Sexual Abuse in Childhood
An estimated 3.7 million children were investigated for child abuse and neglect in 2008 (U.S. Department of Health and Human Services, 2008). The purpose of this paper is to discuss a suspected sexual abuse case in a five-year female child with a medical history of developmental delay and mild mental retardation and a chief compliant of three-day history of a low-grade fever, reduced appetite, dysuria and increased urination. The child is at increased risk for maltreatment because of her history of mental retardation and developmental delays (U.S. Department of Health and Human Services). Additional History Questions
I will ask the mother additional questions on the patient’s past illnesses, injuries, previous hospitalizations and diagnoses to determine if there have been any previous illnesses or injuries related to child abuse or neglect. Additional history questions will include current medication, allergies and immunization status to determine the child’s risk of contracting sexually transmitted diseases (STDS) such as hepatitis B from sexual abuse. I will ask additional questions about problems at preschool, interaction with peers and adults, changes in feeding habits, behavioral changes such as temper tantrums, nightmares, enuresis, bedwetting, mood changes and thumb sucking to identify any behavioral and mood changes that may have occurred as a result of sexual assault (March, Schub & Pravikoff, 2011a). I will ask about a previous history of emotional, physical and sexual abuse or neglect.
I will explore other STDs and signs of physical abuse or neglect by asking questions about any recent weight changes, the presence of skin rashes, bumps, bruises or ulcerations (March et al., 2011a). I will also explore possible sexual abuse in the form of oral sex by asking about oral ulcers, bruises, sore throats, infections and oral pain. I will ask additional questions about abdominal...