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The Amsterdam Sexual Abuse Case (ASAC) presented parents with a dilemma about disclosing preverbal sexual abuse to their child. Advising parents was challenging due to limited knowledge about the consequences of preverbal child sexual abuse (CSA) and the rarity of children having no conscious awareness of their experience. To enhance recommendations and knowledge, we explored parents' experiences over the years. This unique qualitative study introduced "parental disclosure", where non-offending parents disclose CSA to their child, and investigated the decision-making process spanning a decade after the ASAC discovery. Longitudinal qualitative data were collected through yearly interviews. In total, 41 parents participated for 47 children. An additional in-depth interview was conducted with 20 parents in 2015. Quantitative data highlighted that over 10 years, parents of more than half of the children disclosed the preverbal CSA. Our analyses revealed that parental disclosure decisions entail dilemmas and unfold as a gradual process. Factors influencing decision-making included fear of stigma, child's emotional readiness, perceived benefits and risks, parental beliefs, values, and CSA circumstances. This study underscores the complex nature of parental disclosure and shows that it is an ongoing process rather than a singular event. Parents' choices evolved based on changing circumstances and new information. Outcomes enrich the understanding of parental disclosure decision-making, highlighting the need for tailored support services to aid parents navigating the aftermath of preverbal CSA. Parental disclosure is highly individualized and calls for evidence-based interventions and policies. [ABSTRACT FROM AUTHOR]

Abstract Introduction This is a case scenario simulating a physician encounter with a parent who has concerns about the sexual abuse of her child. The case scenario was developed to enhance competencies around the initial steps in management of child sexual abuse. Methods In the initials stages of a case like this, the establishment of rapport despite the emotionally charged nature of the issue is paramount. This resource is most applicable for addressing communication skills of trainees interacting with the caregiver of a possible child victim. In addition, the scenario impresses the need for trainees to acknowledge their role as a mandated reporter of all forms of family violence. Other competencies relevant to this case include being familiar with sexual behaviors that are considered developmentally appropriate in a prepubertal child while acknowledging the implications when there are variations from the norm. Results Prior to this experience, many trainees assumed that they knew how to manage a case of child abuse. After the training, trainees appeared less confident about the initial stages of managing a case of sexual abuse. On the other hand, they could easily identify the competencies they found the most challenging after the experience. The identification of these management challenges will inform curricular efforts on this topic at individual institutions based on available resources. Discussion Lessons learned from implementing this case in a resource-deficient environment can highlight the need for existing resources and bolster the argument for additional ones. This exercise can also serve as a needs assessment tool to inform the processes required for addressing the identified management challenges for similar cases.