DEVELOPMENTAL DIFFERENCES IN DETECTION AND DISCLOSURE OF SEXUAL ABUSE

Objective: This study examined the role of developmental differences i n the detection and disclosure of child sexual abuse. Method: A random medical record review was conducted of 72 children and adolescents se en over a consecutive 3-year period for suspected sexual abuse in the emergency room of a pediatric hospital. The following data were gather ed: (1) demographic information, (2) presenting symptomatology that in itiated caregiver decision to seek evaluation, (3) type of disclosure (purposeful or accidental), and (4) precipitants to disclosure. Result s: Preschool age children were significantly more likely than school a ge children and adolescents to exhibit behavioral or physical symptoms that prompted caregivers' suspicion of sexual abuse. Preschool age ch ildren made disclosures accidentally and typically with an immediate p recipitating event unrelated to the abuse itself. In contrast, sexual abuse disclosures from school age children were purposeful and not ass ociated with a precipitating event. Conclusions: Practitioners need to be aware of the developmental differences in the detection of sexual abuse, including the forces that inhibit disclosure in older children.