THE ASSESSMENT OF CHILD SEXUAL ABUSE ALLEGATIONS - USING RESEARCH TO GUIDE CLINICAL DECISION-MAKING

As reports of child sexual abuse (CSA) have risen, greater attention h as been focused on how clinicians evaluate allegations of abuse. A com mon theme in the CSA assessment literature is to encourage comprehensi ve, multimodal assessments. This recommendation, however, is rarely ac companied by suggestions regarding how clinicians might integrate and differentially weight the information gathered. The present article is designed to address the issue of which sources of information clinici ans should rely upon when conducting CSA assessments. Specifically, th e commonly used indicators and procedures for assessing allegations of abuse are identified and then examined in light of their respective e mpirical literatures. It is concluded that medical examinations and th e child's report are among the best sources of information, and should therefore be most heavily relied upon to arrive at accurate decisions . Clinicians are encouraged to adopt the mind set of a scientist condu cting an a priori, hypothesis-driven research investigation. This appr oach should help clinicians avoid the temptation of post hoc analyses that reflect personal biases more than the actual data. (C) 1998 John Wiley & Sons, Ltd.