As the largest Child Advocacy Center in San Diego County, children who may have been sexually or physically abused or witnesses to violence are seen by professionals at the Chadwick Center’s Forensic and Medical Services program, located on the Rady Children’s Hospital-San Diego campus. San Diego County law enforcement agencies and the County Department of Health and Human Services regularly refer these children to this program. The aim of the Forensic and Medical Services program is to assist the children to provide verbal or physical evidence of the possible abuse they suffered or witnessed. There are two main types of Forensic and Medical Services offered by the Chadwick Center: forensic interviews and forensic medical exams.
Forensic Interview Types
Forensic interviews are conducted in a child-friendly interviewing room with a two-way mirror for law enforcement and Child Protective Services (CPS) to observe and hear the child and the interviewer. All forensic interviews are videotaped and a report is completed by the Chadwick Center evaluator who summarizes the session(s) and information provided by the child.
This is a fact-finding interview conducted by a trained professional who is sensitive to the child’s developmental and emotional needs while asking appropriate, non-leading questions. The goals of the forensic interview are to reduce trauma to the child, reduce the need for the child to be repeatedly interviewed, and to get accurate and detailed information. This is a single interview process.
Follow-Up Forensic Interview
This videotaped follow-up interview is needed when a child has made a disclosure during the first interview but the case is complex, or the child has developmental, behavioral, or emotional issues. The follow-up interview is conducted to get any additional information that was not provided during the first interview.
Extended Forensic Evaluation
This is a new service being offered by the Chadwick Center. An Extended Forensic Evaluation is essentially a “slowed down” forensic interview used with children who have difficulty with the one-time forensic interview approach, due to age or other factors. Instead of meeting with the child for a one-time interview, the interviewer meets with the parent for one session and with the child up to four times. Although the interviewer is meeting with the child more than once, the same questions are not asked each time, which could be viewed as leading. The extended forensic evaluation provides children with more time to develop a sense of safety and comfort with the interviewer. Each evaluation session is recorded on videotape and a DVD so that the law enforcement investigator may observe any or all of the evaluation sessions. The extended forensic interview process provides a thorough psychosocial assessment and information about the suspected abuse that is useful for making decisions about the need for follow-up investigation, protection, therapy and other services.
Forensic Medical Exams
Forensic medical examinations are conducted in a private exam room by an experienced and compassionate medical team with support and reassurance to patients and families. These examinations are provided by pediatric fellows, pediatricians and nurse practitioners trained and supervised in conducting medical evaluations in a sensitive and supportive manner. Most Medical Services take place at the Chadwick Center, located on the Kearny Mesa campus of Rady Children’s Hospital. Some evaluations take place in the inpatient areas of Rady Children’s Hospital.
The following Forensic Medical Exams are available:
Forensic Sexual Abuse Medical Exam
This is a non-traumatizing medical exam appropriate for children who are the subject of a report involving suspected sexual abuse including skin-to-skin contact, sexual intercourse, or oral sex. There are two types of forensic sexual abuse medical exams:
Acute exams, which may only be referred by local law enforcement jurisdictions and are used in cases in which the sexual contact is suspected to have occurred within the past 72 hours.
Non-acute exams, which may be referred by both law enforcement and child protective services with parental consent and do not have suspected sexual contact in the past 72 hours.
Sexual Abuse Screening Exam
This screening exam is appropriate when there are concerns about possible sexual abuse; however, the child is not making a clear disclosure (saying exactly what happened) or has made one, but a complete forensic medical exam is not needed. This exam is often appropriate for younger children who may be behaving in sexually inappropriate ways, have non-specific physical symptoms (irritated genital area), or they have said something about possible abuse. These appointments may be privately referred.
Physical Abuse Examination
Chadwick clinicians provide a forensic medical exam and documentation of physical abuse injuries.
Physical Abuse Screening Exam
This screening exam is appropriate for cases in which injuries are present, but it is unclear if the cause is accidental or possibly abuse; or the child is not providing a history of physical abuse.
CPS workers or law enforcement investigators may request a face-to-face meeting with a medical provider for the following services: Photo Review/Written report, Radiology Review/Written report, and Medical Record Evaluation/Written report