Anna stated that her stepfather warned her not to tell anyone and that no one would believe her, even if she did tell. Over the subsequent months, the abuse increased in severity, involving vaginal penetration and forced oral sex. Anna indicated that her stepfather would read to her in bed and that one night he started touching her chest and rubbing her legs. The purpose of the forensic interview is to determine the details of the child abuse allegations, without asking leading questions or causing undue harm to the child, and to render an opinion on the credibility of the child’s disclosures.ĭuring the course of the forensic interview, Anna said that her stepfather had started abusing her about a year ago and that it happened multiple times a week while her mother, a nurse at the local hospital, was working the evening shift. In addition to the physical examination, a forensic interview was conducted at the CAC. The medical provider explained that the majority of children who are victims of sexual abuse do not have signs of injury regardless of the timing of the examination. B asked if this finally “proved” that the abuse never happened. B did attend the CAC evaluation, stating that she just wanted to “get this over with so that everyone would leave family alone.” At the CAC evaluation, Anna was noted to have a normal genital examination with no signs of injury. B’s anger and disbelief, she reluctantly allowed the pediatrician to conduct a cursory physical examination of Anna but deferred a genital examination until Anna could be seen at her local CAC for a medical examination. B responded, “Do what you need to, but I won’t help you.”ĭespite Ms. The worker informed her that this would entail the police coming directly to her home to question her husband, to which Ms. B for specific information about her husband, which Ms. The CPS worker indicated that she needed to contact law enforcement and asked Ms. B that she would also plan to attend that appointment, as a way to reduce the number of times Anna had to undergo in-depth interviews. Anna was scheduled for the CAC evaluation the following week, and the CPS worker told the pediatrician and Ms. The CPS intake worker stated that a worker would be at their home that day to interview Anna and her mother and to establish a safety plan.
As the alleged perpetrator was a primary caregiver (the child’s stepfather), the pediatrician made the report to the local CPS office. B became increasingly hostile, angrily stating that she did not understand why Anna needed to be seen at the CAC and a report needed to be made, as this “really couldn’t have happened.” Because of her obligation as a mandated reporter, the pediatrician explained that the report was required and that the best plan would be for them to make the telephone call together. B that a report would have to be made immediately to the local child protective services (CPS) office, as physicians are mandated reporters in cases of suspected child abuse. B to speak directly with the CAC to provide any required information. B was still in the office, the pediatrician contacted the CAC to schedule the evaluation and allow Ms. In addition to providing medical evaluations and forensic interviews after abuse disclosures, CACs offer therapy and medical examinations, courtroom preparation, victim advocacy, and ongoing case management. CACs provide a safe, child-focused environment and include a multidisciplinary team of professionals, comprising medical, mental health, law enforcement, prosecution, child protective services, victim advocacy, and school personnel, who work together to coordinate services for children. B was having difficulty believing the allegations, the pediatrician recommended a referral to the local Child Advocacy Center (CAC) for a medical examination and forensic interview. Since Anna was extremely upset after her disclosure and Ms. Furthermore, she said that she and Anna have a very close relationship and that Anna would have shared this if it had occurred. B did not understand how this could have happened since she rarely left her children alone with her husband. She did acknowledge that she and her husband had been experiencing marital problems, which resulted in his moving out of the home temporarily about 6 months ago, but she was still seeing him, and he was still at the house frequently. B was visibly shaken and distressed by the disclosure, stating that she had no idea this had happened. On further inquiry, she said that he had been forcing her to engage in “sex stuff.” Ms. She started crying and disclosed that her stepfather had been “hurting” her.
At a recent visit to the pediatrician for a well-child appointment, Anna refused to remove her clothes and became extremely agitated when the physician started to examine her. “Anna” is a 9-year old girl, currently in third grade.