Each year thousands of children undergo forensic anogenital exams following allegations of sexual abuse. The exam typically involves the use of a colposcope to inspect the child’s anal and genital areas for signs of injury or infection. Literature on children’s exam experiences shows that untoward emotional and behavioral responses tend to be mild and transient. In fact, case studies and clinical observations suggest that some children experience more severe and chronic psychological maladjustment to this medical encounter. A shift in the research questions driving efficacy studies of preparatory medical interventions is proposed. The procedure has been to exclusively study the parameters (timing, modality, specificity, and developmental appropriateness) of effective preparatory interventions. Professionals are now encouraged to focus on how children appraise the medical encounter and how information elicits changes in such higher order cognitive activity. A model of cognition-emotion associations is a potentially useful clinical and research tool to systematically explore individuals’ exam appraisals and to document the impact of exam information on higher order cognitive activity. Given that the model is based on empirical evidence from adult-based research and retrospective studies, future empirical investigations must examine its integrity during an ongoing meaningful stressor as well as its downward extension to children. An intervention may be adapted to a particular child undergoing a specific type of medical procedure by using current best-practice techniques within this cognitive-emotional theoretical framework. 42 references