Forensic Child, Adolescent and Adult Psychiatry

Sexual Abuse Evaluations

Sexual abuse allegations are the hardest form of child abuse to substantiate. This will be the first of several posts on the subject, and you are invited to participate. Sexual abuse of children is a very real and serious phenomenon. From Internet predators to a drunk father fondling his little girl, the problem is omnipresent all over the world. Some abusers go into action while their children are still pre-pubertal: they are pedophiles - adults sexually attracted to children - frequently boys as well as girls. Other abusers find victims in those who have sexually matured. And not all abusers are men. Less frequently recognized are adult women who molest male and female children.

One sure way to ascertain that sexual abuse has occurred is finding a sexually transmitted disease (STD) in the victim. That's why children should have physical examinations and cultures taken of all orifices as part of an evaluation. If, for example, gonorrhea is cultured from a child's mouth, eyes, vagina, penis or anus (or more than one place) that is clear-cut evidence that such abuse has occurred. A blood test might reveal the presence of syphilis. Unfortunately, with most allegations of sexual abuse, no physical evidence is found. What to do?

Future posts will discuss evaluating sexual abuse in children. While some evaluators take a professional and non-political approach to these evaluators, others have made a big business calling themselves “validators,” as if they alone can find the truth of what has happened to a child. As we'll see, it's not that easy.

As always, your comments are welcome.

Texas Returns FLDS Children

Long overdue, the state of Texas has finally been ordered to return the children back to the custody of their parents. The original trial judge ordered that today. It's about time. This entire matter, unfortunately, has shown the child protective system in its worst possible light. Grab kids and talk later is often their M.O. I hasten to say this is not standard operating procedure, and we need these folks to help protect our children at risk. Nevertheless, this case will be studied in law schools and by mental health professionals for a long time to come. You may not like children to grow up in a "cult." You may not approve of the mothers wearing the same style dress and the same hair style. You may have have "problems" understanding the tenets of the Mormon Church. However, absent evidence of child abuse or neglect, the state had no authority here. Parents have a right to raise their children as they see fit. Child protective workers need more than they had here to remove all these children.