Assessment

There may be a number of assessments required to ensure the safety and wellbeing of a child who has been sexually abused. This will include a child protection assessment to ensure that agencies are working together to ensure the protection of the child and a Child Protection Specialist CSA Medical Assessment. These are important, not only to collect forensic samples or identify injuries, but also to reassure children and their families, to identify unmet health needs (including potential risks of self-harm or suicide), to prevent or look for sexually transmitted infections, and to prevent or identify pregnancy.

Most children who come to the attention of police and social care are not referred for medical examination. The reasons for this are not well understood. Evidence from the limited relevant studies suggests that children are not referred because of professionals’ concerns about causing harm through examination, or beliefs that examination is not necessary – particularly where circumstances indicate that forensic evidence is unlikely to be obtained. However, national and local evidence shows that most children reflect on the medical examination as a positive experience. There is evidence the child’s experience depends on the clarity of information and advice they received before the examination, how supportive and sensitive practitioners are perceived to be, the examiners skill and involvement of carers in the process.

The HIPS guide to CSA medical examinations provides additional information on local processes.