When a Child Begins Talking About Abuse: Recommendations for Medical Personnel

The response of medical personnel - doctors, nurses, significantly affects whether children continue to talk about possible abuse or hint at it. Consequently, the child’s safety largely depends on them.

Healthcare professionals can clarify, disrupt, or distort the child’s story, which may be crucial later in legal proceedings.
How to Support a Child When They Begin Talking About Abuse
If a child begins talking about or displaying possible signs of abuse, listen attentively and observe carefully. Many children find it easier to talk if they’re not being directly looked at, so you may observe them while seeming to do something else.

If the child is in a safe environment (e.g., away from the suspected abuser or parent), allow them to share or show what they need.

If you’re unsure of what the child said or meant, use open-ended prompts like “Tell me more about that” or “Show me again.” Then, say things like “Uh-huh” or “Hmm” or “Go on” to show you’re listening. These phrases are safe, as they encourage the child without directing their story. Expressions like “Good” or “Correct” can be problematic, as they show approval of what the child is saying, which may include difficult or sensitive topics.

Through your behavior and body language, show the child that you’re comfortable in the situation and have time to listen. Give the child as much physical space as they need.

Adapt your language and communication style to meet the child’s needs, considering their age and development level. Clearly explain what you need to know.

Ask one open-ended question at a time, allowing the child to use their own words. Avoid rushing; give the child time to respond, and pause between questions.

Try to gather enough information to determine necessary actions. Accurately document the child’s words, behavior, and any questions you asked.

If the child tries to demonstrate abusive or sexual actions using your body, calmly say, “I won’t allow that,” and if needed, increase the distance between you.

Record everything in writing, using the child’s own words. Write exactly what they said without elaboration or editing. Make a note if you observed particular behaviors.

Inform the child of the next steps. This can be very simple: “I’ll think about this and come back,” or, in urgent situations, let them know you’ll stay with them until a social worker or police officer arrives.

The key is to open a door for the child to talk about their experience, remaining impartial to what you see and hear. This process may take a few minutes, an hour, or even several weeks or months, and may involve verbal disclosure, demonstration, or action.