Journal Article

Children and adolescents attending for a forensic medical examination at a regional centre in Ireland: a 5-year retrospective cohort study of patients, alleged perpetrators and service provision

Alzaabi, Abrar, Walsh, Aideen, Geoghegan, Aisling R, Harty, Sinead, Bergin, Naomi, Roe, Susan, Barrett, Michael

2025

Overview

ObjectiveThis study examines the forensic medical examination (FME) service provided to children in a regional centre in Dublin, Ireland, over 5 years. It reports on patient characteristics, alleged perpetrators and service provision. The goal is to inform future service provision and prevention strategies.DesignThe retrospective cohort study included all children and adolescents who underwent FME from January 2018 to December 2022. Data was collected from encrypted child protection reports and analysed with descriptive statisticsSettingThe study was undertaken in the Laurels Clinic, one of the three regional Irish centres for FME.ResultsOf 448 patients, 79% were female, with 37.3% aged 5–11 years. Vaginal penetration occurred in 46% of cases, with digital penetration (vaginal or anal) being the most common method. Anal penetration was reported in 26%, and 6.3% had anogenital findings suggestive of child sexual abuse (CSA). CSA was most often perpetrated in the home, with nearly half of patients showing behavioural changes. About 18% had developmental concerns, and 30% lived in blended families. Alleged perpetrators were mainly male (90.1%), with over 20% being teenagers and 12.8% under 13. Over half of cases involved repeated abuse. Disclosure rates were higher with age, with 69% of disclosures made to a parent.ConclusionThis study highlights CSA risk factors, including blended families and developmental concerns. A worrying finding was that many perpetrators were adolescents or children. Prevention programmes must address risks related to smartphone use and exposure to pornography. These findings can guide clinicians, policymakers and institutions in strengthening CSA prevention and response efforts.

• Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health,BMJ Publishing Group LTD
• Subject: Adolescent / Adolescents / Adults / Age Groups / Anogenital / Behavior Change / Child / Child Abuse / Child abuse & neglect / Child Abuse, Sexual - diagnosis / Child Abuse, Sexual - prevention & control / Child Abuse, Sexual - statistics & numerical data / Child Protective Services / Child Safety / Child welfare / Child, Preschool / Children / Childrens health / Cohort analysis / Early Adolescents / Family (Sociological Unit) / Female / Females / Forensic Medicine / Forensic Medicine - methods / Forensic Medicine - statistics & numerical data / Forensic science / Health services / Humans / Ireland - epidemiology / Male / Medical Evaluation / Original Research / Paediatric Emergency Medicine / Paediatrics / Parents / Patients / Physical Examination / Physical Examinations / Pornography / Prevention / Referral / Retrospective Studies / Risk factors / School Policy / Sex crimes / Sexual abuse / Sexual assault / Teenagers / Vagina / Victims of Crime / Young Children