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  1. Article ; Online: Interpretation of medical findings in suspected child sexual abuse: An update for 2023.

    Kellogg, Nancy D / Farst, Karen J / Adams, Joyce A

    Child abuse & neglect

    2023  Volume 145, Page(s) 106283

    Abstract: Health care professionals who examine children who may have been sexually abused need to be able to recognize, and photo-document any physical signs, and to have access to expert reviewers, particularly when signs concerning for sexual abuse are found. ... ...

    Abstract Health care professionals who examine children who may have been sexually abused need to be able to recognize, and photo-document any physical signs, and to have access to expert reviewers, particularly when signs concerning for sexual abuse are found. Although the general consensus among practitioners is that children will show few signs of sexual abuse on examination, there is considerable variability and rates of positive exam findings among practitioners of different professions, practice settings, and countries. This review will summarize new data and recommendations regarding the interpretation of medical findings and sexually transmitted infections (STIs); assessment and management of pediatric patients presenting with suspected sexual abuse or assault; and testing and treating patients for STIs. Updates to a table listing an approach to the interpretation of medical findings are presented, and reasons for changes are discussed.
    MeSH term(s) Humans ; Child ; Child Abuse, Sexual/diagnosis ; Sexual Behavior ; Consensus ; Health Personnel
    Language English
    Publishing date 2023-09-19
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 799143-5
    ISSN 1873-7757 ; 0145-2134
    ISSN (online) 1873-7757
    ISSN 0145-2134
    DOI 10.1016/j.chiabu.2023.106283
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  2. Article ; Online: Patient Safety Programs for Child Maltreatment: Does One Size Fit All?

    Kellogg, Nancy D / Kissoon, Natalie N

    Pediatrics

    2021  Volume 148, Issue 3

    MeSH term(s) Child ; Child Abuse ; Family ; Humans ; Patient Safety
    Language English
    Publishing date 2021-08-23
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2021-051583
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  3. Article ; Online: Working with child protective services and law enforcement: what to expect.

    Kellogg, Nancy D

    Pediatric clinics of North America

    2014  Volume 61, Issue 5, Page(s) 1037–1047

    Abstract: The process whereby a clinician decides that child abuse is a diagnostic possibility is often marked with doubt and fear. Abusive parents can present convincing lies, and children with suspicious injuries can have unusual accidents. Personal thresholds ... ...

    Abstract The process whereby a clinician decides that child abuse is a diagnostic possibility is often marked with doubt and fear. Abusive parents can present convincing lies, and children with suspicious injuries can have unusual accidents. Personal thresholds for reporting suspected abuse vary considerably. Clinicians may mistrust or misunderstand the roles and responsibilities of the investigators and legal professionals involved. This article aims to improve understanding of the community responses to a report of child abuse, and enable the clinician to work effectively with child protective services, law enforcement agencies, and legal professionals to ensure child safety and family integrity when appropriate.
    MeSH term(s) Child ; Child Abuse/legislation & jurisprudence ; Child Welfare/legislation & jurisprudence ; Health Knowledge, Attitudes, Practice ; Humans ; Law Enforcement ; Mandatory Reporting ; Parents ; Physicians
    Language English
    Publishing date 2014-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 215711-1
    ISSN 1557-8240 ; 0031-3955
    ISSN (online) 1557-8240
    ISSN 0031-3955
    DOI 10.1016/j.pcl.2014.06.013
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  4. Article ; Online: Factors that prevent, prompt, and delay disclosures in female victims of child sexual abuse.

    Kellogg, Nancy D / Koek, Wouter / Nienow, Shalon M

    Child abuse & neglect

    2020  Volume 101, Page(s) 104360

    Abstract: Background: Several studies conducted in clinical and non-clinical settings have described why and when children disclose sexual abuse. Yet, there is incomplete understanding of how adolescents and young children may differ in factors that delay, prompt ...

    Abstract Background: Several studies conducted in clinical and non-clinical settings have described why and when children disclose sexual abuse. Yet, there is incomplete understanding of how adolescents and young children may differ in factors that delay, prompt and deter disclosure that could inform strategies for clinical practice and prevention.
    Objective: The aim of this study was to identify factors that prevent, prompt, and delay disclosure among pediatric patients presenting for acute and non-acute medical evaluations of sexual abuse or assault, and to examine any differences in disclosure tendencies among female adolescents and pre-adolescents.
    Participants and setting: A chart review of a consecutive sample of pediatric patients presenting to the emergency department or outpatient clinic identified 601 patients who were diagnosed with sexual abuse and were willing to answer examiner questions about their disclosure.
    Methods: Data collection included attainment of patient narratives which were utilized to gather information about abuse disclosures. Recursive abstraction was applied to categorize patient statements for further analysis, while Pearson chi square and logistic regression were utilized for quantitative data.
    Results: Young age (<11 years) at abuse onset was the strongest predictor of, and fear of consequences to self was the most common reason for, disclosure delay in both adolescent and pre-adolescent females. Severity of abuse, adult perpetrator, and self-blame predicted delays only in pre-adolescent females.
    Conclusions: Social and moral development during middle childhood likely has a strong influence on disclosure tendency. Strategies to promote disclosure should consider reducing fear of consequences associated with the adult-child paradigm.
    MeSH term(s) Adolescent ; Age Factors ; Child ; Child Abuse, Sexual/diagnosis ; Child Abuse, Sexual/psychology ; Disclosure ; Female ; Humans ; Self Disclosure ; Time Factors
    Language English
    Publishing date 2020-01-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 799143-5
    ISSN 1873-7757 ; 0145-2134
    ISSN (online) 1873-7757
    ISSN 0145-2134
    DOI 10.1016/j.chiabu.2020.104360
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  5. Article: Dental Neglect.

    Spiller, Lora / Lukefahr, James / Kellogg, Nancy

    Journal of child & adolescent trauma

    2019  Volume 13, Issue 3, Page(s) 299–303

    Abstract: Dental neglect can be an indicator of general child neglect. Inadequately treated dental disease may have significant long-term impacts on the physical and psychological well-being of children. Primary care providers play a critical role in the ... ...

    Abstract Dental neglect can be an indicator of general child neglect. Inadequately treated dental disease may have significant long-term impacts on the physical and psychological well-being of children. Primary care providers play a critical role in the prevention of dental neglect, and should be aware of the manifestations of dental caries and dental trauma. When diagnosing dental neglect, health professionals should ensure the child's caregivers have demonstrated an understanding of the condition, its consequences, and the recommended treatment and then failed to comply with the treatment. Attempts should be made to eliminate any barriers preventing caretakers from complying with professional advice. Dental neglect is a form of child maltreatment and, if suspected, should be reported to the appropriate child protective agencies.
    Language English
    Publishing date 2019-02-04
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2502136-9
    ISSN 1936-153X ; 1936-1521
    ISSN (online) 1936-153X
    ISSN 1936-1521
    DOI 10.1007/s40653-019-0247-y
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  6. Article ; Online: Testing and Treating Sexually Assaulted Adolescents: What Are We Waiting For?

    Neuman, Mark I / Kellogg, Nancy D

    Pediatrics

    2015  Volume 136, Issue 6, Page(s) e1600–1

    MeSH term(s) Child Abuse, Sexual ; Emergency Service, Hospital/statistics & numerical data ; Female ; Guideline Adherence/statistics & numerical data ; Healthcare Disparities/statistics & numerical data ; Humans ; Male ; Practice Patterns, Physicians'/statistics & numerical data ; Pregnancy ; Rape
    Language English
    Publishing date 2015-12
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2015-3346
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  7. Article ; Online: Sexual behaviors in children: evaluation and management.

    Kellogg, Nancy D

    American family physician

    2010  Volume 82, Issue 10, Page(s) 1233–1238

    Abstract: Sexual behaviors in children are common, occurring in 42 to 73 percent of children by the time they reach 13 years of age. Developmentally appropriate behavior that is common and frequently observed in children includes trying to view another person's ... ...

    Abstract Sexual behaviors in children are common, occurring in 42 to 73 percent of children by the time they reach 13 years of age. Developmentally appropriate behavior that is common and frequently observed in children includes trying to view another person's genitals or breasts, standing too close to other persons, and touching their own genitals. Sexual behaviors become less common, less frequent, or more covert after five years of age. Sexual behavior problems are defined as developmentally inappropriate or intrusive sexual acts that typically involve coercion or distress. Such behaviors should be evaluated within the context of other emotional and behavior disorders, socialization difficulties, and family dysfunction, including violence, abuse, and neglect. Although many children with sexual behavior problems have a history of sexual abuse, most children who have been sexually abused do not develop sexual behavior problems. Children who have been sexually abused at a younger age, who have been abused by a family member, or whose abuse involved penetration are at greater risk of developing sexual behavior problems. Although age-appropriate behaviors are managed primarily through reassurance and education of the parent about appropriate behavior redirection, sexual behavior problems often require further assessment and may necessitate a referral to child protective services for suspected abuse or neglect.
    MeSH term(s) Adolescent ; Adolescent Behavior ; Adolescent Development/physiology ; Child ; Child Abuse, Sexual/prevention & control ; Child Behavior ; Child Development/physiology ; Family/psychology ; Humans ; Sexual Behavior ; Sexual Development/physiology
    Language English
    Publishing date 2010-11-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 412694-4
    ISSN 1532-0650 ; 0002-838X ; 0572-3612
    ISSN (online) 1532-0650
    ISSN 0002-838X ; 0572-3612
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  8. Article ; Online: Clinical report--the evaluation of sexual behaviors in children.

    Kellogg, Nancy D

    Pediatrics

    2009  Volume 124, Issue 3, Page(s) 992–998

    Abstract: Most children will engage in sexual behaviors at some time during childhood. These behaviors may be normal but can be confusing and concerning to parents or disruptive or intrusive to others. Knowledge of age-appropriate sexual behaviors that vary with ... ...

    Abstract Most children will engage in sexual behaviors at some time during childhood. These behaviors may be normal but can be confusing and concerning to parents or disruptive or intrusive to others. Knowledge of age-appropriate sexual behaviors that vary with situational and environmental factors can assist the clinician in differentiating normal sexual behaviors from sexual behavior problems. Most situations that involve sexual behaviors in young children do not require child protective services intervention; for behaviors that are age-appropriate and transient, the pediatrician may provide guidance in supervision and monitoring of the behavior. If the behavior is intrusive, hurtful, and/or age-inappropriate, a more comprehensive assessment is warranted. Some children with sexual behavior problems may reside or have resided in homes characterized by inconsistent parenting, violence, abuse, or neglect and may require more immediate intervention and referrals.
    MeSH term(s) Child ; Child Abuse ; Child Behavior Disorders/diagnosis ; Child Behavior Disorders/therapy ; Child, Preschool ; Female ; Humans ; Male ; Sexual Behavior
    Language English
    Publishing date 2009-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2009-1692
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  9. Article ; Online: Interpretation of Medical Findings in Suspected Child Sexual Abuse: An Update for 2018.

    Adams, Joyce A / Farst, Karen J / Kellogg, Nancy D

    Journal of pediatric and adolescent gynecology

    2017  Volume 31, Issue 3, Page(s) 225–231

    Abstract: Most sexually abused children will not have signs of genital or anal injury, especially when examined nonacutely. A recent study reported that only 2.2% (26 of 1160) of sexually abused girls examined nonacutely had diagnostic physical findings, whereas ... ...

    Abstract Most sexually abused children will not have signs of genital or anal injury, especially when examined nonacutely. A recent study reported that only 2.2% (26 of 1160) of sexually abused girls examined nonacutely had diagnostic physical findings, whereas among those examined acutely, the prevalence of injuries was 21.4% (73 of 340). It is important for health care professionals who examine children who might have been sexually abused to be able to recognize and interpret any physical signs or laboratory results that might be found. In this review we summarize new data and recommendations concerning documentation of medical examinations, testing for sexually transmitted infections, interpretation of lesions caused by human papillomavirus and herpes simplex virus in children, and interpretation of physical examination findings. Updates to a table listing an approach to the interpretation of medical findings is presented, and reasons for changes are discussed.
    MeSH term(s) Adolescent ; Child ; Child Abuse, Sexual/diagnosis ; Child, Preschool ; Documentation/methods ; Female ; Genitalia ; Humans ; Male ; Physical Examination/methods ; Practice Guidelines as Topic ; Sexually Transmitted Diseases/diagnosis
    Language English
    Publishing date 2017-12-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1325079-6
    ISSN 1873-4332 ; 1083-3188
    ISSN (online) 1873-4332
    ISSN 1083-3188
    DOI 10.1016/j.jpag.2017.12.011
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  10. Article ; Online: The evaluation of sexual abuse in children.

    Kellogg, Nancy

    Pediatrics

    2005  Volume 116, Issue 2, Page(s) 506–512

    Abstract: This clinical report serves to update the statement titled "Guidelines for the Evaluation of Sexual Abuse of Children," which was first published in 1991 and revised in 1999. The medical assessment of suspected sexual abuse is outlined with respect to ... ...

    Abstract This clinical report serves to update the statement titled "Guidelines for the Evaluation of Sexual Abuse of Children," which was first published in 1991 and revised in 1999. The medical assessment of suspected sexual abuse is outlined with respect to obtaining a history, physical examination, and appropriate laboratory data. The role of the physician may include determining the need to report sexual abuse; assessment of the physical, emotional, and behavioral consequences of sexual abuse; and coordination with other professionals to provide comprehensive treatment and follow-up of victims.
    MeSH term(s) Adolescent ; Child ; Child Abuse, Sexual/diagnosis ; Child Abuse, Sexual/legislation & jurisprudence ; Child Abuse, Sexual/rehabilitation ; Female ; Humans ; Male ; Mandatory Reporting ; Physical Examination ; Referral and Consultation ; Risk Factors ; Sexually Transmitted Diseases/diagnosis
    Language English
    Publishing date 2005-08
    Publishing country United States
    Document type Journal Article ; Practice Guideline
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2005-1336
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