Physical Examination Of Limited Use In Sexual Abuse Cases

23 October 2001
Physical Examination Of Limited Use In Sexual Abuse Cases

Although many people find a child's testimony in cases of sexual abuse hard to believe, a new study proves that their allegations should be taken seriously.

The study, conducted at Children's Hospital Medical Center of Cincinnati, shows that allegations made by child victims match closely with confessions of pedophiles. The study also shows that genital exams are most often normal in victims of sexual abuse, even when genital penetration is admitted to, making it all the more imperative to listen to what children say, according to the study's authors.

The lead author of the study was Amy Arszman Daso, a medical student at Case Western University School of Medicine, who worked with Robert Shapiro, M.D., co-director of Cincinnati Children's child abuse team and co-author of the study.

"Physical exams are an unreliable indicator of sexual abuse," says Dr. Shapiro. "We're not saying that children never make things up, but the responsible reaction is to listen carefully to allegations of abuse so that abused children will be identified and false allegations recognized."

The researchers reviewed the records of 31 pedophiles who confessed between 1994 and 1999. The case files contained all available victim, witness and perpetrator statements, and pertinent victim medical records. They analyzed each case for admissions or denials of specific sexual acts. They also analyzed victim medical histories, examinations and reports from criminal investigators for specific histories of sexual assault and exam findings.

The 31 perpetrators confessed to a total of 101 acts of sexual abuse, some of which they committed multiple times. The perpetrators abused 47 children. The 45 old enough to provide a history described 111 acts of sexual abuse.

The perpetrators confessed to 68 percent of their victims' allegations, and they denied 6 percent. The only acts denied were some allegations of penile-vaginal and penile-rectal penetration, possibly because of the stiffer criminal penalties associated with penetration, according to Dr. Shapiro, an emergency medicine physician at Cincinnati Children's. The perpetrators were not specifically asked about the other 26 percent of victim allegations.

"Unlike other areas of medicine, when we interview an alleged victim of abuse, we frequently find that one or more of the historians are being untruthful," says Dr. Shapiro. "The lessons learned from this study help us to decipher conflicting histories and surprising examination findings in cases of alleged child abuse."