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PHYSICAL EXAMINATION: Reassuring the Child/Adolescent and Parent/Caregiver

The physical examination, particularly the genital examination, may trigger recall of the abusive event. As a result, a child/adolescent may spontaneously ask questions about what has happened. Answer these questions in addition to providing reassurance using the following suggestions:

  • Avoid using medical jargon and words like "scarred" or "damaged."
  • When appropriate, discuss good touches and bad touches.
  • Take the time to explain any abnormal or significant physical findings. Drawings or colposcopy images can make the explanation easier to understand.
  • When possible, preface descriptions of tears and lacerations with words like "healing." That is, tears are "healing" tears.
  • When appropriate, reassure the child/adolescent that the injuries are not permanent, will not cause permanent problems, and will heal, often with no residua.
  • Use age-appropriate language to explain the implications of any findings.
  • Utilize appropriate resources, such as sign language interpreters, to assist with reassuring children with disabilities.
  • When the examination is normal, explain why it may be normal despite the incident of abuse. Convey that you believe the child/adolescent even though there is a lack of physical findings. Reasons for lack of findings include:
    • Fondling rarely causes physical damage
    • The vaginal opening is very elastic, even in prepubertal girls
    • The anal area may dilate, therefore reducing the chance of injury
    • Healing of genital areas, including the anus, can be very rapid

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Physical Examination: Overview  Physical Examination: Considerations  Physical Examination: General Physical Examination  Physical Examination: Genital Examination  Physical Examination: Evidence Collection  Physical Examination: Reassuring the Child/Adolescent and Parent/Caregiver  Physical Examination: Additional Resources 

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