The study found that prosecution rates for CSA cases were significantly higher under the FNE program compared to the non-FNE investigative procedure for CSA cases. Although 55 percent of the FNE cases were never charged by the prosecutor, significantly more (77 percent) were never charged under the non-FNE investigations. FNE cases prosecuted were also significantly more likely to result in guilty pleas or trial convictions than the non-FNE cases prosecuted. Cases with older victims who sustained penetration were the most likely to be prosecuted under the non-FNE procedure. This suggests that the FNE program may be more effective in investigating cases with young victims where evidence of sexual abuse is more elusive. Still, the FNE cases that fit the more classic profile of CSA victimization were the most likely to be prosecuted. The comparison of cases from the same midwestern county before and after the implementation of the pediatric FNE program minimized threats to internal validity, i.e., the possibility that factors other than the FNE program produced the improved outcomes. Under FNE/Sexual Assault Nurse Examiner (SANE) program, specially trained forensic nurses provide around-the-clock first-response crisis intervention and forensic medical examinations for child, adolescent, and adult sexual assault/abuse victims. FNEs must complete additional training in child sexual abuse, child development and anatomy, and additional clinical work with children. FNE programs provide important benefits to CSA prosecutors, notably, expert care for victims, high-quality evidence collection, and expert witness testimony. These benefits can increase CSA prosecution rates and successful case dispositions. 1 table and 32 references