Reflex anal dilation (RAD) is the reflexive dilation of the human anus to a diameter greater than two centimeters in response to the parting of the buttocks or anal stimulation, such as brushing with a medical instrument. RAD was theorized to be a clinical marker associated with anal sexual assault in children,[1] and has been associated with other signs of sexual assault[2] but also appears in children with severe chronic constipation and those subject to invasive medical treatments of the anus.[3] The finding of RAD alone is not considered indicative of sexual abuse,[4] and a normative sample of children not suspected of having been sexually abused found that 49 per cent of children showed anal dilation either continuously or intermittently, though the dilation exceeded 20 mm in only 1.2 per cent of cases.[5]
In 1986, Marietta Higgs learned of the RAD connection with sexual assault at a conference where it was presented by Christopher J Hobbs.[citation needed] Higgs used this RAD diagnosis extensively the following year, leading to the Cleveland child abuse scandal. It was discredited during the trial as the sole indication of sexual abuse, determined to be considered a sign of sexual assault by a tiny minority of British doctors.[6] RAD as a clinical marker for sexual abuse is now considered discredited.[7] However Hobbs was still studying RAD in 2014.[8]
^Read NW, Sun WM (June 1991). "Reflex anal dilation: effect of parting the buttocks on anal function in normal subjects and patients with anorectal and spinal disease". Gut. 32 (6): 670–3. doi:10.1136/gut.32.6.670. PMC1378886. PMID 2060876.
^Bruni M (November 2003). "Anal findings in sexual abuse of children (a descriptive study)". J. Forensic Sci. 48 (6): 1343–6. doi:10.1520/JFS2002306. PMID 14640283.
^Clayden, G (1988). "Reflex anal dilation associated with severe chronic constipation in children". Arch Dis Child. 63 (7): 832–836. doi:10.1136/adc.63.7.832. PMC1779059. PMID 3415302.
^Brittain, Charmaine; American Medical Association (2006). Understanding the medical diagnosis of child maltreatment: a guide for nonmedical professionals. Oxford [Oxfordshire]: Oxford University Press. pp. 126. ISBN0-19-517217-5.
^McCann J, Voris J, Simon M, Wells R (1989). "Perianal findings in prepubertal children selected for nonabuse: a descriptive study". Child Abuse Negl. 13 (2): 179–93. doi:10.1016/0145-2134(89)90005-7. PMID 2743179.
^Ashenden, S (2004). Governing child sexual abuse: negotiating the boundaries of public and private, law and science. Routledge. pp. 144–153. ISBN0-415-15894-X.
^Liz Bonner; Mandy Wells (2007). Effective Management of Bladder and Bowel Problems in Children. Class Publishing. pp. 75. ISBN978-1-85959-165-9.
^Hobbs CJ, Wright CM (2014). "Anal signs of child sexual abuse: a case-control study". BMC Pediatr. 14: 128. doi:10.1186/1471-2431-14-128. PMC4047438. PMID 24884914.
February 19, 2023
reflex, anal, dilation, reflexive, dilation, human, anus, diameter, greater, than, centimeters, response, parting, buttocks, anal, stimulation, such, brushing, with, medical, instrument, theorized, clinical, marker, associated, with, anal, sexual, assault, chi. Reflex anal dilation RAD is the reflexive dilation of the human anus to a diameter greater than two centimeters in response to the parting of the buttocks or anal stimulation such as brushing with a medical instrument RAD was theorized to be a clinical marker associated with anal sexual assault in children 1 and has been associated with other signs of sexual assault 2 but also appears in children with severe chronic constipation and those subject to invasive medical treatments of the anus 3 The finding of RAD alone is not considered indicative of sexual abuse 4 and a normative sample of children not suspected of having been sexually abused found that 49 per cent of children showed anal dilation either continuously or intermittently though the dilation exceeded 20 mm in only 1 2 per cent of cases 5 In 1986 Marietta Higgs learned of the RAD connection with sexual assault at a conference where it was presented by Christopher J Hobbs citation needed Higgs used this RAD diagnosis extensively the following year leading to the Cleveland child abuse scandal It was discredited during the trial as the sole indication of sexual abuse determined to be considered a sign of sexual assault by a tiny minority of British doctors 6 RAD as a clinical marker for sexual abuse is now considered discredited 7 However Hobbs was still studying RAD in 2014 8 See also EditAnal wink Body memoryReferences Edit Read NW Sun WM June 1991 Reflex anal dilation effect of parting the buttocks on anal function in normal subjects and patients with anorectal and spinal disease Gut 32 6 670 3 doi 10 1136 gut 32 6 670 PMC 1378886 PMID 2060876 Bruni M November 2003 Anal findings in sexual abuse of children a descriptive study J Forensic Sci 48 6 1343 6 doi 10 1520 JFS2002306 PMID 14640283 Clayden G 1988 Reflex anal dilation associated with severe chronic constipation in children Arch Dis Child 63 7 832 836 doi 10 1136 adc 63 7 832 PMC 1779059 PMID 3415302 Brittain Charmaine American Medical Association 2006 Understanding the medical diagnosis of child maltreatment a guide for nonmedical professionals Oxford Oxfordshire Oxford University Press pp 126 ISBN 0 19 517217 5 McCann J Voris J Simon M Wells R 1989 Perianal findings in prepubertal children selected for nonabuse a descriptive study Child Abuse Negl 13 2 179 93 doi 10 1016 0145 2134 89 90005 7 PMID 2743179 Ashenden S 2004 Governing child sexual abuse negotiating the boundaries of public and private law and science Routledge pp 144 153 ISBN 0 415 15894 X Liz Bonner Mandy Wells 2007 Effective Management of Bladder and Bowel Problems in Children Class Publishing pp 75 ISBN 978 1 85959 165 9 Hobbs CJ Wright CM 2014 Anal signs of child sexual abuse a case control study BMC Pediatr 14 128 doi 10 1186 1471 2431 14 128 PMC 4047438 PMID 24884914 Retrieved from https en wikipedia org w index php title Reflex anal dilation amp oldid 1038191540, wikipedia, wiki, book, books, library,
