Inclusion of a specific prompt within the standard clinical pro forma used in assessment of patients referred to a child and adolescent sexual assault treatment service: A suggested safety-net to facilitate detection of other children at risk of child sexual abuse

• Published in: Journal of forensic and legal medicine Vol. 66; pp. 91 - 94
• Main Authors: Treston, Bryony, Kennedy, Kieran M., Nelson, Joanne
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2019
• Subjects: Child abuse; Child protection; Child sexual abuse; Consideration of close child contacts; Forensic examination; Child protection; Consideration of close child contacts; Child abuse; Child sexual abuse; Forensic examination
• ISSN: 1752-928X; 1878-7487
• DOI: 10.1016/j.jflm.2019.06.011

Evaluation of an index case of child abuse necessitates risk assessment of other children who could be vulnerable to abuse from the same perpetrator/s. To determine the effectiveness of the addition of a prompt to the standard clinical pro forma used for the assessment of new referrals to a child and adolescent sexual assault treatment service in terms of impact upon detection of other at risk children. All referrals to a Child and Adolescent Sexual Assault Treatment Service, Galway, West Ireland. Retrospective chart review of all children assessed between September 2016 and March 2017. Intervention initiated on September 1st, 2017. Prospective chart review of all children assessed between September 2017 and March 2018. Chart reviews established whether potential risk to siblings, and other close child contacts, of the index case had been adequately considered. Comparing pre and post intervention groups, documentation of children at risk significantly increased from 70% to 96% (p = 0.0124). Cases in which a letter was sent to social services regarding other “at risk” children also significantly increased from 50% to 92% (p = 0.0005). There was a change in the percentage of “at risk” children examined or planned for examination, from 66% to 84%, however that was not statistically significant (p = 0.80). Introduction of a simple prompt within the standard clinical pro forma had a significant positive impact upon clinicians’ consideration of other “at risk” children. We suggest that other services consider including a similar section in their own pro forma documents. •A simple written prompt to consider other at-risk children was added.•The documentation of children at risk significantly improved.•The rate of written correspondence to relevant services significantly increased.•The rate of examinations of the at-risk children increased.•Results support introduction of this prompt in all paediatric forensic proformas.