Medical Evaluation

Medical evaluation is coordinated through Kids’ Space Child Advocacy Center and includes scheduling, triage, and secondary procedures by a medical provider who specializes in child maltreatment. The medical exam takes place at Kids’ Space in a child friendly examination room receiving a thorough head to toe exam similar to a well-child exam, free of charge.

Beyond the physical component of the exam, our medical providers help assure parents that their child is healthy and that if abuse has occurred, it will not be visible to others. Our providers offer extensive, one-on-one consultation not received during a regular doctor’s visit and take as much time as necessary to help the children by explaining each step of the check-up and finding ways to put the child at ease.

Kids' Space - Child Advocacy Center - Medical Interview

All burns or fractures in children under the age of 3;
All bruises or marks on children under the age of 2;
Unexplained or implausibly explained bruises, burns or fractures in children of any age;
All bruises, burns, or fractures in non-ambulatory children;
All cases of reported malnutrition and failure to thrive;
All cases of serious medical neglect; if the family claims to be providing medical care, a consultation with their doctor will suffice;
Reports in which children have an observable injury, the caretaker admits responsibility for the injury and medical documentation is needed to determine if there are internal or old injuries;
Children who exhibit signs or symptoms that indicate the need for immediate psychological or psychiatric evaluation.

“Red Flag” Indicators of the Need for a Medical Evaluation

TEN-4 bruising: bruising in torso, ear or neck region in children up to 4 years of age OR any bruise in an infant 4 months old or younger
Any injury in a non-mobile infant
Any injury in a child that is inconsistent with history provided or unaccounted for play/ activity typical for developmental level of the child
“Sentinel” injuries (poorly explained minor appearing injuries in non-mobile infants) are often dismissed as insignificant but have been found to be predictors of subsequent abuse/ severe injury
Injuries of differing ages
Patterned injuries to skin
Disclosure/witnessed event of injury/ potential injury
Siblings of victim child or other children in the same household where abuse occurred

If bruising in any of the three components (Regions, Infants, Patterns) is present without a reasonable explanation, call Kids’ Space to schedule a medical exam.

Please refer to this screening tool to improve the recognition of potentially abused children with bruising who require further evaluation.

Emergent cases will be scheduled without delay and includes indicators such as medical, psychological or safety concerns such as acute bleeding, suicidal ideation, or suspected human trafficking; alleged assault within previous 72 hours; need for emergency contraception; need for post-exposure prophylaxis (PEP) or STIs.

Acute/urgent cases will be scheduled as soon as possible not longer than 120 hours after suspected sexual contact. Indicators include suspected sexual contact within the last two weeks that doesn’t meet the above “emergent” indicator threshold.

Non-urgent cases will be scheduled at the convenience of the family, ideally within 1-2 weeks with indicators such as disclosure of abuse by child, sexualized youth behaviors, an MDT member suspects sexual abuse, family concern for sexual abuse but contact occurred more than two weeks prior without emergency medical, psychological or safety needs identified.

Follow-up evaluations will be scheduled as determined by the medical provider.