Unmet health care needs among children evaluated for sexual assault

Arch Pediatr Adolesc Med. 2006 Jan;160(1):70-3. doi: 10.1001/archpedi.160.1.70.


Objectives: To determine in a population of children who underwent a medical examination after alleged sexual assault the proportion who had unmet medical or psychiatric needs.

Design: Retrospective medical record review.

Setting: A referral center for alleged child victims of sexual assault in Houston, Tex, from December 1, 2003, through April 30, 2004.

Participants: Four hundred seventy-three children (81% girls). Nine children refused all or part of the medical evaluation.

Main outcome measure: Diagnoses that warranted intervention at the time of the medical evaluation.

Results: A medical or psychological diagnosis that required intervention as judged by the examiner was made in 123 children (26%) (95% confidence interval, 22%-30%). In 39 children (8% of the total study population) (95% confidence interval, 6%-11%), the diagnosis had the potential to result in significant patient morbidity if not immediately addressed. In contrast, 44 children (9%) (95% confidence interval, 7%-12%) had probable or definite physical or laboratory evidence that supported the allegation of sexual assault.

Conclusion: Among children undergoing a medical evaluation after an alleged sexual assault, important unmet health care needs are at least as common as forensic findings.

MeSH terms

  • Adolescent
  • Child
  • Child Abuse, Sexual / diagnosis*
  • Child Abuse, Sexual / psychology
  • Child Advocacy
  • Child Welfare
  • Child, Preschool
  • Female
  • Forensic Medicine
  • Genitalia, Female / injuries
  • Genitalia, Male / injuries
  • Health Services Needs and Demand*
  • Humans
  • Infant
  • Male
  • Physical Examination*
  • Retrospective Studies
  • Texas