual abuse in the United States (Ceci & Friedman, 2000). There are two major reasons for this lack of data. First, present estimates of the incidence of child sexual abuse (CSA) are primarily based on reports received and validated by child protection agencies. These figures, however, do not reflect the number of unreported cases or the number of cases reported to other types of agencies (e.g., sheriff's offices) and professionals (e.g., mental health diversion programs). Second, the accuracy of diagnosis of CSA is often difficult because definitive medical or physical evidence is lacking or inconclusive in the vast majority of cases (Bays & Chadwick, 1993; Berenson, Heger, & Andrews, 1991), and because there are no gold standard psychological symptoms specific to sexual abuse (Kendall-Tacket,

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Section: Rates Of Disclosure (Denial)mentioning

confidence: 99%

Disclosure of Child Sexual Abuse: What Does the Research Tell Us About the Ways That Children Tell?

London¹,

Bruck²,

Ceci³

et al. 2005

Psychology, Public Policy, and Law

494

419

View full text Add to dashboard Cite

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“…Although additional forensic interviewing may have revealed a history of abuse, lower rates of disclosure have been reported for children younger than 5 years of age. 11,12 The source of infection in case 2 was never understood clearly. This child was 3 1 ⁄2 years old when he presented with the papulosquamous rash of syphilis.…”

Section: Discussionmentioning

confidence: 99%

Preschoolers With Syphilis

Christian¹,

Lavelle²,

Bell

1999

Pediatrics

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Syphilis in preschoolers is rarely described in current medical literature, despite the rise in syphilis in both the adult and the pediatric populations during the past decade. Since that time, 3 children between 3 and 4 years of age have been diagnosed with syphilis at the Children's Hospital of Philadelphia. The presentations and clinical manifestations of syphilis in these 3 children are described, and the difficulty in identifying the source of infection is discussed. The presentations of these children included nephrosis and secondary syphilis, the corymbiform and palmar rash of syphilis, and subtle signs of late congenital infection in an otherwise asymptomatic child. One child had documented congenital infection, 1 had probable congenital infection that went untreated, and 1 did not have appropriate neonatal testing documented. None of the children gave a verbal history of sexual abuse, although it is likely that all three cases resulted from sexual abuse. The evaluation of preschool children with syphilis is confounded by the interpretation of acquired infection in consideration of a history of possible or documented congenital disease. The assessment is complicated further by problems with recognition of clinical disease, the inability of young children to provide a history, prenatal and neonatal testing methods used, changes in treatment recommendations made during the past decade, and inadequate follow-up to document cure of congenitally infected infants. With the increase in syphilis seen in recent years, physicians are more likely to encounter preschoolers with syphilis. Our ability to document acquired infection, however, is hampered by the difficulties encountered in following recommended guidelines for evaluation and follow-up and by limitations in interviewing young victims of sexual abuse, which may impair our ability to protect children from additional harm. Understanding the pathophysiology and progression of this disease remains challenging even in this modern era.

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“…Refuting evidence cases are quite rare (Jones & McGraw, 1987;Lamb, Sternberg, Esplin, Hershkowitz, Orbach, & Hovav, 1997). Table 1 summarises data about the distribution of cases across the fi rst four categories of the proposed typology from fi ve fi eld studies (DeVoe & Faller, 1999;DiPietro, Runyan, & Fredrickson, 1997;Dubowitz, Black, & Harrington, 1992;Elliott & Briere, 1994;Gordon & Jaudes, 1996). There is no refuting evidence category in Table 1 because there were no refuting evidence cases reported in any of these studies.…”

Section: A Typology Of Evidence In Forensic Csa Evaluationsmentioning

confidence: 94%