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The child psychiatric examination of the sexually abused child
Authors:David A Mrazek MD  MRC Psych  
Abstract:Child psychiatric examination of the sexually abused child is strongly indicated as more than two-thirds of these children have concomitant emotional problems. Special considerations which are important in approaching these children but would not be a part of the routine child psychiatric evaluation are highlighted. The approach to the child who has been sexually assaulted by someone outside the family is contrasted with the evaluation of an incestuous family.Five specific expectations of the child psychiatric examination are as follows: 1. The nature of any emotional problem must be defined and an appropriate treatment plan established. 2. An immediate proposal must be made for the care of the child which will provide protection from future abuse while minimizing emotional stress. 3. Long-term planning for the family should be initiated based on an assessment of the likelihood of future recurrence of sexual abuse. 4. The child's reality testing should be evaluated if there is a question regarding the occurrence of the sexual abuse. 5. Psychological characteristics of the child which might influence the success of long-term care proposals should be documented.
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