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Components - Medical Forensic Exam
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Components of the Medical Forensic Exam for Examiners

 

 

History taking in prepubescent children

 

Child Abuse Evaluation & Treatment for Medical Providers offers details in all aspects of medical exam for child abuse.  Authored by Ann S. Botash, MD, SUNY Upstate Medical University

 

The Centers for Disease Control offers a Developmental milestones guide to help parents, caregivers and professionals that work with children to measure the child’s achievement of developmental milestones.

 

The Centers for Disease Control offers a Compendium of screening measures for young children to identify first line screening tools that meet quality parameters set by federal partners.

 

 

Examination resource documents

 

International Rescue Committee (IRC), Caring for Child Survivors of Sexual Abuse.  Guidelines for health and psychosocial service providers in humanitarian settings provides global research on child sexual abuse and evidence from field practice.  The content targets providers of psychosocial, case management and health services to survivors of child sexual abuse, with focused content around reporting, confidentiality, consent and assent of the child and caregiver as well as challenging scenarios and scripted responses. 


USAID. The clinical management of children and adolescents who have experienced sexual violence


Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused  from Medical specialist in Child Abuse Pediatrics reviewed research, recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics to reach consensus on the updates to the guidelines.  If evidence based research was not available, recommendations were based on expert consensus.  Adams JA, Kellogg ND, Farst KJ, Harper NS, Palusci VJ, Frasier LD, Levitt CJ, Shapiro RA, Moles RL, Starling S.  Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused Journal of Pediatric and Adolescent Gynecology (2015), doi: 10.1016/j.jpag.2015.01.007.

 

Child Abuse Evaluation and Treatment for Medical Providers offers physical examination considerations for the health care provider. Topics that are addressed are consent, personnel present during the exam and preparing the child for the exam.

Harvard University, Center on the Developing Child strives to present a variety of scientific based topics to a wide range of readers.

 

DNA

 

Frequently asked questions on the CODIS program and the National DNA Index System 

 

Cold cases are any case whose probative investigative leads have been exhausted.  Many communities are looking back on cold cases, and retesting the evidence. 

 

Collection of Forensic Evidence From Pediatric Victims of Sexual Assault



Evidence Collection, Timing and Integrity

The National Institute of Standards and Technology offers the Biological Evidence Preservation Handbook: Best Practices for Evidence Handlers for those involved in biological evidence storage, tracking, preservation and disposition.  It details issues, makes recommendations and includes a glossary of related terms.  

 

State-by-state comparison of statute of limitations for sexual assault and abuse. 

  

Collection of Forensic Evidence From Pediatric Victims of Sexual Assault Pediatrics 2011;128;233; originally published online July 25, 2011; Rebecca Girardet, Kelly Bolton, Sheela Lahoti, Hillary Mowbray, Angelo Giardino, Reena Isaac, William Arnold, Breanna Mead and Nicole Paes.

 

Consent and Assent to the examination

 

Guttmacher Institute

 >> Minors and the Right to Consent to Health Care 

 >> Minors Access to STI Services

  

International Rescue Committee (IRC), Caring for Child Survivors of Sexual Abuse.

 

Military One Source provides information on child sexual abuse and response within the military installation  

 

USAID. The clinical management of children and adolescents who have experienced sexual violence

  

Child Abuse Evaluation and Treatment for Medical Providers offers physical examination considerations for the health care provider. Topics that are addressed are consent, personnel present during the exam and preparing the child for the exam.

 

Safety Planning

Safety planning resources: Stop it NOW! 

 

Military One Source provides information on child sexual abuse prevention, safety and reporting.

 

The National Child Traumatic Stress Network offers resources for parents and caregivers promoting their instrumental role in the child’s healing.  This resource is for the birth parents, adoptive parents, resource or foster parents, grandparents and all caregivers. 

 

Child Welfare Information Gateway provides guidance for foster and adoptive parents who know or suspect that a child has experienced sexual abuse. This resources provides information on educating yourself, establishing family guidelines for safety and privacy and how to seek help.

 

Child abuse response and evaluation services (CARES) northwest is a collaborative community-based medical program. Their website offers resources that include family safety tips and what to do if your child has been sexually abused


Midwest Regional Course Creating Long Term Safety for Children offering guidance for CAC’s and advocates in their provision of long term safety for children.

 

Tools for responders to assess if caregiver is a perpetrator

Perpetrators of Child Sexual Abuse is a resource from Child Welfare Information Gateway

 

The Mama Bear Effect offers information about offenders of child sexual abuse 

 

Myths about the perpetrators of sexual abuse and other helpful resources about child sexual abuse can be found through Clermont County, Child Protective Services website.

 

STD testing and clinical presentation in children

Centers for Disease Control and Prevention Sexually Transmitted Disease Surveillance 2014. Atlanta: U.S. Department of Health and Human Services; 2015,  presents statistics and trends for sexually transmitted diseases (STD’s) in the United States through 2014.  

 

Congenital Syphilis is increasing in the United States, is a major source of health problems that can impact the health of the unborn baby. 

 

CDC STD treatment guidelines discuss the updates in treatment of STD’s and related evidence based topics are for the treatment of persons who have or are at risk for STD’s.  Workowski, K, Bolan, G. (2015) Sexually Transmitted Diseases Treatment Guidelines. MMWR Recommendations and Reports 2015; 64(3)

 

CDC Treatment Guidelines  wall chart for quick reference

 

Clinical consultation   offers immediate online and telephone access to HIV experienced health care providers who can offer guidance for HIV management and blood borne pathogen exposures.

 

Child sexual abuse and the overlap with other forms of child maltreatment

Recognizing When a Child’s Injury or Illness is Caused by Abuse is a guide for providers in assessing injuries and determining if they are accidental or non accidental in nature.  


Children's Hospital Association updates on child abuse.

 

Child Physical Abuse Fact Sheet  from the National Child Traumatic Stress, Network, Physical Abuse Collaborative Group. (2009). Child physical abuse fact sheet. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.


Poly-victimization information, research and technical assistance are available on the National Children’s Advocacy Center Child Abuse Library Online. 


Defining the Children's Hospital Role in Child Maltreatment, Second Edition outlines the role of the child protection team in terms of infrastructure, staffing and functions.  


Preventing Abusive Head Trauma in Children from the Centers for Disease Control and Prevention, Division of Violence Prevention provides   information and research for caregivers and health care providers. 

 

The Commission to Eliminate Child Abuse and Neglect Fatalities provides recommendations for actions that will be most effective in ending tragic deaths of children.


Child Help offers current U.S. child abuse statistics 


See the National Children's Alliance child abuse statistics 

 

Drug endangered children checklist for first responders including national resources hotlines and website addresses.  

 

National Alliance for Drug Endangered Children  ( National DEC) provides an online resource center with useful tools, information and articles to aid in protecting drug endangered children.


 

Drug endangered children resources from the Child Abuse Library Online (CALiO).     
                                                                   

Resources on drug-endangered children from the Office for Victims of Crime (OVC).   

 

While physical abuse is shocking due to the scars it leaves, not all child abuse is as obvious.  This site offers guidance in recognizing different types of abuse in children.


 

Drug Facilitated Sexual Assault

Drug facilitated sexual assault is less common in prepubescent children but should be a consideration if the child or caregiver reports a history of altered mental status, behavior consistent with CNS depression, or intoxication.

 

This online chart was adated by Rhona Jack, Ph.D., Children’s Hospital and Regional Medical Center Laboratory, Seattle, WA  August,2001 

      

Society of Forensic Toxicologists, Inc, provide resources on drug facilitated crimes, fact sheet and resources.

 

 

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