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The value of paediatric assessment in historic child sexual abuse
  1. Sarah Al-Jilaihawi1,
  2. Kevin Borg1,
  3. Sabine Maguire2,
  4. Deborah Hodes1
  1. 1Department of Paediatrics, University College London Hospital, London, UK
  2. 2Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK
  1. Correspondence to Dr Sarah Al-Jilaihawi, Department of Paediatrics, Northwick Park Hospital, Watford Rd, Harrow HA1 3UJ, UK;{at}


Introduction A perception exists 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 prepubertal girls and all boys, were assessed in a specialised paediatric clinic. Clinic data were collected prospectively between October 2009 and November 2014 and through retrospective case note review.

Results Among the 249 children who presented with possible historic CSA, ages ranged from 0 to 17 years (median 7, SD 4.3). 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, while 18 (7%) children had physical signs supportive of CSA. 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.

Conclusions 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 group. The findings have important implications for the child, their families and the multiagency team.

  • historic child sexual abuse
  • multiagency
  • unmet health needs

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  • Contributors DH conceptualised and designed the study, based on the clinic for which she is the clinical lead, and critically revised the final manuscript. SA acquired and analysed the data and drafted the initial manuscript. KB participated in acquiring data. SB critically revised the manuscript. All authors participated in the revision of the initial and subsequent versions of the manuscript and approved the final manuscript as submitted.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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