When sexual assault is known or suspected, it can be confusing and overwhelming for everyone involved.
The Sexual Assault Response Team (SART) at Children’s Hospital of Philadelphia (CHOP) is an Emergency Department-based program dedicated to providing the best clinical care while minimizing further trauma in young sexual assault victims. It is one of the few programs of its kind designed for a pediatric population.
Meeting a need
Sexual assault in children and adolescents is an alarming public health problem. According to the National Sexual Violence Resource Center, 1 in 4 girls and 1 in 6 boys will be sexually abused before they turn 18 years old.
Children who are victims of sexual assault have a complex and highly unique set of needs. The Sexual Assault Response Team (SART) was created out of a recognition that these patients are best served at a pediatric focused facility that is well-equipped to meet the emotional and physical needs of children.
Since its inception in 2009, SART has provided care for more than 1,000 pediatric patients from infancy to adolescence, with our youngest patient being just 4 weeks of age. The team evaluates approximately 100 children a year. Although the majority of our patient population resides in Philadelphia and its surrounding suburbs, our team has provided care for patients from other states in the U.S., such as New Jersey, Maryland, Delaware and Florida.
A specially trained team
When a child enters Children’s Hospital of Philadelphia’s Emergency Department (ED) as a victim or suspected victim of sexual assault, they are met by a compassionate, experienced team of specialists. The SART team includes ED nurses, advanced practice providers, child life specialists, social workers, pediatric emergency medicine and trauma physicians, child abuse pediatrics physicians and special immunology providers.
This expert team is specially trained to care for the complex physical, emotional and psychological needs of these vulnerable children, and works together to streamline the clinical, behavioral, child protection and legal care.
The majority of the patients seen by SART are girls younger than 16 years old, brought to the ED within 24 hours of the incident. Alleged perpetrators include family members, non-family acquaintances, dating relationships and stranger abductors. Given the potential for involvement of the court system for these patients, it is crucial that information be collected in a systematic, careful way, and documentation is clear and thorough.
SART’s uniquely devised sexual assault clinical pathway ensures a standardized approach to evaluation and documentation and provides recommendations for care, screening, treatment and follow-up.
Evaluation typically includes a medical history, a complete physical examination with photo documentation, forensic evidence collection, pregnancy and STI screening, and prophylaxis for sexually transmitted infections. Department of Human Services and police reports are filed.
Team members not only assess and care for the medical needs of the patient, but their role also includes:
- Helping caregivers deal with challenging behaviors a child may be exhibiting due to stress and anxiety
- Helping the caregiver/child process and understand medical information
- Helping families navigate the different entities involved, including child welfare, legal and medical systems
- Educating caregivers about typical sexual development
- Improving the quality of communication between caregiver and child about difficult experiences
- Connecting the patient to the appropriate behavioral health resources in the community
Follow-up care after sexual assault
Upon discharge, physicians, social workers and psychologists from Safe Place: The Center for Child Protection and Health (part of the SART team) work with each patient. Experts in the critical issues of child abuse, this team provides additional medical and forensic expertise, care coordination, and follow-up to sexually assaulted patients.
The Child Abuse, Referral and Evaluation (CARE) Clinic is the outpatient clinical service of Safe Place. The CARE clinic is staffed by a team of physicians, social workers, and mental health clinicians (psychologists and clinical social workers) who provide trauma-based services that address long-term emotional and physical needs.