A 12-year-old girl reports sexual contact with her mother's boyfriend; the clinician reports to the local child abuse hotline. What is the next action?

A 12-year-old girl reports sexual contact with her mother's boyfriend; the clinician reports to the local child abuse hotline. What is the next action?

• A. Attaining a history of the abuse from the child
• B. Obtaining urethral specimens for STI testing
• C. Performing a colposcopic examination to evaluate for trauma
• D. Referring the child to the ED for forensic specimen collection

Answer: (D)

When a child discloses sexual abuse, the immediate priority is to secure safety and preserve potential evidence through a forensic examination conducted by trained professionals in an appropriate setting. Referring the child to the emergency department for forensic specimen collection ensures evidence is collected and documented properly, with proper chain-of-custody, and within the time window where such evidence is most likely to be detectable. This approach also connects the child with specialized care and support systems. Taking additional history can occur, but it should not delay the forensic evaluation. STI testing and colposcopic examination have roles when indicated, but they're not the next step in this scenario because evidence collection and documentation by a trained forensic team takes precedence to support any ongoing investigation.

When a child discloses sexual abuse, the immediate priority is to secure safety and preserve potential evidence through a forensic examination conducted by trained professionals in an appropriate setting. Referring the child to the emergency department for forensic specimen collection ensures evidence is collected and documented properly, with proper chain-of-custody, and within the time window where such evidence is most likely to be detectable. This approach also connects the child with specialized care and support systems.

Taking additional history can occur, but it should not delay the forensic evaluation. STI testing and colposcopic examination have roles when indicated, but they're not the next step in this scenario because evidence collection and documentation by a trained forensic team takes precedence to support any ongoing investigation.