Children's response to the medical visit for allegations of sexual abuse: maternal perceptions and predicting variables

Allard-Dansereau, Claire; Hébert, Martine; Tremblay, Caroline; Bernard-Bonnin, Anne-Claude

doi:10.1002/car.688

Cited by 16 publications

(7 citation statements)

References 27 publications

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“…Similarly to Allard‐Dansereau, 33 our findings suggested that physician behaviour had an influence on the child's degree of distress. The emphasis parents and children placed on staff attitudes, explanations offered and the relationship between doctor and child has implications for clinician training and practice.…”

Section: Discussionsupporting

confidence: 72%

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Do no more harm: The psychological stress of the medical examination for alleged child sexual abuse

Marks

Lamb

Tzioumi

2009

J Paediatrics Child Health

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Aim: Currently, there is some controversy that the medical examination following allegations of child sexual abuse may further traumatise the child. Access for children to appropriate care may be hindered if decisions about referral are influenced by personal beliefs, rather than by recognition of the potential health and psychological benefits of the assessment. We aimed to study the expectations and emotional responses of children and their parents to the medical examination. Methods:We conducted a prospective quantitative and qualitative study at the Children's Hospital at Westmead. Participants completed questionnaires pre-examination and post-examination, including Children's Anxiety and Pain Scales. Clinicians recorded a Genital Examination Distress Scale and a questionnaire about potentially prognostic variables. Results: Parents found the medical examination significantly less stressful than they had anticipated. They highlighted the importance of being involved in the process, the child's reaction, staff attitudes and the doctor's explanations. Although most parents expected that the medical would be stressful for their child, this did not correlate with the children's reports of feeling scared beforehand. Increased parental and child distress were significantly associated with the child being 12 years or older. The type of abuse was not significantly linked to any of the parent or child self-reports. Conclusion: Our findings indicate that the medical examination is not as stressful as expected and support the recommendation that timely medical assessment by appropriately trained professionals should be offered for all children following allegations of sexual abuse.

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Section: Discussionsupporting

confidence: 72%

“…Allard‐Dansereau et al. 33 made a similar finding. This suggests that is it the very fact that there was abuse (rather than the specific details) and that a medical is needed (rather than what the doctor actually does) that is stressful for parent and child.…”

Section: Discussionmentioning

confidence: 67%

Do no more harm: The psychological stress of the medical examination for alleged child sexual abuse

Marks

Lamb

Tzioumi

2009

J Paediatrics Child Health

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“…Later studies have reported less negative responses to the ano‐genital examination. Allard‐Dansereau, Tremblay, & Bernard‐Bonnin (2001) explored maternal perceptions of their child's reaction to the medical evaluation for alleged sexual abuse and found more than 60% of children were perceived by their mothers as being reassured regarding physical integrity. A total of fifty mothers of male and female children between the ages of 4 and 12 years were interviewed six months after their child was seen for a medical examination for child sexual abuse.…”

Section: Review Of the Related Literaturementioning

confidence: 99%

Emotional response to the ano-genital examination of suspected sexual abuse

Hornor

Scribano

Curran

et al. 2009

Journal of Forensic Nursing

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“…In New Zealand, Davies et al () demonstrated that post CSA medical examination, 42.9 per cent ( n = 9) of children reported feeling a ‘bit better’ but 23.8 per cent felt ‘worse’, with negative responses reflecting a perceived lack of choice or preparation for medical examination. Allard‐Dansereau et al (), in Canada, found that 62 per cent of mothers felt reassured about the physical condition of their child following examination, with ‘kindness’ of the physician as a factor in alleviating the impact of the examination. ‘Reassurance’ (that serious harm has not been caused) as a purpose of examination is supported by Mears et al () in the USA, with 78 per cent of children aged 11–17 years ( n = 77) stating that medical examination was ‘helpful’ and made them ‘feel better’.…”

Section: Introductionmentioning

confidence: 99%

Multiagency Response to Childhood Sexual Abuse: A Case Study that Explores the Role of a Specialist Centre

2017

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Through the application of case study methods, this research explored the role of a specialist centre that responds to actual or suspected childhood sexual abuse (CSA). When CSA is suspected to have occurred, children and families and professionals from statutory agencies are required to navigate complex processes. This study was undertaken to explore those processes in a specialist children's referral centre. It comprised three datasets: (1) 60 children (0–17 years) were ‘tracked’ to ascertain reasons for referral, the type of examination and outcomes in terms of health, social care and criminal justice actions; (2) semi‐structured interviews with 16 professionals (paediatricians, specialist nurses, child abuse investigation police officers and children's social workers); and (3) analysis of ‘patient’ and parent/carer satisfaction questionnaires. Medical examination rarely confirmed abuse and only 13 per cent of cases were pursued within the criminal justice system. However, 66 per cent of children had an identified health need requiring follow‐up. Professionals from all groups believed the centre provided a ‘child friendly’ facility that enhanced co‐operation. However, challenges with focusing on the needs of children and with mulitagency working were identified. Routine patient satisfaction data collected at the time of the study demonstrated positive views of the care received, although other data suggest that this may be an incomplete picture. Key Practitioner Messages Medico‐legal considerations may dominate health assessment of children when CSA is suspected and yet only a small proportion of cases proceed to court. A specialist centre can provide a child‐friendly environment and enhance interprofessional communication. A high proportion of children referred to statutory services following suspected CSA have a range of health and psychosocial needs that require further follow‐up. Roles that cross professional boundaries may enhance CSA services but this concept requires further research.

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Children's response to the medical visit for allegations of sexual abuse: maternal perceptions and predicting variables

Cited by 16 publications

References 27 publications

Do no more harm: The psychological stress of the medical examination for alleged child sexual abuse

Do no more harm: The psychological stress of the medical examination for alleged child sexual abuse

Emotional response to the ano-genital examination of suspected sexual abuse

Multiagency Response to Childhood Sexual Abuse: A Case Study that Explores the Role of a Specialist Centre

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