Pathway Background and Objectives

According to the U.S. Department of Health and Human Services, in 2017, there were 674,000 substantiated cases of child maltreatment in the U.S., 8.6% of which were sexual abuse. In Connecticut, there were 8,442 victims of child maltreatment, and 401 of those cases involved sexual abuse/assault. Because management can be complex, this pathway was developed to standardize decision making and assure that medical, forensic, and safety concerns are simultaneously addressed when a child presents with a concern of sexual abuse or assault. The specific objectives of this pathway are to:

  • Create standardization of clinical care for suspected sex abuse/assault
  • Help providers to think about the medical, forensic, safety, and mental health components required when caring for a child of suspected sex assault or abuse
  • Serve as a guide for outpatient medical providers who are determining if a child needs to be sent to the CT Children’s emergency department or not, thereby decreasing unnecessary ED visits or transfers from outside hospitals
  • Direct appropriate history gathering from the child and family
  • Properly identify who should have forensic evidence collection kits performed and how to execute evidence collection appropriately
  • Ensure proper STI testing and treatment is provided in the correct circumstances, based on CDC guidelines
  • Ensure appropriate Department of Children and Families (DCF) reporting
  • Link the child to appropriate medical follow up

Algorithm  Educational Module

  • Percentage of patients eligible for pathway with order set usage
  • Percentage of patients who have a referral to the Suspected Child Abuse and Neglect (SCAN) team
  • Percentage of patients age ≥ 12 years old with pregnancy testing performed
  • Percentage of patients with DCF report completed
  • Percentage of patients with completed and/or offered appropriate STI testing (HIV, syphilis, chlamydia, gonorrhea)
  • Number of patients with forensic evidence collection completed
  • Percentage of patients with forensic evidence collection completed who have a referral to the SCAN team
  • Nina Livingston, MD
    • Suspected Child Abuse and Neglect (SCAN) Team
  • Rebecca Moles, MD
    • Suspected Child Abuse and Neglect (SCAN) Team

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.