The Diagnosis of Child Sexual Abuse

Medical evidence in child sexual assault cases

“…Out of all cases, it was found that only 40 percent contained medical evidence of assault, such as abrasions or a ruptured hymen, which would be considered acceptable by court standards (Enos et al, 1986). Similar results were found by Dubowitz et al (1992), in which 41 percent of genital findings were found to be abnormal, 28 percent of which were indicative of child sexual abuse. Overwhelmingly, research suggests that superficial wounds to external genitalia are the most common form of medical evidence found in CSA cases (Enos et al, 1986;Christian et al, 2000).…”

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

“…Rates of disclosure during the first visit increased as a function of abuse certainty, with 7%, 8%, 59%, and 76%, respectively, disclosing. The overall disclosure rate in Dubowitz, Black, and Harrington (1992) was 58%; however, among their cases rated by an interdisciplinary team as holding low to possible likelihood, the disclosure rate was only 19%, compared with the disclosure rate of 83% for the moderate to high likelihood cases. Elliott and Briere (1994) examined the case records of 399 8- to 15-year-olds who were seen at a child sexual assault assessment center.…”

“…For example, in the Elliott and Briere (1994) study, there were 118 children involved in cases with external evidence: 84% of these 118 children at one point disclosed abuse. In Dubowitz et al (1992), the finding that 83% of children disclosed abuse was based on the calculation of the number of children with medical findings (but see Gordon & Jaudes, 1996).…”

Understanding expert testimony on child sexual abuse denial after New Jersey v. J.L.G.: Ground truth, disclosure suspicion bias, and disclosure substantiation bias

“…1 Unlike the other five studies described here, Dubowitz et al (1992) was specifically discussed by the court in J.L.G.…”