Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused

J Pediatr Adolesc Gynecol. 2016 Apr;29(2):81-7. doi: 10.1016/j.jpag.2015.01.007. Epub 2015 Feb 12.


The medical evaluation is an important part of the clinical and legal process when child sexual abuse is suspected. Practitioners who examine children need to be up to date on current recommendations regarding when, how, and by whom these evaluations should be conducted, as well as how the medical findings should be interpreted. A previously published article on guidelines for medical care for sexually abused children has been widely used by physicians, nurses, and nurse practitioners to inform practice guidelines in this field. Since 2007, when the article was published, new research has suggested changes in some of the guidelines and in the table that lists medical and laboratory findings in children evaluated for suspected sexual abuse and suggests how these findings should be interpreted with respect to sexual abuse. A group of specialists in child abuse pediatrics met in person and via online communication from 2011 through 2014 to review published research as well as recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics and to reach consensus on if and how the guidelines and approach to interpretation table should be updated. The revisions are based, when possible, on data from well-designed, unbiased studies published in high-ranking, peer-reviewed, scientific journals that were reviewed and vetted by the authors. When such studies were not available, recommendations were based on expert consensus.

Keywords: Child sexual abuse; Differential diagnosis; Expert opinion; Expert testimony; Medical history taking; Peer review; Sexually transmitted infections.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Child Abuse, Sexual / diagnosis*
  • Child Abuse, Sexual / legislation & jurisprudence
  • Child Welfare / legislation & jurisprudence
  • Child, Preschool
  • Consensus Development Conferences as Topic
  • Female
  • Humans
  • Male
  • Medical History Taking / methods
  • Medical History Taking / standards*
  • Pediatrics / standards*
  • Physical Examination / methods
  • Physical Examination / standards*
  • Practice Guidelines as Topic*
  • Sexually Transmitted Diseases / diagnosis
  • Substance-Related Disorders / diagnosis
  • United States