Pediatric emergency medicine providers’ experience with digital sexual exposure and abuse

BACKGROUND Digital devices and online platforms are a ubiquitous part of childhood and adolescence, and offer both opportunities and risks. One of those risks is digital sexual exposure and abuse, which emerging research finds to be highly prevalent. Pediatric Emergency Medicine (PEM) providers are first responders, mandated reporters and trusted professionals, but how knowledgeable and prepared they are to address these issues is their practice is unknown. OBJECTIVE To assess the familiarity, experiences, and concerns of PEM providers in the U.S with identifying and supporting victims of digital sexual abuse in their clinical practice. METHODS PEM providers (n=286), recruited through a PEM listserv, were surveyed anonymously about how often patients and/or their parents shared concerns about digitally-mediated sexual content or abuse, to what extent presentations of suicidal ideation/attempts were related to digitally-mediated sexual abuse, provider familiarity with different types of digital sexual content and abuse, what resources providers used to support patients, and what additional information or supports they felt were needed to address these topics in their clinical practice. RESULTS Though respondents were familiar with some terms (e.g., sexting, cyberbullying related to sexual images), less than 1 in 5 respondents reported feeling prepared to address sextortion, cyberflashing, or porn addiction. More than 20% of providers reported seeing digital-mediated sexual abuse in their clinical practice monthly or more often, though many reported not asking or screening for these types of abuse. Almost 2/3 of respondents had had patients with suicidal ideation or attempt that was associated with non-consensual image sharing and/or cyberbullying around sexual images. Providers used hospital social work and psychological services to support patients but wanted more education on screening and treating, more resources for families, and greater support from K-12 settings for families. CONCLUSIONS Though based on a convenience sample drawn from the largest PEM listserv, findings indicate the need for more educational resources, updated screening tools, reporting mechanisms, and family-accessible resources for addressing digitally-mediated sexual exposure and abuse among pediatric patients.