Age differences in the prosecution of child abuse cases.

Evidence in child abuse cases can be scarce and is often centred around the child's testimony. However, child testimony varies with the child's development. Here, an overview of suspects, case decisions and court verdicts from a cohort of children is presented, stratified across children aged 0-3, 4-7, 8-11, and 12-15 years. Children seen at the Department of Forensic Medicine, Aarhus University, Denmark, in 2001-2013 were analysed, including all case files from the police, courts and healthcare services. A total of 647 cases were presented. The most frequent suspect was the child's parents. The police referred to the prosecutor in 69% of all cases, and 37% were tried in court. The lowest proportion of cases of tried cases was found among children aged 0-3 years (20%) and the highest among children aged 8-11 years (57%). Across ages, no corroborating evidence, the accused's refusal of guilt and no case to pursue (insufficient strong evidence) were the most frequent reasons for case closure. Cases relating to children aged 0-3 years were frequently dismissed because the fault could not be placed, whereas cases relating to children aged 12-15 were frequently rejected because of lacking evidence of compulsion (non-consent). Results show variations across ages regarding children tried in court and case dismissal. A dedicated child court may be considered to ensure equal access to justice. Questioning during the forensic examination and the use of psychologists may strengthen the available evidence. These materials have received financial support from the Danish Victims Fund. The execution, content and results of the materials are the sole responsibility of the authors. The analysis and viewpoints made evident from the materials belong to the authors and do not necessarily reflect the views of the Council of The Danish Victims Fund. Not relevant.

Eg MB ，Græsholt-Knudsen T ，Madsen KB ，Obel C ，Vesterby A ，Hansen OI ... -  《Danish Medical Journal》

Trajectories of children evaluated for abuse.

Eg MB ，Græsholt-Knudsen T ，Vesterby A ，Hansen OI ... -  《Danish Medical Journal》

Hymenal lesions and legal outcome in sexually abused girls with a history of vaginal penetration.

In many cultures, it is commonly accepted that the hymen remains unchanged throughout childhood, until it is torn at the first episode of sexual intercourse. Therefore, the definition of virginity is directly linked to a normal hymen. However, most girls referred for medical forensic colposcopic examination have normal or nonspecific findings, the prevalence of abnormal findings in girls with a history of genital penetration being only 4-6%. The aim of this study was to investigate the relation between hymenal findings seen at the colposcopic examination and the legal outcome: prosecution in court and conviction in court. During the 80-month period of our study, 426 girls with a median age of 9 years (range 0-15 years) were included. A history of at least one vaginal penetration was given in 226 of the girls with a median age of 12 years (range 2-14 years). The hymenal findings were described as normal in 125 of the 226 cases (55%). In 50 cases (22%), hymenal clefts were found, 17 (34%) of which were complete and 33 (66%) incomplete. The finding of hymenal clefts increased with age. Of the 226 cases of girls being sexually assaulted with vaginal penetration, 119 cases (53%) were prosecuted in court, 102 of which (86%) resulted in conviction. Thirty-five (70%) of the cases with hymenal clefts and 100 (57%) of the cases without hymenal clefts were prosecuted in court, showing a correlation between hymenal clefts and conviction; however, the correlation was not significant (χ(2) test=2.1 and P=0.14). In total, 29 (58%) of the cases with hymenal clefts and 88 (50%) of the cases without hymenal clefts were convicted in court, which shows no significance (χ(2) test=1.0 and P=0.33). The single most important feature for conviction in court is the child's testimony and not hymenal findings seen at the colposcopic examination. Especially the testimony of the older children leads to conviction, raising the question whether the videotaped testimonies are aimed at the court proceedings, or whether hearing the child's testimony directly in court has a more powerful effect. Overall, it is crucial that the videotaped police questioning of the younger children is performed by specialized personnel, with the aim of presenting the testimony in a detailed and credible manner in court, giving children of all ages a fair trial.

Eg MB ，Hansen LA ，Sabroe S ，Charles AV ... -  《-》

Evaluation of forensic medical history taking from the child in cases of child physical and sexual abuse and neglect.

Suspected child physical abuse, sexual abuse and neglect are not uncommon presentations. As part of the assessment of these cases, a forensic medical history may be taken. This forensic history is used not only to determine the steps necessary to address the child's wellbeing but also to direct the forensic examination. Currently, there is no clear consensus on whether or not a forensic medical history should consistently be considered an integral element within the paediatric forensic evaluation. This study examines the value derived by the medical practitioner taking a forensic medical history rather than relying on hearsay evidence when a child presents for an assessment. A retrospective review of paediatric cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 2014 and 2015 was undertaken. 274 forensic case reports were reviewed and the data was entered into an Excel spread sheet and analysed using chi squared tests within STATA®. With increasing age of the child, a forensic medical history is significantly more likely to be taken. Additional information is made available to the medical practitioner what would otherwise have been provided if the medical practitioner relied only on the interview conducted by the police. Discrepancies observed between the official third parties (police or child protection) report of what a child has said and what the child says to the medical practitioner decrease with age, as do discrepancies observed between the child's version of events and a third party's (eg. parents, caregivers, friends) version of events. The study showed that by taking a forensic medical history from the child additional information can be obtained. Further, that there is a value in the examining medical practitioner taking a forensic medical history from children in cases of child physical and sexual abuse and neglect.

Drummond R ，Gall JA 《-》

Child abuse and neglect in Denmark: medico-legal aspects.

Gregersen M ，Vesterby A 《-》