Legal proof of child sexual abuse in the absence of physical evidence.

Child sexual abuse criminal court cases from a 12-month period were reviewed to determine the frequency and significance of physical evidence in legally "proven" felony cases with penetration. One hundred fifteen consecutive cases were reviewed, and 87 (76%) had resulted in conviction of the perpetrator on felony charges. Charges of vaginal rape were made in 88 cases, and oral and/or anal sodomy in 67 cases. Physical evidence was present in only 23% of all cases that resulted in felony convictions. Felony convictions were obtained in 67 (79%) of 85 cases without physical evidence and in only 20 (67%) of 30 cases with physical evidence. Eight of the 10 cases without physical evidence that did not result in conviction involved victims younger than 7 years of age. Cases involving the youngest victims had a significantly lower conviction rate (12 of 23), despite a very high frequency (13 of 23) of physical evidence (P less than .0005). Physical evidence was neither predictive nor essential for conviction. Successful prosecution, particularly in cases involving the youngest victims, depended on the quality of the verbal evidence and the effectiveness of the child victim's testimony.