The DOI matches its Crossref record; 19 of the 20 references it cites were found in a registry or an index.
Child sexual abuse—Medical statement conclusions in criminal legal process
Abstract
Objectives To evaluate medical statement conclusions in the criminal-legal process in suspected cases of child sexual abuse (CSA). Study design An observational study of a random sample of 130 medically examined, police reported CSA suspected cases during 2001-2009. Medical statements were evaluated and their conclusions were analyzed with an end-point in the legal process. The data consists of official investigation documents from the University Hospital records, the Police, crime laboratories, the State Prosecutor, and the Courts of Law. Results The median age of the children was 5.3 years (range 11 months-17.3 years) at the time of the suspected sexual abuse. In most cases (76.2%, 99/130) medical statement conclusions neither supported nor excluded the suspicion of CSA. Twenty-one (16.2%) medical statements supported and in 10 cases (7.7%) the conclusion did not support the suspected CSA. Of the suspected CSA cases a hundred (76.9%) proceeded to the Prosecutor. The charge filing rate was 41.5% (54/130). The final conviction rate was 30.8% (40/130) and 74% in the charged cases. Medical statements were mentioned as evidence in the Prosecutor's decision to file charges in 18 (33.3%) of suspected CSA cases and in 15 (36%) of verdicts. A child's clear disclosure of CSA (p<0.001) and medical statements (p=0.037) had a significant role in decision making on convictions. Conclusion In medical statement conclusions, physical findings with proper documentation and interpretation are needed to avoid misunderstandings in the legal process. The present study supports a routine medical statement peer review to minimize the risk of neglect caused by lack of knowledge among authorities working with sexually abused children.
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“In the forensic context, one of the major challenges faced by professionals is the identification of sexual abuse when there is no physical or biological evidence, which accounts for the majority of cases referred for medical forensic assessments (Joki-Erkkila, Niemi, & Ellonen, 2014).”
From Psychological and Behavioral Indicators in the Forensic Assessment of Child Sexual Abuse (2018) · cites this paper as Joki-Erkkila, Niemi, & Ellonen, 2014
In the citing paper
“the majority of the allegations of sexual abuse against children do not leave physical injuries (Joki-Erkkila et al., 2014)”
From Psychological and Behavioral Indicators in the Forensic Assessment of Child Sexual Abuse (2018) · cites this paper as Joki-Erkkila et al., 2014
Citations
Cites
Children referred for possible sexual abuse: medical findings in 2384 children
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Cost-Effectiveness of Interventions to Promote Physical Activity: A Modelling Study
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A case-control study of anatomic changes resulting from sexual abuse
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Genital Anatomy in Pregnant Adolescents: “Normal” Does Not Mean “Nothing Happened”
Kellogg, N. D., Menard, S. W., & Santos, A. (2004) · PEDIATRICS · doi:10.1542/peds.113.1.e67 · Cited by 164
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Walsh, W. A., Jones, L. M., Cross, T. P., & Lippert, T. (2008) · Crime & Delinquency · doi:10.1177/0011128708320484 · Cited by 155
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Prosecution of child sexual abuse: Which cases are accepted?
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Guidelines for medical care of children evaluated for suspected sexual abuse: an update for 2008
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Adams, J. A. (2011) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2011.606107 · Cited by 87
Legal Proof of Child Sexual Abuse in the Absence of Physical Evidence
Jong, A. R. D., & Rose, M. (1991) · PEDIATRICS · doi:10.1542/peds.88.3.506 · Cited by 86
Medical Assessment and Legal Outcome in Child Sexual Abuse
Palusci, V. J., Cox, E. O., Cyrus, T. A., Heartwell, S. W., Vandervort, F. E., & Pott, E. S. (1999) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.153.4.388 · Cited by 70
Jewkes, R. K., Christofides, N. J., Vetten, L., Jina, R., Sigsworth, R., & Loots, L. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000164 · Cited by 69
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Adams, J. A., Starling, S. P., Frasier, L. D., Palusci, V. J., Shapiro, R. A., Finkel, M. A., & Botash, A. S. (2012) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2012.01.004 · Cited by 52
The physical signs of child sexual abuse. An evidence-based review and guidance for best practice
Acharya, P. N., & Gill, D. S. (2008) · BDJ · doi:10.1038/sj.bdj.2008.579 · Cited by 49
Sugue-Castillo, M. (2009) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2008.09.004 · Cited by 33
Medical Findings and Legal Outcomes in Sexually Abused Children*
Hansen, L. A., Mikkelsen, S. J., Sabroe, S., & Charles, A. V. (2009) · Journal of Forensic Sciences · doi:10.1111/j.1556-4029.2009.01230.x · Cited by 23
Cited by
Blandino, A., Maggioni, L., Chiaffarino, F., Parazzini, F., Capano, D., Florio, E. M., Margherita, M., Bertelle, G. M., Franceschetti, L., Amadasi, A., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0253980 · Cited by 17
Child sexual abuse — Initial suspicion and legal outcome
Joki‐Erkkilä, M., Niemi, J., & Ellonen, N. (2018) · Forensic Science International · doi:10.1016/j.forsciint.2018.06.032 · Cited by 13
Self-citationIndicadores psicológicos e comportamentais na perícia do abuso sexual infantil
Schaefer, L. S., Brunnet, A. E., Lobo, B. D. O. M., Carvalho, J. C. N., & Kristensen, C. H. (2018) · Temas em Psicologia · doi:10.9788/tp2018.3-12pt · Cited by 21
Relevance of medical reports in criminal investigations of cases of suspected child abuse
Janßen, K., Greif, D., Rothschild, M. A., & Banaschak, S. (2017) · International Journal of Legal Medicine · doi:10.1007/s00414-017-1533-6 · Cited by 10
Hendrix-Dicken, A., Conway, L., & Baxter, M. A. (2020) · Journal of Forensic Sciences · doi:10.1111/1556-4029.14463 · Cited by 5
Metadata
- Authors
- Joki-Erkkilä, M., Niemi, J., & Ellonen, N.
- Affiliations
- Police University College (FI)
- ORCID
- Ellonen, Noora
- Venue
- Forensic Science International
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 239
- Pages
- 31-36
- ISSN
- 0379-0738 (ISSN-L)
- OpenAlex
- W2046704302
- Cited by
- 15
- References
- 20
- Citations by year
- 2025: 2 · 2024: 2 · 2021: 4 · 2020: 2 · 2018: 2 · 2017: 2 · 2016: 1
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Forensic Science International (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
- Keywords
- child sexual abuse, forensic medical examination, conviction rates, child disclosure, medical peer review, child protection, police investigation
- MeSH terms
- Adolescent, Child, Child Abuse, Sexual, Child, Preschool, DNA, Documentation, Female, Finland, Forensic Medicine, Humans, Infant, Male, Physical Examination, Retrospective Studies, Semen, DNA Fingerprinting
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