SWK 490 Lecture 5: Class 10:7

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Child Maltreatment Class (10/7)
1
PowerPoint:
Prepubertal Female Genital Tract
Male Reproductive System
Child Sexual Abuse
Sexual activity by an adult or older or more powerful child with a child
below the legal age of consent:
o ANY form of sexual intercourse
o Physical contact in an act of apparent sexual stimulation with a child’s clothed or
unclothed genitals, pubic area, or buttocks or with a female’s clothes or unclothed
breasts
Sexual Abuse
Also includes non-contact acts:
o Voyeurism
o Lewd exhibition of the breasts, genitals or pubic area
o Photo or video of nude child(ren) used for purpose of sexual stimulation
o Compelling child to look at pornographic pictures, videos or to witness others
engaging in sexual acts
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Child Maltreatment Class (10/7)
2
Sexual AbusePhysical Indicators
There are rarely physical findings
Repeated urinary tract infections or yeast infections (especially in young children)
Tears, fissures, abrasions, or other injuries to genitalia
Also conduct an oral exam to check for palate petechiae from oral penetration
Sexual Abuse—STD’s
Sexually transmitted diseases
o Gonorrhea (usually diagnostic of abuse)
o Syphilis (usually diagnostic of abuse
o HIV (usually diagnostic of abuse)
Sexually transmitted diseases
o Gonorrhea and chlamydia can have oral diagnoses
Some STD’s will clear on their own (after 9 months or so):
o Trichomonas, Gonorrhea, Chlamydia
Best practices recommend that positive STD tests be re-tested using different methods to
rule out false positives.
Other possible sources of STD infection
Chlamydia, Trichomonas, Herpes, and Genital Warts may or may not be indicators of
abuse depending on the child’s age and other factors
In utero transmission (can occur with syphilis, gonorrhea, or HIV)
Perinatal transmissions (can occur with chlamydia, HPV, or HSV)
Indicator of AbuseAnal Trauma
Most acute anal trauma heals within a few days to weeks
There are rarely medical findings
Some medical findings might include:
o Abrasions
o Lacerations
o Bruising
Minor anal trauma or enlarged anus can also be caused by large bowel movements. This
also heals quickly.
Colposcopy
The Pros:
The Cons:
Non-invasive
Cost of equipment
Excellent way to record and
document examination
Space
Bright light
Good magnification
Sexual Abuse: Potential Indicators in Preschool Age Children
Regressive Behavior
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