Medical Examinations / Consultations

Why does my child need an exam?

Law enforcement, Child Protective Services, or other medical providers may make a referral to Partners for a medical exam or consult. Medical exams are used to identify, document, and interpret any findings or injuries. A significant portion of Partners’ comprehensive medical evaluation is the psychosocial history. The medical staff talk with the child and child’s caregiver. This information is then used to assess the caregiver’s protectiveness toward the child and the child’s ability to cope with the incident. They record the information about the family structure and/or dynamics and those dynamics triggered by the abuse/assault. Partners’ pediatric team provides education to the non-offending family member(s) regarding the investigation process and the Child Protective Service evaluation.

While Partners’ pediatric team are well trained in the technical diagnosis of child abuse/neglect injuries, they recognize that the medical evaluation is not solely an assessment of the physical injury and that the process must also involve sensitive communication, which is essential to begin the healing process for the injured child. Recommendations for therapy and further treatment are made and the non-offending caregivers are provided with referrals to appropriate agencies for treatment, advocacy and counseling.

Referrals for services also include obtaining or assisting the family to access a primary medical provider if the family does not have one. Non-offending family members are encouraged to contact the medical team if questions or concerns arise after leaving the facility. Additionally, Partners’ medical team provide assistance to the families regarding accessing and completing the Crime Victims Compensation application.

What happens during the medical exam?

The medical staff explains (age appropriately) the exam. The head-to-toe examination may include the genitalia, which is examined with a non-invasive photocolposcope. The results are review with the parent or guardian at the time of the exam. If you have a small child, it may be helpful to have another adult who can watch the child during the visit, as siblings and other children are not allowed in the exam room.

My child already had a medical exam in the emergency room, why should he/she have another one at the Children’s Advocacy Center?

The medical team at Partners is specially trained in child sexual abuse, and sometimes the E.R. physician or detective will recommend an exam at the CAC. Our staff includes a pediatrician, an Advanced Registered Nurse Practioner (ARNP) and a registered nurse who are considered the child abuse experts in Eastern Washington and are called to the hospital to consult on many cases where abuse is a possibility.

Medical Exam Referral Procedure:

Any suspicion of child abuse or serious neglect should be reported immediately to law enforcement and/or CPS. Law enforcement, medical personnel and CPS may make referrals for medical exams to Partners on the following types of cases:

  • Any victim disclosure (or reliable allegation i.e. witness or suspect admission) of:
  • Any type of anal or vaginal penetration
  • Any oral to genital contact
  • Any genital fondling skin to skin
  • Based upon inappropriate sexual acting out behavior.
  • If pornographic pictures have been discovered of a child.
  • If the child exhibits physical manifestations such as sores in the genital area, pain and/or discharge.
  • Physical abuse with bruising, cuts, bite marks, etc.
  • Child exhibits signs of poor growth or has severe attachment issues.
  • Concern about the child’s poor living conditions
  • If the child has been discovered to have been living and/or exposed to drugs and/or drug paraphernalia.
  • If the caregiver of the child has failed to obtain medical care for the child or failed to provide the child with medical follow-up care.
Cases not routinely referred to Partners:
  • Current rape cases-should be seen in ER if less than 72 hours have elapsed.
  • Exposure to and showing pornography to the child.
  • Cases maybe screened with the medical team on an as needed basis to determine the appropriateness of an exam.
NOTE: The child may be referred initially to his/her primary care physician for an exam.
Referral procedure for Hospital Consults:

When a child presents in the Emergency Department or on any medical floor with an injury which appears suspicious or exhibits signs of abusive trauma, the hospital staff will contact Child Protective Services and then make a referral to Partners for a hospital consult. In making the referral, Partners’ medical team will need to know the following:

  • Name & phone number of referrant
  • Child’s name, gender & date of birth
  • Admit date
  • Extent of injury(ies)
  • Tests performed and results
  • Tests ordered, but not completed
  • Attending physician/hospitalist’s name

Calls received by Partners will be triaged and a medical staff child abuse expert will be notified as soon as possible. A determination for the need of an on-site hospital consult versus a telephone consult will occur with the assistance of the referrant.

If a child presents after hours or during a holiday with suspicious trauma injuries and hospital medical personnel are in agreement that the child should not be returned to the home, Child Protective Services should be contacted. The child may then be placed on a hospital hold by law enforcement or admitted to the hospital. If the child is admitted, staff should contact Partners' immediately on the next business day. A message requesting a consultation may be left at:

(509) 473-4830 or (509) 473-4810.