Characteristics of victims of alleged child sexual abuse referred to a child guidance clinic of a children's hospital.

Abstract

Child sexual abuse (CSA) is a major public health problem affecting all cultures and social classes. Estimated global prevalence of CSA is 11.8% [1]. Retrospective studies in Sri Lanka have shown prevalence of sexual abuse among adolescents to be 21.9% [2]. A retrospective descriptive study was carried out of all children referred through courts or Judicial Medical Officer to a Child Guidance Clinic at Lady Ridgeway Hospital, from 2010-2014, due to alleged CSA. Psychological consequences were assessed by a Consultant Psychiatrist and diagnosis was made according to the International Classification of Diseases, 10th edition. Approval was obtained from Ethics Review Committee of The Lady Ridgeway Hospital, Colombo. Data obtained from case records were suitably altered to maintain confidentiality. Thirty-five children presented with alleged CSA, during 2010-2015, with the highest number referred in 2013(Table 1). Majority (57.1%) were females. Commonest age group was 12-14 years (9/35). Sixty percent were from Colombo District. In 9 (25%), parents were separated. In 5 (14%) the mother was abroad. In all cases, the perpetrator was male. Majority 29 (83%) were known to the child. In most (29/35), a single perpetrator was involved. In 23 (66%), abuse occurred on several occasions by the same person. Threats or violence was used in 17 (49%) and rewards were given in 7 (20%). The commonest form of sexual abuse was non-penetrative contact 17 (49%). Co-existing forms of abuse were present in 13 (37%). Psychological consequences were present in 24 (68%), with post-traumatic stress disorder being the commonest 7 (20%). Globally, CSA is commoner in females [1], which is compatible with our findings. Similarly, highest rates of CSA has been reported among adolescents [3]. Mother