Caring for young adolescent sexual abuse victims in a hospital-based children's advocacy center

Laurel Edinburgh, Elizabeth Saewyc, Carolyn J Levitt

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Objectives: This study compared health care assessments, referrals, treatment, and outcomes for young adolescent sexual assault/sexual abuse victims seen at a hospital-based Child Advocacy Center (CAC), to that provided to similar victims evaluated by other community providers. A second purpose was to document how common DNA evidence is found among such cases. Method: A retrospective matched case-comparison design matched index CAC cases diagnosed with extra-familial sexual assault to non-CAC cases referred for prosecution in the same county, matched by age and sex of victim, age and sex of perpetrator, and type of assault (N = 128 pairs). Since the case-comparison design produces paired data, analyses used paired t-tests, McNemars test, and Wilcoxon signed-rank tests. Health care outcomes included whether victims received a health exam, indicated tests, findings of trauma on genital exams and counseling referrals; legal outcomes included whether cases were prosecuted, verdicts, and length of sentences. Results: CAC cases were significantly more likely to receive a physical exam, a genital exam when indicated, and referral for counseling (all p < .001). In the CAC group 26.7% vs. 4.8% had positive genital trauma findings, and only 6.3% of CAC cases failed to get indicated sexually transmitted infection (STI) tests or prophylactic treatment for STIs vs. 80% of the comparisons (p < .001). There were no differences in decisions to prosecute, convictions, or sentence lengths between the groups. DNA was documented in only 27.3% of acute cases, although evidence kits were completed. Conclusions: Young adolescent sexual abuse victims received markedly different health care in a hospital-based CAC compared to elsewhere. DNA is not commonly found in acute cases. Implications for practice: Community health care providers and law enforcement should be encouraged to refer victims to hospital-based CACs for specialized examinations and treatment.

Original languageEnglish (US)
Pages (from-to)1119-1126
Number of pages8
JournalChild Abuse and Neglect
Issue number12
StatePublished - Dec 2008

Bibliographical note

Funding Information:
This study was supported by a research grant from Children's Hospital and Clinics of Minnesota Education and Research Committee and in part by a Scholar Award from the Michael Smith Foundation for Health Research, British Columbia, Canada (Saewyc).

Copyright 2009 Elsevier B.V., All rights reserved.


  • Child sexual abuse
  • Children's Advocacy Centers
  • Legal outcomes
  • Medical evaluations


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