Importance of the forensic medical interview in the evaluation of sexual abuse in pediatric patients

Abstract

Justification: Even in confirmed cases of childhood sexual abuse, the child's interview is often the most important element in its determination. During the pediatric sexual forensic analysis there are clinical differences and rules that must be followed and that can influence the outcome of the assessment

Objective: To analyze the importance of forensic interview in the evaluation of sexual abuse in pediatric patients.

Methodology: a randomized prospective study was conducted during the first semester of 2006, at the Forensic clinic of the Legal Medicine Department in Costa Rica. The variables analyzed were: cause of consultation, age, nationality, years of school, accompanying person during the evaluation, source of information (direct or indirect), type of abuse or contact, willingness or unwillingness to collaborate, the presence of obvious lesions and physical disabilities found.

Result: The sample was of 53 children. The reason of consultation in 40 cases was sexual abuse, in 12 it was rape and in 1 it was corruption of minors, 79% of the individuals were female. Only 1 person was not Costa Rican and in 4 cases the source of information was indirect. The ages were between 2 and 12 years old, 47 % were below 6 years of age and 40 children were accompanied with their mothers. in 36 cases there was hand/finger contact and only in 7 cases there was important previous medical record. Genital injuries were found only in 2 cases, contusions in an extra genital area in 2 cases too, and nonspecific erythema was found in 3 cases. All the patients collaborated with the physical examination and none had a physical disability as a consequence.

Conclusion: The most important aspect in a forensic legal evaluation is the expertise of the medical examiner who should be able to transmit this to stimulate the cooperation of the children to be evaluated.