Medical Child Abuse: Essentials for Pediatric Health Care Providers

Genital Examination of the Prepubertal Female: Essentials for Pediatric Nurse Practitioners

“…The PNP must then determine if the practices are age-appropriate or indicate an inappropriate emphasis on genital care (Hornor, 2007). Inappropriate genital care can result in negative psychological and even physical consequences for children; they can be a form of medical child abuse (Hornor & Ryan-Wenger, 1999;Hornor, 2021). Anticipatory guidance should also address any caregiver concerns regarding sexual behaviors.…”

“…Discuss with caregivers the importance of teaching their children the correct anatomical names for their private parts. Inform the caregiver that this is to help ensure that children who experience sexual abuse can disclose victimization in words that can be understood by any adult (Hornor, 2021). Educate caregivers that children who experience sexual abuse rarely have any physical findings on examination (Adams, Farst, & Kellogg, 2018) An adequate light source and knowledge of normal prepubertal genital anatomy are necessary to perform an accurate genital examination (Figure 1).…”

Challenging Case: Caregiver-Fabricated Illness Masquerading as Autism Spectrum Disorder

“…It is estimated that pediatric health care professionals, including developmental-behavioral pediatric clinicians, will most likely encounter at least 1 factitious disorder in another (FDIA) or caregiver-fabricated illness (CFI) victim in the course of their career. 1 Falsified mental health problems have included learning disorders, attention-deficit disorder, autism spectrum disorder, and bipolar disorder. 2,3…”