Assessment of Sexual Abuse

Abstract

Assessment of children who are alleged to have been sexually abused is challenging, in part because there is no way to determine the truth about what happened with absolute certainty. Moreover, once an opinion about what happened is established, it is very difficult to change it. In the assessment of sexual abuse, the clinician functions as a “fact finder,” gathering information and making professional judgments about the meaning of those facts. The clinician must review a number of areas to determine if there is a pattern of factors that increase or decrease the probability that abuse has occurred. It is imperative that the criteria used in making probability statements about abuse be made explicit, including the support for and limitations of each criterion (Berliner & Conte, 1993). To do this adequately, the clinician must have knowledge of child development (particularly sexual development), be familiar with recent research on memory and suggestibility, and adopt a “quasiscientific” approach which examines alternative hypotheses.