Do Physicians Recognize Sexual Abuse?

Using conservative statistics on reported cases of child abuse from the American Human Society and the National Incidence of Child Abuse Study, 1 it may be predicted that a physician is at least ten times as likely to see a child in his practice suspected of being sexually abused than he is to see one case of phenylketonuria. Like phenylketonuria, the effects of sexual abuse are often chronically debilitating; however, there is no screening mechanism for this condition. Retrospective studies that include unreported cases of abuse indicate an even higher incidence of the problem and suggest that 1% to 3% of all children have had a significant sexually abusive experience before reaching adulthood. 2 Yet, as evidenced by Ladson and Johnson's 3 study in this issue of AJDC , physicians are generally not prepared to deal with this issue. Considering the chronic disabling physical and mental health sequelae of child sexual