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A Practical Guide to the Evaluation of Sexual Abuse in the Prepubertal Child

A Practical Guide to the Evaluation of Sexual Abuse in the Prepubertal Child

October 1992 | 168 pages | SAGE Publications, Inc

"The major strengths of this book are the manual format, the comprehensiveness of the text, the direct focus on medical practitioners, the diagrams, and the photo-illustrations. The sections on normal anatomy, normal sexual growth, and development are excellent as is the section on conducting the physical examination. The concise listing of treatments and drug doses for various conditions is invaluable."

Suzanne M Sgroi
The Problem
The Evaluation
Interview and History
Physical Examination and Laboratory Specimens
Differential Diagnosis of Anogenital Findings
Sexually Transmitted Diseases (STDs)
Julie Lippmann and Ester Deblinger-Sosland
Mental Health Evaluation
Documentation and Conclusions
Extended Contents Suzanne M Sgroi
Chapter One: The Problem
Scope of the Problem
Incidence and Prevalence

Categories Included in Sexual Abuse
Conceptual Models
Preconditions for Sexual Abuse
Characteristics of the Perpetrator
Longitudinal Progression of Sexual Abuse
Child Sexual Abuse Accommodation Syndrome
Long-Term Effects of Sexual Abuse
Issues of Power and Control
Chapter Two: The Evaluation
Approach to Evaluation of Sexual Abuse
Emergent Evaluation
Physical Examination
Laboratory Studies
Chapter Three: Interview and History
Interview as Diagnostic and Therapeutic
The Interview Process
Compliance with Legal Responsibilities
Chapter Four: Physical Examination and Laboratory Specimens
Physical Examination
Familiarity with the Prepubertal Examination
Laboratory Findings
Lack of Evidence
Basic Anatomy and Development
Estrogen Effect on Female Genitalia
Huffman Stages

Outward Sexual Development
Tanner Stages

Normal Female Genitalia
Male Anatomy
Anal Anatomy
Variables Affecting Physical Evidence
Findings in Sexual Abuse
Degree of Physical Contact
Extragenital Trauma
Fondling and Digital Penetration
Male Abusive Findings
Anal Examination Findings
Penile Contact with Genitalia and Anus
Oral-Genital Contact
Penile Penetration
Summary of Abuse Findings
Accidental Trauma
Preparing for the Physical Examination with the Child
Genital and Perianal Examination
Examining the External and Internal Structures
Collection of the Specimens
Forensic Evidence
Chapter Five: Differential Diagnosis of Anogenital Findings
Framework for Consideration
Anogenital Erythema, Excoriation, Pruritus
Anogenital Bruising
Anogenital Bleeding and/or Bloody Vaginal Discharge
Nonbloody Vaginal Discharge
usual Anatomic Appearance
Chapter Six: Sexually Transmitted Diseases
Chlamydia Trachomatis
Condyloma Acuminata
Herpes Genitalis
Pediculosis Pubis
Gardnerella Vaginalis
Chancroid and Granuloma Inguinale
Chapter Seven: Julie Lippmann and Ester Deblinger-Sosland: Mental Health Evaluation
Purpose of the Mental Health Evaluation
Interviewing the Child
Aspects of Validation
Assessment of Emotional Impact
Interviewing Other Family Members
Feedback and Recommendations for Treatment
Chapter Eight: Documentation and Conclusions
Detail of the Medical Record
Recording the History
Recording the Physical Examination
Court Testimony
In Brief

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ISBN: 9780803948150