ABSTRACT
Helen was nearly six years old and ‘severely mentally handicapped’ when she was referred to the clinic with her older sister Clare. A diagnosis of chronic sexual abuse had been made nine months previously by the local hospital. When Helen was five, her intellectual level was about eighteen months. She had little language and was not toilet trained. Her violence to other children, extreme mood swings and sexualised behaviour alerted her special school, and an examination under local anaesthetic revealed ‘recent and old’ penetration of the anus, as well as other bruises consistent with physical abuse.
