Suspected Sexual Abuse

Pathway Background and Objective(s):

According to the U.S. Department of Health and Human Services, in 2017, there were 674,000 substantiated cases of child maltreatment in the U.S., 8.6% of which were sexual abuse. In Connecticut, there were 8,442 victims of child maltreatment, and 401 of those cases involved sexual abuse/assault. Because management can be complex, this pathway was developed to standardize decision making and assure that medical, forensic, and safety concerns are simultaneously addressed when a child presents with a concern of sexual abuse or assault. The specific objectives of this pathway are to:

  • Create standardization of clinical care for suspected sex abuse/assault
  • Help providers to think about the medical, forensic, safety, and mental health components required when caring for a child of suspected sex assault or abuse
  • Serve as a guide for outpatient medical providers who are determining if a child needs to be sent to the CT Children’s emergency department or not, thereby decreasing unnecessary ED visits or transfers from outside hospitals
  • Direct appropriate history gathering from the child and family
  • Properly identify who should have forensic evidence collection kits performed and how to execute evidence collection appropriately
  • Ensure proper STI testing and treatment is provided in the correct circumstances, based on CDC guidelines
  • Ensure appropriate Department of Children and Families (DCF) reporting
  • Link the child to appropriate medical follow up

Algorithm:

Download Suspected Sexual Abuse Pathway Algorithm Updated: October 11, 2021

Quality Metrics:

  • Percentage of patients eligible for pathway with order set usage
  • Percentage of patients who have a referral to the Suspected Child Abuse and Neglect (SCAN) team
  • Percentage of patients age ≥ 12 years old with pregnancy testing performed
  • Percentage of patients with DCF report completed
  • Percentage of patients with completed and/or offered appropriate STI testing (HIV, syphilis, chlamydia, gonorrhea)
  • Number of patients with forensic evidence collection completed
  • Percentage of patients with forensic evidence collection completed who have a referral to the SCAN team

Educational Module:

Download Suspected Sexual Abuse Education Module Updated: October 11, 2021

Key References:

Pathway Contacts:

  • Nina Livingston, MD
    • Suspected Child Abuse and Neglect (SCAN) Team
  • Rebecca Moles, MD
    • Suspected Child Abuse and Neglect (SCAN) Team
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