Sometimes a doctor needs to examine foster kids to gather evidence to be used in court when allegations of abuse or neglect are made. This is called a forensic medical exam. Here’s what one is like.
Child Protective Services will request that a particular doctor examine a particular child. Where we live, the county uses a special unit at a children’s hospital. The foster parent takes the child to that clinic.
The waiting room is small, but has lots of toys to keep kids busy. While the foster parent fills out paperwork, someone comes to explain to the child what the exam will be like. I forget what the exact title for that person, but it’s a child specialist whose job is to keep a child calm during a medical exam. She does this by first showing the child different medical instruments and showing him/her what they are for. Then she talks about the exam, using easy-to-understand terms. “You will wear a hospital gown that opens in the back. It’s like putting on a jacket backwards.” “The doctor will look at your skin from head to toe.”
During the exam, the doctor begins at the head and works his way down, documenting any injuries, such as bruises, cuts, burns, scars, etc. He will set a ruler next to the injury and take a photo to document the size and severity of the injury. He will also use the stage of healing to determine how frequently injuries are occurring. If physical abuse is particularly severe, the doctor may take x-rays to see if there is evidence of previous broken bones. If sexual assault is suspected, the exam may include swabbing genitals for evidence of semen or hairs. If severe neglect is suspected, weight and blood work showing nutritional deficiencies may be ordered.
During the exam, the foster parent can be present if the child feels comfortable with them in the room. The child specialist will be charged with distracting the child during the exam. At our clinic, she uses an iPad with games on it. And if a child becomes anxious during a particular part of the exam, she will redirect their attention to the game or ask them a question or otherwise distract them.
At the end of the appointment, the child gets to pick out a toy to take home.
The forensics doctor usually only gives the foster parent a cursory read out – something really general like diagnosis suspected child, bruises and burns. You can get a fuller report from the social worker, who may say something like the number of injuries, what may have caused them (e.g. cigarettes).
The medical report will be used by the county to substantiate their claims of abuse or neglect. This helps the judge determine whether the county was justified in removing the child from his/her home. The medical report may also be used to prosecute a criminal case, if the county decides to file charges against parents for the maltreatment of their child.
We really like our local forensics pediatrician. You would be surprised, but kids actually kinda have fun. They get to play video games and get a nice toy (think remote control car, teddy bear, etc.). The exam doesn’t include any vaccinations, so no shots – a bonus in most kids’ minds.
Bottom line: It may seem scary to take a child to a forensics pediatrician to have their injuries documented, but really it’s not bad at all. I recommend foster parents go along and keep calm, lending their strength to these young children in need.