OBJECTIVE: Little is known about the prevalence of intellectual and academic problems in sexually abused children. Such problems may have significant implications for their management. This study examined the prevalence of such problems in a population of Australian children referred for sexual abuse evaluation. The study also assessed the clinical utility of the Parents’ Evaluation of Developmental Status (PEDS^®) questionnaire as a screening tool for learning and developmental problems in this population.

METHODS: Over a 12-month period, children referred for sexual abuse evaluation to the Mater Children’s Hospital Child Protection Unit were enrolled and background demographic and abuse related data collected. Parents, many of whom were the suspected perpetrators, completed PEDS^® and the Child Behavior Checklists (CBCL). Day care providers and schoolteachers completed the corresponding Caregiver or Teacher Report Forms (TRF).

RESULTS: A total of 21 of the 35 eligible children completed all study measures. Mean scores for intelligence and academic achievement were within the average range. However, three (14%) of the tested children were intellectually impaired and three (14%) showed academic underachievement. Sixty-two per cent of children had problems in the clinical range on the CBCL and 33% on the TRF. The PEDS^® showed a sensitivity of 64%, specificity of 60% with a positive predictive value of 77%.

CONCLUSION: In this population of referred children, over one quarter showed problems with intellectual impairment or academic under achievement. Most of these children were not receiving learning support at school. A high index of suspicion is therefore required when assessing sexually abused children for comorbid intellectual and learning problems.

Comment from Dr. Glascoe: This is certainly lower sensitivity and specificity than I’d like to see but the study makes an important case for having other informants (e.g., foster parents) answer PEDS^® questions. Parents facing legal action are understandably likely to be defensive and thus less than forthcoming. An alternative is to use a skill-focused measure such as PEDS^®:Developmental Milestones, preferably via a hands-on professional administration.