Do you want to know what incest is? What it really is? No ...

The children's examining room has kites stenciled along the top of the wall. A koala
bear sits atop a cabinet, wearing a stethoscope. The office is equipped with a
colposcope, which is a microscope that allows for magnified examination of the child's
genitals and anus and makes a photographic record of the findings. A fantasy town
painted on a folding screen hides the examining table. It's a tiny table—much, much
smaller than those in a gynecologist's office. It has a pillow at one end and metal
stirrups at the other. I found the sight of it agonizing. I couldn't look at it without getting a
vivid image of a four-year-old in position for a pelvic exam. But the children who come to
Stuart House aren't traumatized by the exam. To the contrary, many are reassured.
Matti
Five-year-old Matti was sitting in the bathtub, strangely silent. Her mother, Mary Lou,
asked her what was wrong. "If I tell you," Matti said, "you'll punish me. He said so." Mary
Lou promised she wouldn't punish Matti. Then Matti told. Her mother's friend, a man
who took care of Matti, who took her on outings and to his house, had made her
undress and go into the bathtub with him. He licked her. He made her play with him.
"White stuff would come out," Matti said.
Mary Lou called her pediatrician. He sent her to the local emergency room. There, Matti
was examined by a male doctor. Mary Lou, in the next room, heard Matti scream, "Don't
do that! Don't do that to me!"
The next day, Mary Lou took Matti to Stuart House. Eventually Matti told her therapist
there that she had been photographed. She remembered what the photo album looked
like and exactly where her abuser kept it. Immediately, the police got a search warrant
and found it. Although Matti had no physical signs of abuse, the photos showed that she
had been raped and sodomized for months.
Incredibly, several months later, Matti asked for another pelvic exam, to be done at
Stuart House. She said she wanted to know for sure that her body was all right. A
female doctor, one of the experts in child sexual abuse who staff Stuart House,
examined her on the little table. This time her mother was at her side.
Vertical case management
Stuart House uses vertical case management: The same social worker, prosecutor, and
police officer stay with a case all the way from intake to resolution. Children and family
non-offenders get free long-term individual and family therapy. They see the
investigators and social workers regularly.
Kathy Giugliano, Stuart House's child advocate, telephones families often to keep them
up-to-date on what is happening with their case. There are no long out-of-touch periods
of confusion. Cases—and children—don't get lost in the system. New cases often take
only one day to go from the initial complaint of abuse to the interviews with child and
family, the gathering of medical information, the interview with the suspect, the issuing
of a warrant, and the filing of charges. In other places this process might take weeks,
months, even years.
Once the filing takes place, the case is in the hands of the courts and the same delays
occur as elsewhere. Meanwhile, therapy at Stuart House, for victims and family non-of-
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