Non-abused preschool children's perception of an anogenital examination

• Published in: Child abuse & neglect 2007-08, Vol.31 (8), p.885-894
• Main Authors: Gulla, Kari, Fenheim, Gred Eva, Myhre, Arne K, Lydersen, Stian
• Format: Article
• Language: English
• Subjects: Anal Canal; Anogenital examination; Anogenital examiniation; Attitude Measures; Attitude to Health; Biological and medical sciences; Child; Child Abuse, Sexual - diagnosis; Child Abuse, Sexual - psychology; Child Sexual Abuse; Child, Preschool; Children & youth; Children's perception; Colposcopy - psychology; Emotional distress; Emotional Response; Emotions; Female; Foreign Countries; Genitalia, Female; Genitalia, Male; Health Care Services; Health risk assessment; Human Body; Humans; Male; Medical sciences; Medical screening; Non-abused children; Norway; Nurses; Parent Attitudes; Pediatrics; Perception; Perceptions; Physical Examination - psychology; Physical Examinations; Preschool Children; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Questionnaires; Rating Scales; Reference Values; Sexual Abuse; Social impact; Surveys and Questionnaires; Victimology; Young Children
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2007.03.017

Abstract Objective An anogenital examination is usually part of the standard medical assessment in children evaluated for suspected sexual abuse, and the emotional impact on the child has been studied. The primary aim of this study was to assess non-abused preschool children's responses to an anogenital examination. Method One hundred and fifty-eight children (119 girls), aged 5–6 years old, were recruited by self-selection from a town community in Norway. After a full medical “top-to-toe” examination, including an anogenital examination with use of a colposcope, the children were asked for their reactions to different parts of the examination. The instrument used was a Faces Rating Scale with five faces, ranging from smiling to crying. Parents and nurses also completed questionnaires regarding their perceptions of the children's reactions. Results The results from the self-report scales showed that only 7.7% of the children rated the anogenital examination as somewhat negative, but the children rated the anogenital part of the examination as significantly more distressing than the examination of their ears and mouth. Microbiological swabbing from the anogenital area was most frequently mentioned as something the children disliked. Complementary data from the parents supported the children's responses regarding the anogenital part, but also emphasized the importance of good preparation and a “child-friendly” atmosphere when performing the examination. Conclusions Most preschool children, who have no history of sexual abuse do not find an anogenital examination traumatic if the examination is well planned and performed by experienced professionals in a supportive atmosphere.