child maltreatment

Question 1

international prevalence of child sexual abuse

Answer 1

13% of girls

6% of boys

Question 2

ontario reported prevalence of child sexual abuse

Answer 2

22% females

8.3% males

Question 3

negative impacts associated with child sexual abuse

Answer 3

substance use
mental health problems
physical health consequences

Question 4

prevalence of child sexual abuse in indigenous population

Answer 4

25-50% of women experienced CSA as a child

Question 5

can you tell law enforcement about suspected CSA

Answer 5

NO!

always to CAS only, otherwise violates confidentiality

Question 6

age 12-13 years consent for sexual acitivity

Answer 6

need to have a partner less than 2 years older

Question 7

age 14-15 consent for sexual activity

Answer 7

partner needs to be less than 5 years older

Question 8

age of sexual activity consent in canada

Answer 8

16

Question 9

it is recommended to schedule examinations for CSA

Answer 9

after their interview with law enforcement
consider when the abuse last occured, who the offender was, and type of contact
if within the last 72 hours should be urgent

Question 10

medical history to gather after suspected child sexual abuse

Answer 10

symptoms of ano-genital pain, discharge, bleeding, itching
urinary and bowel health
abdo pain
mood, behaviours
PMHx

Question 11

physical findings in suspected CSA cases that are normal variants

Answer 11

hymenal notches and bumps, intravaginal ridge
failure of midline fusion
partial dilatation of external anal sphincter

Question 12

findings caused by something other than trauma or sexual abuse

Answer 12

erythema, labial adhesion, anal fissures

Question 13

Findings mistaken for sexual abuse

Answer 13

urethral prolapse
lichen sclerosus
vulvar ulcers

Question 14

findings where there are no expert consensus that they signify sexual abuse

Answer 14

(e.g., complete anal dilatation with relaxation of external and internal anal sphincter without predisposing factors; a notch or cleft nearly to the base of the hymen at or below the ‘3 o’clock’ or ‘9 o’clock’ position)

Question 15

findings caused by trauma and sexual abuse

Answer 15

, acute injury or signs of residual (healed) injury to genital or anal tissues). One example is a hymenal transection/complete hymen cleft – a defect in the hymen below the 3-9 o’clock location that extends to or through the base of the hymen

Question 16

best way to test for STI in prepubertal children with suspected CSA

Answer 16

culture for G& C is best for medical-legal purposes, but can use NAAT if you send 2 different samples to different labs

Question 17

what are the recommendations regarding prophylactic treatment for STIs in suspected CSA in Canada

Answer 17

not recommended, rate of STI is very low in pre-pubertal children
testing is recommended and treatment of positive test but not prophylactic treatment
test for G& C, hepatitis B and C, syphilis. HIv should be tested at 6,12, and 24 weeks post exposure
hep C 12 and 24 weeks

Question 18

indicators to start HIV-PEP in prepubertal suspected CSA

Answer 18

1. suspected offender is HIV +
2. significant exposure (oral,anal,vaginal penetration without condum)
   No later than 72 hours post exposure should be started

Question 19

recommendations regarding hepatitis B transmission due to CSA in pre-pubertal children

Answer 19

if possible transmission, confirm immunization status and consider starting Hep B vaccine series and immune globulin

Question 20

optimal treatment for children who experience CSA

Answer 20

trauma-focused CBT