CHICAGO (AP) - Citing disturbing statistics showing adolescents have the nation's highest rate of rape, the American Academy of Pediatrics says doctors should ask patients at their annual checkups if they have ever been sexually assaulted.

Pediatricians may be the first professionals these victims encounter, and they are in a position to offer psychological support or refer such patients for counseling and other services, the academy said.

Nationwide data from 1998 show that 330,088 rapes and sexual assaults were reported in victims ages 12 and up. Rates for those ages 12 through 19 were the highest of all age groups and more than double those of victims 25 and older.

"It can be uncomfortable for some physicians to bring up sexually related questions," said Dr. David Kaplan, a Denver pediatrician and chairman of the academy's committee on adolescence. But he said including such questioning as part of regular checkups may help make it become more routine.

The recommendations were published in the June issue of the academy's journal, Pediatrics. They strengthen the academy's 1994 policy statement in light of increases in the use of date-rape drugs and changes in legal procedures.

The academy also urged pediatricians to encourage adolescent patients to avoid situations that could lead to sexual assault, such as late-night use of alcohol or drugs, noting that 40 percent of adolescent victims and assailants report use of drugs or alcohol right before a sexual assault.

Rape awareness educator Katie Koestner, who was raped in college, applauded the recommendations and said doctors might be among the only people a girl feels comfortable telling because of the privacy of the office setting.

She said doctors need to be prepared to offer advice, such as asking whether the victim still has the clothing she wore during the rape, and telling her to put it in a paper bag, not plastic, to preserve the evidence.

The academy said pediatricians also should know that if the attack was recent, victims should be examined by someone with forensic experience, and that DNA technology allows for a forensic exam beyond the previous 72-hour cutoff.

Even if the attack was not recent, pediatricians can help patients by giving them an opportunity to talk about it, the academy said.

"In some situations it would clearly be an educational service for the young woman," said John Stein, deputy director of the National Organization for Victim Assistance. "There's a lot of ignorance about sex and about improper sexual activities."

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