A variety of factors such as abuse history, time since abuse occurred, previous medical examinations, past medical treatment experience, family dynamics, developmental level, temperament, etc., all influence the child’s perception of the examination. The CAST medical component’s goals are to check the child’s medical condition, collect forensic specimens, coordinate information with child protective services agencies, and, most importantly, provide reassurance to the child and his/her family.
The examiners are either doctors or nurse practitioners who are experienced in working with children and testifying in court. In addition, they provide educational programs to the medical community on child abuse evaluations.
The CAST examination room is spacious and a concerted effort has been made to make children feel as comfortable as possible. The wall murals and toys give the room a warm feeling. To abate the apprehension of an exam the child is given the opportunity of choosing which advocate (volunteer) will be her/his friend during the exam. In the exam room the colposcope (a binocular instrument similar to binoculars), is demonstrated. The examination is explained to the child in a way that is appropriate to their developmental level. The child dictates the pace of the exam and is allowed as much control as possible. The exam is done with the child positioned in a manner that is least traumatic and minimally uncomfortable. During the exam an advocate plays, reads, sings, finds Waldo etc., with the child. A child is usually given a stuffed animal lion after the exam for "being brave".
After the examination, a child and his/her caregiver are told the results of the exam and provided information and emotional support.
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