Sometimes when we are knee-deep in our work, we forget that those outside of our co-worker circle don’t always fully understand what we mean by things like a “forensic interview” or a “forensic medical exam.” The University of Maryland Children’s Hospital CHAMP (child abuse medical providers) has shared this fact sheet with us. Our doctors and nurses are trained to work gently and compassionately with children, and that this isn’t an invasive examination.
Maryland Child Abuse Medical Providers (CHAMP)
When sexual abuse is suspected:
Common concerns about the medical evaluation
1. Why does my child have to go through this after she/he has gone through so much?
- The medical exam is an important part of the overall evaluation of possible sexual abuse. It can find both new and old injuries, test for sexually transmitted diseases (STDs) like Gonorrhea, and sometimes collect evidence of sexual contact.
- Children and teens may worry about their bodies following sexual abuse. This exam should help answer questions your child may have. The exam can ease any worries that your child or you may have about his or her body.
2. Why can’t my family physician/pediatrician do the exam? My child knows that physician and their office.
- This exam requires special knowledge and skills concerning sexual abuse.
- There is a need to document the exam findings, with a camera.
- If the matter comes to court, it helps to have an expert to testify.
3. My child told me about what happened. The last time he/she was touched was a long time ago. Is there still a need for an exam?
- Yes. Even though the abuse may have happened long ago, your child may still worry about her/his body being normal or “damaged.”
- Sometimes, injuries heal in ways that can still provide evidence of the abuse.
4. Will I be able to be with my child throughout the physical exam?
- Yes. We want you to be there to comfort your child.
- Some teens prefer privacy and we will respect their choice.
5. Will this examination be uncomfortable for my child?
- The Maryland Child Abuse Medical Providers (CHAMP) program trains doctors and nurses to appropriately examine children. We try hard to make sure children are as comfortable as possible, although it’s not always an easy experience for kids. Rarely, a child may get very upset. If so, we do not force the exam.
- Sometimes, tests for STDs are needed. If so, this will be done very gently.
6. What will the exam involve?
- First, a general head to toe exam. This helps because children are used to it. Sometimes, problems related to abuse are found in other parts of the body. Unrelated medical problems may also be found.
- Then, a careful exam of the genital and anal areas.
- The girl’s exam is almost always limited to looking at the outside, without putting anything inside the vagina. No Pap smear is needed.
- In some teenage girls who have had their period, testing for STDs may need a speculum – one specially made for this age group.
- The examination of the anus only involves looking at the outside.
7. Will the doctor/nurse be able to tell if my child was abused?
- Most children who have been abused have normal exams.
- Occasionally, physical or laboratory findings will confirm the diagnosis of sexual abuse.
- It’s important to know that even when the exam is normal, this does not mean that abuse could not have happened. The abuse may not have caused any injury. And, even if there was an injury, it may have fully healed without any scars
- What your child says about what happened is the most important part.
8. What if my child has a sexually transmitted disease (STD) like Chlamydia?
- We will contact you with the results and recommend treatment.
9. Will the doctor provide a written report about the findings to Child Protective Services
and law enforcement?
10. What happens after the exam? Can the physician / nurse help me deal with my child’s
mental health needs?
- Yes. The doctor or CPS worker can help find a counselor for your child. Going through this
process can be hard for parents, too. You may also want a referral for professional support.
11. Who pays for the medical evaluation?
- This is covered by the Maryland Department of Health and Mental Hygiene. You do not need to pay for the exam or STD tests. However, you or your insurance may be billed for follow-up care, like repeat STD testing, and medications.