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ORIGINAL ARTICLE

Forensic issues in the
assessment of sexually
assaulted adolescents
Anne Niec MD FRCPC FAAP

A Niec. Forensic issues in the assessment of sexually assaulted
adolescents. Paediatr Child Health 2002;7(3):153-159.

Des enjeux médico-légaux dans l’évaluation
d’adolescents agressés sexuellement

This article provides ageneral overview of the principles of conducting a forensic evaluation of adolescents who have been
exposed to sexual abuse. This problem is common and is associated with a large burden of suffering. There is a strong likelihood
that most paediatricians will be called on to perform such evaluations at some point in time. This overview includes a description
of the forensic examination, focuses onsuch issues as consent and
contact with child protection services, and provides specific
guidelines about interviewing the adolescent. Familiarity with
how to conduct a forensic evaluation will hopefully improve the
availability of this service for adolescents. Contact with the legal
profession can be stressful. At the same time, paediatricians are in
a unique position to advocate on behalf oftheir adolescent
patients.

Le présent article donne un aperçu général des principes nécessaires pour
effectuer une évaluation médico-légale des adolescents victimes d’agression sexuelle. Ce problème est courant et relié à un important fardeau de
souffrances. Il est fort probable que la plupart des pédiatres soient appelés
à procéder à de telles évaluations un jour ou l’autre. Le présentaperçu
inclut une description de l’examen médico-légal, porte sur des questions
comme le consentement et le contact avec les services de protection de
l’enfant et donne des directives précises sur l’entrevue de l’adolescent. La
familiarité avec la manière de mener une évaluation médico-légale
améliorera, nous l’espérons, la disponibilité de ce service pour les adolescents. Le contact avec lemilieu juridique peut être stressant. Cependant,
les pédiatres sont dans une position idéale pour se porter à la défense de
leurs patients adolescents.

Key Words: Adolescent; Forensic issues; Sexual assault

n Canada, it is well recognized that the prevalence of sexual abuse is high. As a result of studies such as the report
by Badgley (1983) (1,2) and the Ontario Health
Supplement to theOntario Health Survey (OHSUP)
(1990) (3), information about the frequency of this problem is available. The rates of sexual abuse in children and
adolescents were estimated at 17.6% of girls and 8.2% of
boys in the report by Badgley (1,2), while the OHSUP estimated 12.8% of girls and 4.3% of boys had experienced
some form of sexual victimization by an adult (3). Both
studies based theirinformation on retrospective reports of
individuals. Badgley (1,2) surveyed individuals 18 years of

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age and older across Canada, while the OHSUP surveyed
individuals 15 years of age and older living in Ontario. In
the latter survey (3), participants were asked questions
regarding their exposures to sexual abuse while they were
‘growing up’. One of the limitations of both surveys relates
tothe fact that the prevalence of sexual assault during adolescence specifically was not addressed.
Sexual assault in adolescence may include intrafamilial
abuse (sexual abuse by a family member) and/or extrafamilial abuse (sexual abuse by someone outside of the family). This latter term may include stranger assault and date
rape (4).

Hamilton Health Sciences Corporation, McMaster Site,Hamilton, Ontario
Correspondence: Dr Anne Niec, McMaster Children’s Hospital, Hamilton Health Sciences Corporation, Room HSC 3G40, 1200 Main Street
West, Hamilton, Ontario L8N 3Z5. Telephone 905-521-2100 ext 73268 or 73687, fax 905-522-7982, e-mail nieca@mcmaster.ca
Paediatr Child Health Vol 7 No 3 March 2002

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Adolescence encompasses a...