FAQs



 

 How do I make an appointment?

Often children are referred or sent to us by police or a child protection agency.  The Audrey Hepburn CARE center also gets referrals from other doctors, pediatricians, and emergency room physicians.  Once we receive the referral, you will be contacted to schedule an appointment.

What will happen during my child’s visit?

You will be greeted and welcomed by one of our trained staff members.  You and your child will be escorted into a private child-friendly den where staff will explain what is going to happen, help you with your paperwork, and get some insurance information.  Volunteers are often present to entertain and distract your child if you think your child would enjoy making crafts or just playing.

Before the checkup, a nurse will check your child’s height, weight, and blood pressure.  The nurse can also assist with answering your questions and addressing your concerns.

You will then meet one of the Audrey Hepburn CARE center physicians, who will ask questions about your child’s general health.  Once your child feels comfortable, the physician and a trained staff member will talk to your child in private about why he or she is at the doctor today.  The physicians are all trained pediatricians who are extremely talented in making children feel at ease, even those who find it difficult to separate in other situations.  You will then join your child for a full head-to-toe checkup.  If your child is twelve years of age or older, he or she will be able to choose whether or not he or she would like to have another person present in the room.  Afterwards, the doctor will discuss what was learned from talking to the child and from the checkup to give advice for the health of your child.  The Audrey Hepburn CARE center case manager will also give you information about resources available in your community, referrals for counseling, and written materials to help you through the process.

How long will the appointment take?

Each child is scheduled for 90 minutes of the doctor’s time.  Please prepare to be here for two hours and make sure that your child has had something to eat.  If for any reason there is not enough time, the doctor will do her best to complete as much as possible, but you might have to reschedule to finish the checkup.

Does it hurt?

No.  The exam is similar to a regular pediatric visit.  The doctor will check the child from head to toe and everything in between.  As recommended by the American Academy of Pediatrics, pediatricians should check the private areas of all patients during all well child visits.  For young children, the doctors will need to look at the outside of your child’s private area, which will require a light touch of the skin.  For some fully developed, older teenagers, a pap smear may be needed.

We tell all of our patients that this is a “no ouch” visit.  It is important that your child knows that they won’t be getting any shots and that they are in complete control of the exam.  If at anytime the child says that something hurts, the physician will adjust the exam for the child’s comfort; the child is in complete control of the exam.

How can I help my child prepare for the appointment?

Children do better when they know what is going to happen.  You can help your child by explaining that they are going to a special doctor that talks to kids like them everyday.  Let the child know that the doctor will do a checkup but that nothing will hurt and that there will not be any shots.

What does it mean when the doctor says that my child has a “normal” exam?

More often than not an exam will result in a normal finding.  This does not mean that the abuse did not occur.  The part of the body that is examined heals very quickly and may not have sustained trauma.

Why does my child have to get a checkup, if most exams result in normal findings?

“All children who are suspected victims of child abuse should be offered a medical evaluation”

  • To obtain the history from the child and/or guardian
  • To consider alternative explanations for a concerning sign or symptom
  • To identify and document evidence of injury or infection
  • To diagnose and treat medical conditions resulting from abuse
  • To identify and treat medical conditions unrelated to abuse
  • To assess the child for any developmental, emotional, or behavioral problems needing further evaluation and treatment and make referrals as necessary
  • To assess the child’s safety and make a report to child protective services if needed
  • To reassure the child and family, as appropriate
  • To document findings in such a way that information can be effectively and accurately presented, if requested by a social service or law enforcement agency
  • To help to ensure the well being of the child

Adams, J et al.  Guidelines for Care of Children who may have been abused J Pediatr Adolesc Gynecol (2007) 20:163-172

Why does my child need a forensic exam—the perpetrator has confessed and is in jail?

 Your child still needs medical attention.  He or she may need to be tested for STD’s and pregnancy or treated for injuries.  Some of the child’s injuries may not be obvious without a thorough physical exam.  Also, when obtaining a history from the child, the physician often discovers information about other perpetrators, other victims, and other occasions of abuse.

Why does my child need a forensic exam?  She says she was only fondled.

Sometimes children will say that “nothing happened” or “he only touched me.”  During the physical exam, an injury or other evidence may be discovered.  When asked about the injury, the child may reveal that a sexual assault of a more invasive nature actually occurred.  Often with children, disclosure is a process.  They may tell a little of their story at first, then disclose more as the history progresses.

Why does my child need a full forensic exam—the perpetrator is seven years old?

Knowing what we know about seven year old children with sexual behavior problems, which is that someone has likely abused them, the other child is also a victim.  Sometimes the victim and the child with sexual behavior problems have the same adult abuser.  We won’t know whether there is a connection until we ask.

Does the exam have to take place immediately after the child discloses?

No.  If the last contact with the potential perpetrator was more than 3 days ago (72 hour), then there is no need for an urgent exam.  The exam can be scheduled in the future and nothing will be lost.  Typically, children disclose longer than 3 days after the abuse, so an appointment should be scheduled at a time that is best for the child and family.  It is much better for the child to be scheduled in the Audrey Hepburn CARE center cottage at a time when the child and family are calm, rested, and fed.

Does my child need an exam if it happened years ago?

Yes.  It is never too late to have a forensic exam.  While there is no need to rush an exam if the abuse occurred more than 72 hours ago, it is just as important to have a full medical history and exam if the abuse occurred long ago.

Why does my child need a follow-up exam if she has already had a rape kit done at the hospital?

 The Center for Disease Control (CDC) has guidelines that specify that a victim of sexual assault have a follow up exam two weeks after the initial exam.

In addition, the Audrey Hepburn CARE center doctors are forensic pediatric specialists using state of the art technology to diagnose injury and collect evidence.  Audrey Hepburn CARE physicians examine the child from head to toe to assure that no injury is overlooked.  The checkup is generally non-invasive, and care is taken to prepare the child ahead of time in order to avoid further trauma.  Typically, neither regular physicians nor emergency room physicians photograph the injuries or take a forensic medical history; these are important parts of the Audrey Hepburn CARE center visit.  Nor do they render child abuse forensic reports for purposes of law enforcement and child protection.  Our physicians are also experienced in testifying in court and assisting in preparing cases for trial.  The Audrey Hepburn CARE center will order pregnancy and STD tests and will follow up with the patient regarding lab results.

Why does my child need an exam—law enforcement believes that this is only a custody situation?

 Just because there is a custody battle does not mean that there has not been abuse.  The CARE center staff has seen cases of false allegations and has had extensive training in talking to children.  If a child makes a disclosure of abuse, it should be taken seriously.  Sometimes during a marital separation, the offending parent has left the home and the child feels that it is safe to talk about the abuse.

My child has been abused—will he or she become an abuser?

Although research shows that most child abusers were themselves victims of child abuse, that does not mean that being a victim makes you an abuser.  If your child gets the love and support needed after such an incident takes place, along with counseling to help him or her heal, he or she can recover.

What child sexual behaviors are normal?

It’s normal to expect that children may engage in some types of sexual behavior.  But it’s also difficult to decide what sexual behaviors are normal and what behaviors are concerning and/or abusive.  Children’s sexual behaviors can be influenced by their age, their parents’ religious beliefs and values, and the family’s background.  In addition, children develop differently.  They have unique personalities, behaviors, and sexual interests.

What child sexual behaviors are not normal?

When trying to decide whether a sexual behavior is normal, it’s important for parents to be aware of and think about several things.  Concerning and/or abusive behavior can include sexual activity between children that is kept secret or occurs between children with a sizable age difference and/or children with unequal power or developmental levels.  Parents should consider whether the child’s behavior appears to be compulsive, if the child seems to be obsessed with it, and/or if the child is not able or does not respond to the parents’ redirection.  Normal child sexual behaviors are often accompanied by giggling and amusement. Concerning and/or abusive sexual behaviors can be accompanied by physical force, threats, intimidation, rewards, promises, gifts, and/or coercion.

 

For helpful information about child sexual development, please visit:

www.tcavjohn.com – This is a link to Dr. Toni Cavanagh Johnson’s website where you can purchase an affordable and useful booklet about normal and concerning child sexual behaviors. The booklet is available in English and Spanish.

www.aap.org – This is a link to the American Academy of Pediatrics where you can learn more about child sexual development and explore many other health topics.

www.kidshealth.org – This is a link to the KidsHealth organization where parents, children and teens can learn about sexual development and other health topics.

 

When in doubt, parents should seek help immediately from a mental health professional.  Call the Child Abuse Hotline at 1-800-25ABUSE or contact the New Orleans Children’s Advocacy Center at (504) 894-5484.

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© Copyright 2012 • New Orleans Children’s Advocacy Center
1101 Calhoun St. • New Orleans, LA 70118 • (504) 896-9237 • fax (504) 896-9733

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