Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas / Edition 1

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While awareness of child sexual abuse has increased greatly, physicians have traditionally received little or no training in evaluating suspected abuse. This is the first medical book to combine a step-by-step discussion of how to interview and evaluate sexually abused children with a complete photographic atlas containing 120 color illustrations documenting signs of abuse. Chapters in the text deal with such topics as the psychological aspects of abuse, sexually transmitted diseases, the forensic team, and the role of the physician in court. This volume is a comprehensive and authoritative resource for pediatricians and all other primary care physicians who see children in their practice.

"The first medical book to combine a step-by-step discussion of how to interview & evaluate sexually abused children with a complete photographic atlas documenting signs of abuse."

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Editorial Reviews

From the Publisher

"Provides a comprehensive guide to adequate detection and evaluation of child sexual abuse. The uniqueness of the book lies in the photographic atlas. . . . clearly distinguish between normal and traumatized genitalia. . . . invaluable instruments in training a physician to correctly identify genital anomalies. . . . a well-researched, highly visual book that provides invaluable information about child sexual abuse. . . . an indispensable visual resource in working with children who have been sexually abused." --Journal of Pediatric Psychology

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Product Details

  • ISBN-13: 9780195074253
  • Publisher: Oxford University Press, USA
  • Publication date: 1/28/1992
  • Edition description: New Edition Due 07/2000
  • Edition number: 1
  • Pages: 256
  • Product dimensions: 6.88 (w) x 9.56 (h) x 0.80 (d)

Meet the Author

About the Authors
Astrid H. Heger, M.D. is Professor of Pediatrics at the University of Southern California School of Medicine where she is Executive Director of the LAC/USC Violence Intervention Program. Dr. Heger is a pioneer researcher in the diagnosis of child sexual abuse and in the use of colposcopy and photodocumentation for the evaluation of pediatric genital anatomy. She has published and lectured widely on the medical evaluation of the sexually abused child.
S. Jean Emans, M.D. is Associate Chief in the Division of Adolescent Medicine and Associate Professor of Pediatrics at Harvard Medical School. Dr. Emans has been actively involved in the medical care of pediatric and adolescent patients with gynecological problems and has been a longtime consultant to the Child Sexual Abuse Team at Children's Hospital, Boston. She has been the author of numerous scientific papers, including research on the medical criteria for the diagnosis of child sexual abuse.

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Table of Contents

1 Helping the Medical Professional Make the Diagnosis of Sexual Abuse 3
2 The Child Protection System 9
3 Psychological Effects of Child Sexual Abuse 15
4 The Medical Interview 31
5 Physical Examination of the Child and Adolescent 39
6 Forensic Examination: The Role of the Physician as "Medical Detective" 51
7 Anatomy 63
Embryology of the Genital Tract 63
Anatomic and Physiologic Changes 71
Anatomical Terms of Female External Genitalia 74
8 Photographic Atlas 79
Normal Genitalia 85
Developmental Changes 94
Variants 99
Other Variants 101
Changes with Technique and Position 105
Nonspecific Changes 109
Accidental Trauma 113
Acute Genital Trauma - Sexual Abuse 116
Chronic Changes - Sexual Abuse 122
Sexually Transmitted Diseases 126
Normal Ani or Anal Variants 133
Anal Changes 134
Nonspecific Anal Changes 137
Anal Trauma 140
9 Sexually Transmitted Diseases 145
10 Testifying as an Expert Witness 171
Glossary 183
App. A. State of California Sexual Abuse Protocol 189
App. B. Memphis, Tennessee, Sexual Abuse Protocol 195
App. C. Commonwealth of Massachusetts Sexual Abuse Protocol 201
App. D. Pilot Sexual Abuse Protocol, Children's Hospital, Boston 208
App. E. Preappointment Questionnaire, University of California, Irvine 220
Annotated Bibliography 223
Index 239
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