Forensic Nurse Examiner Program


Program Highlight
Since 1999, Turning Point’s Forensic Nurse Examiner Program (FNEP) has provided services to the community for survivors of sexual assault. The program, open 24 hours a day and seven days a week, is staffed with Forensic Nurses and First Response Advocates. About 250 cases come into FNEP a year with the oldest client being 97 and the youngest, just days old. In addition to providing emergency services, the Forensic Nurses are also available to provide expert witness testimony at court proceedings, suspect exams at local law enforcement agencies, and trace evidence collection at homicide scenes as requested by the Macomb County Medical Examiner. First Response Advocates are available to speak with sexual assault survivors confidentially, offering support throughout the process and providing survivors with information on sexual assault, what happens next, the criminal justice system, and other support or resources they may need. Check out our resources page for links to the IAFN and SANE-SART for more in-depth information.

To learn more about Forensic Nursing: Click Here

What we should know about sexual assault

Recent reports about sibling sexual assault in the Duggar family have brought this issue along with much confusion to the forefront. What is the difference between natural child exploration and abuse? What should parents do?  Is sibling sexual assault harmful?

Sibling sexual assault is not rare but it is vastly under-reported and not understood by parents and even some professionals. Some studies indicate it represents a quarter of all child sexual assault incidents. Sibling abuse includes relationships with foster and step siblings. It is an abuse of power and trust. Acts of abuse can include penetration to touching, and also nonphysical acts such as exposure to pornography, taking pictures or watching siblings shower, bathe or use the toilet.
This is vastly different than natural sexual curiosity between equally curious children. Sexual exploration is natural as children are curious about each other’s differences. Exploration is considered “natural” when the interaction is between children who are of a similar developmental and emotional age, and where their knowledge and experience are on a par with each other.

Parents and even some professionals often minimize sibling assaults failing to recognize that it is a serious family and social problem with potentially serious mental health consequences.  Victims of this type of abuse often get the message that no harm was done, that it was child’s play while at the same time hearing a message that it is taboo and wrong. This response can be as harmful and confusing as the abuse itself.

There are multiple reasons that victims do not disclose.  Most often it is the fear of being blamed or getting their sibling into trouble or upsetting their parents.  Often adults interpret this silence about what was happening as consent or complicity. For some victims the behavior is misinterpreted as attention, affection and normal.

People who are isolated, powerless and lack information about sexual assault are the most at risk to experience sexual violence.  These factors along with gender inequality within the family and what the abuser has experienced or learned about power in their family escalate the risk factors for child sexual assault and sibling incest.

Victims of sibling sexual assault often suffer the same emotional consequences as other victims of child sexual assault. Due to the typically long duration of the abuse and the violation by a trusted family member many victims report lifelong difficulties with intimacy and trust, depression, anxiety and other symptoms reported by parent child incest survivors.  Bullying, emotional abuse and other forms of physical abuse may also be present and compound the traumatic aftermath. Victim/survivors need a trauma informed intervention and to repeatedly hear the message that the abuse is not their fault and that they did nothing wrong. Parents and professionals should reassure them that they will do everything they can to keep them safe and get the abuser help. Adolescents who have abused their sibling or other children should receive appropriate counseling to help them understand and stop their behaviors and determine if they themselves experienced abuse or neglect.

Prevention education is the key to avoiding these detrimental consequences. Successful prevention programs recognize that children are more at risk for sexual assault from the people they live with and trust than a stranger.  Ensuring that all children receive age appropriate sex education that includes consent education and information about their boundaries, bodies and safety can prevent the devastating and lifelong consequences of sibling sexual assault.  For more information on child sexual assault visit or to contact Turning Point at 586-463-6990

Domestic Violence and Pregnancy

89680462The recent news of a young pregnant woman from Warren, who was abducted, shot, and then set on fire by her ex-boyfriend has shocked all of us. This appears to be a targeted killing of a young woman and her unborn child. Thankfully, she survived. While the viciousness of this attack is rare, domestic violence during pregnancy is not.

Homicide is the leading cause of traumatic death for pregnant and postpartum women in the United States. Each year, about 324,000 or 4% of pregnant women in this country are battered by their intimate partners. That makes abuse more common for pregnant women than gestational diabetes or preeclampsia, a complication of high blood pressure during pregnancy. Also, unintended or forced pregnancies are 2 to 3 times likely to be associated with abuse than an intended pregnancy.

So why does battering begin or increase during pregnancy? Pregnancy is a time when women are more physically vulnerable and more dependent on their support system as they prepare for motherhood. Her attention is focused on her unborn child’s needs, her physical well being and health. Some men, who batter, may feel jealous or anger toward the unborn child for the diversion of her attention toward the child. Or for some pregnancy makes no difference and they continue to use physical violence and other tactics to maintain their control regardless of the pregnancy.

Approximately 8% of the women coming to Turning Point’s shelter are pregnant when they arrive. Most will deliver that child while in shelter. Women who are battered during pregnancy have high rates of miscarriages, babies with low birth rates and post pregnancy complications. This is not the way any child should begin their life! OBGYN doctors are now beginning to screen for domestic violence during their checkups, a promising intervention to decrease the rates of domestic violence during pregnancy.