Clinic Appointments: Frequently Asked Questions | Child Advocacy and Protection Program | Children's Hospital at Dartmouth-Hitchcock (CHaD)
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Clinic Appointments: Frequently Asked Questions

Why do children need CAPP appointments?

This appointment is for your child (or teenager) and it is about his or her health. (When the word “child” is used here, it also refers to teenagers.) If there are concerns of abuse, there may be injuries or changes that are not obvious. More importantly, children and families often have unasked worries or questions about the child’s body. Sometimes child protective workers or helpers also have questions. Usually we can reassure everyone about the child’s health. The child’s life can go on without health worries. Sometimes we need to refer children to other services so that they can be most healthy.

Who should come to the medical appointment?

The child and an adult they trust. Please do not bring other children with you. The appointment can take one to two hours. Some children like to bring a favorite stuffed animal or toy. If the parent or legal guardian is not coming to the appointment, they must send a signed form or letter stating we have permission to examine the child. Please call if you have questions.

Should I try to find out from the child what really happened?

You are helping by coming to the appointment. Please do not ask the child questions about his or her maltreatment or abuse. When there is a possibility of abuse, children may talk to several people (for example, police officers, social workers or others). Talking with these people is often the best way to learn what happened. Do spend time with the child. If he or she wants to talk, it is best to simply listen in a caring way, without asking questions. Remember what the child says and how the child looked or acted when talking.

What happens at the appointment?

A CAPP doctor or nurse practitioner and other team members (like our CAPP nurse, a social worker and/ or a child life specialist*) will meet with you and the child. We will check your child’s weight, height and blood pressure. The doctor or nurse practitioner will talk with you about your concerns.

In another room, our child life specialist will play with your child and explain what will happen during the check-up. Our CAPP doctor or nurse practitioner may want to talk to your child alone for a few minutes. We will give your child a choice of who will be in the room during the exam. The exam itself is fairly short. During the exam, we often use a screen that helps us see small genital or anal injuries. We will make a video record of that part of the exam. This record will be stored in a locked area, separate from the child’s regular medical record.

If there is a question of physical abuse, we will arrange for any needed x-rays and tests. Sometimes these require sedation or brief anesthesia.

(*A child life specialist has training in child development. Her job is to help children trust, and to provide emotional support through play.)

What should I tell my child about the appointment? Will it hurt?

Tell the child he or she is going to have a check-up of their entire body to make sure everything is healthy. We try to make the exam a positive experience. For young girls, there is no “internal exam” as for an adult woman. Even for teens this is rarely needed. Very rarely, a child is upset during the exam. If this happens, we may need a second appointment to complete the exam. We never force children. We believe the child should have a say in what happens to his or her body. We tell children to let us know if something bothers them so we can stop. A child will often sense the adult’s mood or worries. Call us if you have concerns.

How long should it take?

The exam is short, but the whole appointment can last one to two hours.

What will the exam show?

Many of the exams are normal. They show no injuries. This happens whether or not the child has been abused. It is important to have an exam to find any changes or problems that may be there. The exam can also reassure the child and others that his or her body is normal and healthy.

Why are the results of exams of private parts’ often normal?

The genital and rectal tissues are stretchy, and may not be injured. If there are injuries, they often heal quickly.

How will I get the results from the appointment?

The doctor or nurse practitioner will speak with you shortly after the exam to share the results with you. If lab tests or x-rays are done, we will call you with the results within one to two weeks. You can request another way to learn these results. We can arrange for help with any needed treatment.

Who else should get the results?

We are usually required by state law to send a report of the exam to the local child protection office. We can also send results to the child’s health care provider, any police involved and others who may help the child. It helps if you can bring a list of people who need to get the results.

What if I need to cancel or reschedule the appointment?

If you need to reschedule, please call us as soon as possible, so that another child may use that time. Refer to our list of locations for contact information.

What if my child does not have insurance?

We will never turn a child away as a result of financial need. Please contact us if you think this may be a problem.

What if I have other questions?

Please call the phone number listed for the appropriate CAPP location. The CAPP secretary can find the right person to answer your question. We can talk with you before or after the appointment.

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