A new ‘Purple Book’ to improve assessment and management of children exposed to sexual abuse has been launched.
Over 2,800 children in the UK were identified as needing protection from sexual abuse last year, and with the physical signs sometimes hard to distinguish, child protection experts have updated guidance for healthcare professionals to support examinations for child sexual abuse.
The Purple Book brings together the latest knowledge and evidence to aid clinical decision-making. The new version (updated from 2008), includes three new chapters – anogenital signs of accidental injuries in girls and boys, genital bleeding in prepubertal girls and healing in anogenital injuries.
As some physical signs of child abuse can be difficult to interpret, this resource ensures that decision making is underpinned by scientific evidence, and also provides good practice guidance for health professionals to piece together additional information such as the history, context, the child or young person’s behaviour and demeanour, and statements made by the child to professionals, in order to inform the assessment.
The Purple Book has been developed by the Royal College of Paediatrics and Child Health in collaboration with the American Academy of Pediatrics (AAP), the Faculty of Forensic and Legal Medicine (FFLM), the faculty of genitourinary Medicine and the Royal College of Physicians of London.
Dr Amanda Thomas, consultant community paediatrician and chair of the ‘Physical Signs of Child Sexual Abuse’ Project Board for the Royal College of Paediatrics and Child Health, said: “In recent years there has been a step-change in society’s understanding of and response to child sexual abuse.
“But although understanding has grown and we are seeing more children and young people prepared to disclose alleged sexual abuse, challenges still remain in establishing whether or not a child or young person has been sexually abused, the significance of some of the physical signs present, and ensuring that these signs are translated into a medical assessment which supports the judicial process and ultimately ensures the child or young person is protected from further harm.”
The latest statistics in the UK are reported by the NSPCC and state that there were 50,732 children on child protection registers or the subject of child protection plans in the UK as of 31st March 2013. Furthermore, 18,915 sexual crimes against children under 16 were recorded in England and Wales in 2012/13.
She added; “All healthcare professionals have a duty to protect children from sexual abuse and this updated guidance should give them evidence-based tools to enable a full picture to emerge.
“Due to the in-depth, evidence base and thorough nature of the book, I have no doubt that it will be regarded as the go-to source for any medical practitioner who encounters circumstances where the issue of child sexual abuse is, or ought to be, raised.”