The clinical-forensic dichotomy in sexual abuse evaluations: moving toward an integrative model

Disorders of Sex Development: Pediatric Psychology and the Genital Exam

Objective

To provide suggestions for clinical care of youth with disorders of sex development (DSD) and their families, by drawing on preexisting pediatric psychology literature with a particular focus on child sexual abuse (CSA) genital exams.

Method

Relevant peer-reviewed papers published since 1990 in the CSA literature were systematically reviewed, as well as an illustrative sample of general pediatric psychology papers.

Results

Empirical research from the CSA literature provided information on prevalence of distress and the impact of provider behavior, the importance of preparation, and proposed interventions. Expert recommendations from CSA literature and general findings gleaned from pediatric psychology also address these issues.

Conclusions

Psychological findings in the CSA pediatric population suggest that fears and anxieties are not universal and can be linked to a number of variables. Based on this review, we make a number of recommendations for potential interventions for youth with DSD and their families, emphasizing the need for further clinical research.

Language competence in forensic interviews for suspected child sexual abuse

Forensic interviews with children for suspected child sexual abuse require meeting children "where they are" in terms of their developmental level, readiness to disclose, culture, and language. The field lacks research indicating how to accommodate children's diverse cultural and linguistic backgrounds. This article focuses on language competence, defined here as the ability of an organization and its personnel (in this case, Child Advocacy Centers and forensic interviewers) to communicate effectively with clients regardless of their preferred language(s). In this qualitative study, 39 U.S. child forensic interviewers and child advocacy center directors discussed their experiences, practices, and opinions regarding interviews with children and families who are not native speakers of English. Topics include the importance of interviewing children in their preferred language, problems in interpreted interviews, bilingual interviews, and current and recommended procedures. Recommendations for practice and further research are included.

Forensic, cultural, and systems issues in child sexual abuse cases--part 2: research and practitioner issues

This article introduces the second issue of the special double issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. We briefly review the articles, which include a discussion of child sexual abuse myths, an empirical analysis of extended child sexual abuse evaluations, an article on the role of the medical provider in child sexual abuse evaluations, a study of satisfaction levels with multidisciplinary teams in child advocacy centers, and a commentary advocating for the credentialing of forensic interviewers. We call for further empirical examination of media related to child sexual abuse risk, research on appropriate models for extended sexual abuse interviews and evaluations, and optimal practices relevant to each member of multidisciplinary teams in a child advocacy center.