July 23, 2020, CARE Center, partnering with Ultra Health, opened the tri-county’s first sexual assault medical forensic exam facility for children.
The purpose of the exam is to collect evidence and document trauma that may be present. The exam is also used to assess for and treat sexually transmitted infections, injuries, and pregnancy. Most importantly, it is performed to reassure the child and family that his/her body is okay. A medical exam is offered to any child who has allegations or concerns of abuse.
The medical exam will take place in a child-friendly examination room located at Ultra Health, Claypool Hill, VA, and will be performed by a specially trained medical professional. The exam may begin by first gathering pertinent medical history. Then the child will receive a thorough head-to-toe exam, much like a normal check-up at a pediatrician’s office. This exam will also include an external inspection of the genitalia and anal area to make sure they appear normal. Unlike an adult pelvic examination, the child’s examination is different and less invasive. It is highly unusual for a preadolescent child to require an internal vaginal or rectal examination.
For most children, the check-up is not painful. Nevertheless, some children may feel worried, embarrassed, or uncomfortable about their exam. These feelings of concern or anxiety are normal and are understood by the medical staff. Therefore, medical professionals will take as much time as necessary to help children throughout the medical evaluation by explaining each step of the check-up and finding ways to put the child at ease.
Sources: CARE Center and nationalcac.org/medical-services/
Is the medical exam required?
All children will be offered an exam, but no child will be forced to have a medical exam. The investigator may request an exam for your child if:
- The reported abuse involved mucous membrane contact (oral, anal or genital);
- Your child complains of genital or anorectal pain, itching, burning, bleeding, or discharge;
- You or your child have/has concerns that may be best answered by a healthcare provider;
- Your child would be reassured of health and safety by an examination, and/or
- The extent or nature of the abuse is unclear and may be clarified by an examination.
Who can be present during the exam?
Many children want a parent or supportive adult in the exam room with them for comfort and reassurance. Other children prefer to do the exam on their own. When possible, our health care provider(s) would ask that the child’s preference be respected. For any exam involving the more private parts of the body, a chaperone will always accompany the primary healthcare provider.
Will the exam show whether the child has been sexually abused?
Not necessarily. Based on current research, most children have no visible physical injuries to their genital or anal areas after reported sexual abuse. A lack of visible injury does not mean that no sexual abuse has occurred. A lack of visible physical injury after reported sexual abuse may be due to the nature of rapid healing in children after injury, delayed disclosure (telling someone) or the reported abuse/assault may not have caused a physically visible injury.
What is a pediatric-sane exam (Pedi-SANE exam)?
A Pedi-SANE exam helps ensure first and foremost the health and well-being of your child (ages 0-17). The exam may also provide photo-documentation of possible physical and forensic findings, along with allowing for the collection of possible evidence that may be present on your child’s body or clothing using a Physical Evidence Recovery Kit (PERK). The exam may include collection of medical specimens and administration of medication(s) based on chief complaint and individual situation.
What other services do Pedi-SANEs provide for children & families?
The Pedi-SANE provides support, teaching, referral, follow-up and anticipatory guidance to children and families referred to the Children’s Advocacy Center through face to face and telephone consultation. Skilled intervention provides a sense of well-being and normalcy to not only an abused child, but to their family.
Will the Pedi-SANE exam hurt my child?
Pedi-SANE exams are typically non-invasive and painless. The “Stop Rule” is followed in caring for children who report sexual abuse. At any time during the exam, your child can say “stop” and the exam will be discontinued. Utilizing this approach, the child’s boundaries are respected, and safety and control is maintained by your child.
Will the Pedi-SANE consult with my child’s pediatrician or other healthcare providers?
Yes, Pedi-SANEs will provide interpretation of forensic exam findings and act as an important liaison between you and your child’s pediatrician. Your child will be evaluated by a medical provider as part of the Pedi-SANE exam.
If my child is unable to complete the exam, will another examination be scheduled?
If your child is unable to complete the exam, the decision to reschedule the exam would be based on your child’s clinical presentation and the level of concern for injury based on the reported history of the event. There may be situations when it is determined that it may not be in the best interest of your child to attempt another exam. Any decision not to reschedule an exam would be discussed with you, the parent.