Introduction There is a perception that there are few benefits of a paediatric assessment in historic child sexual abuse (CSA), as the likelihood of finding forensic evidence is low.
Aim To determine the value of a comprehensive paediatric assessment in a dedicated clinic for children and young people who present following suspicion or allegation of historic CSA.
Method All children with suspected or alleged historic CSA, defined as >7 days after the last episode of sexual assault in pubertal girls, or >3 days for pre-pubertal girls and all boys, were assessed in a specialised paediatric clinic. Clinic data was collected prospectively between October 2009 and November 2014 and through retrospective case note review.
Results 249 children presented with possible historic CSA, ranging from one week to one year after the episode. Ages ranged from 0–17 years, median 7 years, standard deviation 4.3. Indications for referral varied significantly with age (p<0.001). Of these children, 141 (57%) had a medical concern(s) related to the referral reason, 78 (31%) had an unrelated medical concern(s) and 55 (22%) had emotional or behavioural concerns requiring onward referral (Table 1). Furthermore, 18 (7%) children had physical signs supportive of CSA, significantly associated with alleged penetration (p<0.001). Findings referable to Social Care were identified in 26 cases (10%), the police in 6 cases, and 15 (6%) parents required professional help for anxiety symptoms.
Conclusion This study highlights the value of a comprehensive paediatric assessment in a dedicated clinic for cases of suspected or alleged historic CSA, by identifying a broad variety of unmet health needs in this vulnerable group. These findings have important implications for the child, their families, and the multiagency team.
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