A review of child sexual abuse cases presenting to a paediatric emergency department

Child sexual abuse (CSA) adversely affects a child’s growth and well-being. This studyaimed to describe the profile of children presenting to a tertiary paediatric emergency department(ED) with CSA.Methods: Children 0–16 years old presenting to KK Women’s and Children’s Hospital ED from June2016 to August 2020 with sexual abuse were retrospectively reviewed. We performed a secondaryanalysis on girls and stratified them by age <13 and ≥13 years o ld.Results: There were 790 patients who made 833 visits for CSA. Victims were predominantly girls(747, 94.8%) and perpetrators were predominantly men (763, 96.6%). The abuse first occurred beforethe age of 13 years in 315 victims (39.9%). For 468 (59.2%), more than one incident occurred beforepresentation. Compared to girls ≥13 years old, girls <13 years old were more frequently abusedby a family member (47.7% versus 8.0%, P<0.001) and abused in their own home (55.7% vs 21.0%,P<0.001). Among all children, parental divorce and the absence of one or both biological parentsin the household were prevalent, with 287/783 (36.7%) having divorced parents, and only 374/784(47.8%) residing with both biological parents.Conclusion: The findings highlight common characteristics of CSA cases, and can aid the futureidentification and protection of vulnerable children. The fact that most children presented after morethan one incident suggests the need to more closely monitor and protect potentially at-risk children.Keywords: Child abuse, child sexual abuse, child welfare, sexual abuse