Sexual abuse Flashcards
Source
Incest and sexual abuse of children within the family occur more frequently than is acknowledged.
Only 6% of child sexual abuse is by strangers.
Sexual abuse presents in three main ways:
allegations by the child or an adult
injuries to the genitalia or anus
suspicious presentations, esp.:
- –genital infection
- –recurrent urinary infection
- –unexplained behavioural changes/psychological disorders
Sexual abuse can take many forms, including:
genital fondling
digital penetration
penetration with various objects
simulated sexual intercourse (anal in boys)
full sexual penetration
pornography
prostitution
Management
It is important to act responsibly in the best interests of the child.
It is important to realise that the child will be in crisis.
Children are trapped into the secrecy of sexual abuse
- often by a trusted adult, by powerful threats of the consequences of disclosure.
When we encounter real or suspected child abuse, immediate action is necessary.
The child needs an advocate to act on its behalf
- and our intervention actions may have to override our relationship with the family
Some golden rules are:
Never attempt to solve the problem alone
Do not attempt confrontation and counselling in isolation (unless under exceptional circumstances)
Seek advice from experts (only a telephone call away)
Avoid telling the alleged perpetrator what the child has said
Refer to a child sexual assault centre where an experienced team can take the serious responsibility for the problem
Supporting the child
Acknowledge the child’s fear and perhaps guilt
Assure the child it is not his or her fault
Tell the child you will help
Obtain the child’s trust
Tell the child it has happened to other children and you have helped them
Practice tips and guidelines
A child’s statement alleging abuse should be accepted as true until proved otherwise
Children rarely lie about sexual abuse
False allegations, however, are a sign of family disharmony and an indication that the child may need help
Do not insist that the child ‘has got it wrong’, even if you find the actions by the alleged perpetrator unbelievable
Do not procrastinate—move swiftly to solve the problem
Be supportive to the child by listening, believing, being kind and caring
Note:All GPs should become familiar with local legislation about mandatory reporting.
When to refer
Unless there are exceptional circumstances, referral to an appropriate child abuse centre where an expert team is available is recommended.
If doubtful, relatively urgent referral to a paediatrician is an alternative.
National Child Abuse Helpline: ?????
