Medical Response to Child Sexual Abuse

Dr. Rich Kaplan is a board-certified pediatric child abuse specialist of Children's Hospitals and Clinics of Minnesota. He is an associate professor of pediatrics at the University of Minnesota Medical School. He is the medical director of The Center for Safe and Healthy Children - the University of Minnesota Amplatz Children's Hospital Child Abuse Program and the Associate Medical Director at Midwest Children's Resource Center, a regional medical child abuse evaluation program at Children's Hospitals and Clinics of Minnesota. First, as a social worker and now as a pediatrician, he has been working with child abuse victims for over 30 years. Most recently, Dr. Kaplan has become board certified in the new pediatric specialty, child abuse pediatrics. He is also certified in general pediatrics.

Dr. Joyce Adams has been involved in the medical evaluation of suspected sexual abuse since 1984, first as the director of the Sexual Abuse Evaluation Program at the University of Kansas Medical Center, and then at Valley Medical Center in Fresno, California. Dr. Adams has published extensively in the field of medical evaluation of suspected sexual abuse. She also speaks regularly at national and international meetings on topics of sexual abuse and adolescent gynecology, and is active as an expert witness in child sexual abuse cases nationwide. Currently, Dr. Adams is a Professor of Clinical Pediatrics in the Division of Primary Care Pediatrics and Adolescent Medicine at UCSD. She is involved in teaching, clinical care, and research in several settings, including the Chadwick Center for Children and Families at Rady Children's Hospital of San Diego. Dr. Adams also acts as a consultant for the Sexual Abuse Response Team and Child Abuse Program at Palomar and Pomerado Hospitals in San Diego County.

Dr. Suzanne P. Starling is a professor of pediatrics at Eastern Virginia Medical School and medical director of the Child Abuse Program at Children's Hospital of The King's Daughters in Norfolk, Virginia, where she also directs the Child Abuse Pediatrics Fellowship program. Dr. Starling earned her medical degree from East Carolina University in Greenville, NC, completed her pediatrics residency in Greenville, South Carolina, and her fellowship in Child Abuse Pediatrics at the University of Colorado and The Children's Hospital in Denver Colorado. She testifies nationally as an expert witness in child abuse and neglect cases and has published more than 25 journal articles and book chapters in the field. Dr. Starling is immediate past chair the Executive Committee of the Section on Child Abuse of the American Academy of Pediatrics. She also serves as chair of the American Board of Pediatrics subboard on Child Abuse Pediatrics, the board that oversees the education and certification process in the field of child abuse. Dr. Starling is a charter member of the Ray E. Helfer Society, an honorary society for physician specialists in child abuse. She has received many awards for her work, including being named Outstanding Professional by the American Professional Society on the Abuse of Children.

Angelo Giardino is the medical director of Texas Children's Health Plan, a clinical associate professor of pediatrics at Baylor College of Medicine, and an attending physician for the Texas Children's Hospital's forensic pediatrics service at the Children's Assessment Center in Houston, Texas. Dr. Giardino completed his residency and fellowship training in pediatrics at the Children's Hospital of Philadelphia. Immediately after his fellowship training, Dr. Giardino became the assistant, and then the associate, medical director at Health Partners of Philadelphia, where he had primary responsibility for utilization management, intensive case management, and health care data analysis. He also shared responsibility for the plan's quality improvement program. Additionally, Dr. Giardino began the Child Abuse and Neglect Team for Children with Special Health Care Needs, which was funded by a three-year grant from a local philanthropist. In 1998, he was appointed associate chair of clinical operations in the Department of Pediatrics at the Children's Hospital of Philadelphia (CHOP), and in June of 1999, he was asked to chair the CHOP Quality Committee. These accomplishments are only a few of his career.

This text is destined to be an excellent resource for novices as well as experienced providers of medical care to victims of sexual abuse. In addition, investigators and social workers without medical backgrounds will benefit from increased understanding of the nature, importance, and value of these medical assessments. Clinicians faced with the seemingly never-ending stream of victims will find the last chapter on prevention particularly helpful, providing hope that we can effect change.

Deborah Lowen, MD
Associate Professor of Pediatrics
Director Child Abuse Pediatrics
Vanderbilt University School of Medicine
Nashville, Tennessee

This textbook offers a comprehensive and detailed accounting of the medical assessment of the alleged childhood sexual abuse victim. It serves as an excellent resource for the multidisciplinary team responsible for the evaluation of these complex cases. Both Martin Finkel and Allan De Jong have provided the clinician with a well-referenced guide for how to accurately and effectively medically assess, interpret, and document sexual abuse or assault in children and adolescents. Anyone working in the field of child maltreatment should add this publication to their annals.

Barbara L. Knox, MD, FAAP
Medical Director Child Protection Program
University of Wisconsin
American Family Children’s Hospital
Assistant Professor Department of Pediatrics
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin

This is a valuable, exhaustive resource combining anatomic, epidemiologic, therapeutic, and preventative strategies for children and young adults. Beginning with historical context and moving through basic anatomy, physiology, and pathology, the reader quickly learns best practices in health services for sexual abuse, assault, and exploitation. Team approaches, collaboration, telemedicine, training, treatment, and mental health services are reviewed in great detail, and there is a superlative discussion of research methods and the state of knowledge in the field topped off with legal and international issues and prevention. This book should be read by any professional who wants to responsibly provide services for children and families facing these difficult problems.

Vincent J. Palusci, MD, MS, FAAP
Professor of Pediatrics
New York University School of Medicine
New York, New York

This comprehensive text will be an invaluable resource to any medical provider who has contact with children. With topics ranging from basic genital anatomy to court testimony and future directions for prevention, it is an excellent resource not only for those whose careers are primarily focused on child sexual abuse but also to those who simply desire a basic understanding. In recent decades, there have been tremendous advances in medicine related to child sexual abuse, and this book synthesizes all of this information.

Mark Hudson, MD
Midwest Children’s Resource Center
Children’s Hospitals and Clinics of Minnesota
St. Paul, Minnesota

This comprehensive text ought to be available to each multidisciplinary team member tasked with treating and/or investigating child and adolescent sexual abuse and assault. Diverse topics are carefully addressed including interviewing children with impairments, commercial sexual exploitation, and efficacious mental health therapies. Dr. Allan De Jong’s chapter on acute sexual abuse should be required reading for physicians and sexual assault nurse examiners tasked with forensic evidence collection and acute medical treatment. Dr. Martin Finkel details the highest standards to which clinicians should adhere as they elicit histories, conduct physical exams, and complete medicolegal documentation. This text is an excellent resource for both novice and established clinicians who serve child sexual abuse survivors and their families.

Tanya Hinds, MD, FAAP
Child Abuse Pediatrician
Children’s National Medical Center
Washington DC

Dr. Kaplan’s new text is much more than a “how to do a sexual abuse exam” or a “how to interpret the exam” handbook. The book includes chapters on how to talk with families after the examination, the history and future of child sexual abuse prevention, and child and youth prostitution and pornography. This is both a reference book and a thoughtful stimulus to broaden our thinking about the causes and effects of child sexual abuse and the role of the medical professional in caring for our patients and for the community.

Naomi F. Sugar MD
Clinical Professor of Pediatrics
University of Washington Medical Director
Center for Sexual Assault and Traumatic Stress
Harborview Medical Center
Seattle, Washington