This journal article reports the findings of a study of demographic characteristics and trends, indications for referral and medical findings in children and young people seen for suspected sexual abuse. The study was carried out as an audit of the regional specialist child abuse assessment unit base at Starship Hospital Auckland known as Te Puaruruhau. The method of analysis was retrospective review of consecutive medical records over a 7-year period from 1992 to 1998. Genital examinations were performed in 2162 of the 2310 new patient cases in which sexual abuse and/or genital symptoms were a concern. Of these 2134 were statistically analysed. The age range of these patients was 1 month to 17 years, with peaks at 3 and 14 years. Eighty-six percent of patients were female. The majority of referrals were from statutory authorities. A marked reduction in these was noted from 1997. In cases where perpetrator information was available, 97% were male and 92% were family members or friends. Medical findings diagnostic of sexual abuse were found in 130 cases (6%). Diagnostic findings were more likely to be found in adolescent girls. The authors argue that, in general, physical symptoms were of no value in differentiating between patients who had been sexually abused and those who had not. In conclusion, the authors argue that the demographics are in agreement with the literature. The authors suggest the reduction in referrals may be a reflection of changes in practice by statutory authorities. In pre-pubertal children, referrals were often made on the basis of physical symptoms, which, the authors argue, have no predictive value in the diagnosis of sexual abuse.

Journal of Paediatrics and Child Health, 42(3) March 2006 : 112-117