Assessing Child Sexual Abuse
Forensic Issues
Provided by Allen N. Cowling
Of the nearly 3.6 million children who were the subjects
of a Child Protective Service Investigation in 2006, maltreatment was substantiated or indicated in
28%. Nearly 9% of these substantiated/indicated cases were related to sexual abuse
allegations.
When sexual abuse is alleged, children may face
investigative interviews, family disruptions, a change in their school environment, mental health
counseling, and even trial court testimony. This article reviews factors that affect the reliability of
children's statements and provides guidelines for evaluators to help minimize the risk of their
contaminating a child's report of sexual abuse.
Reliability of child sexual abuse
allegations
- Factors to consider when evaluating the reliability of sexual abuse
allegations include an assessment of the child's memory and suggestibility. Reporting a memory
requires a person to perceive the event, retain the memory, and retrieve the memory when asked to
do so.
- Memory can be divided into 3 categories: recognition memory, recall
memory, and reconstructed memory. In general, recognition memory is the least complex form of
memory: one need only recognize a single stimulus that he or she has had. Children as young as 3
years are fairly reliable at memory tasks that involve basic recognition of objects they have seen.
By age 6 years, children can recognize a familiar face nearly as well as an adult.
- In contrast, recall memory requires the reconstruction of what the
child saw or experienced without the benefit of a prop or prompt. In this situation, a child who is
interviewed may fail to report all or part of an event he experienced. This is known as an error of
omission and is more commonly observed when preschoolers are interviewed than when older children
are.
- An error of omission is the endorsement of having experienced
something that did not actually occur. It can result from deliberate lying, confusion between
different memories that are similar, and difficulty in distinguishing real from imagined
events.
- Reconstruction memory involves the process of extracting a memory
that is not spontaneously volunteered through questioning or other types of prompts, such as
pictures or videotapes. An original memory trace can be altered by the suggestions of other people
who interact with the child, through inappropriate investigative interviews, or from therapy
provided by clinicians who do not appreciate the influence of suggestibility on childhood
memories.
- Ceci and Bruck's defined suggestibility as the "degree to
which children's encoding, storage, retrieval, and reporting of events can be influenced by a
range of social and psychological factors." One of the most famous cases involved alleged
child abuse at the McMartin Preschool in Manhanttan Beach, Calif. Seven defendants were charged
with over 300 counts of abuse that involved more than 100 children. Many of the allegations were
extremely bizarre and highly unlikely. After 7 years and at a cost of $15 million, none of the
accused were found guilty.
- In trying to understand how children could make such bizarre and
graphic allegations, researchers have described 6 problematic techniques that were discovered when
the transcripts of the McMartin interviews were reviewed. These techniques are sometimes referred
to as the "McMartin factors":
Suggestible questions
- This potentially corruptive technique consists of introducing new
information during the interview when the child has not yet provided that information. For example,
the question, "Did he touch you in your privates?" represents a highly leading question
if the child had not mentioned any type of inappropriate touching.
Asked-and-answered
- This technique consists of asking the child a question that he has
clearly just answered. The transcript excerpt from the McMartin case illustrated this particular
technique:
- Interviewer - Did your teacher touch you in your private
area?
- Child - No.
- Interviewer - No? Are you sure?
- Child - No, he didn't.
- Interviewer - Do you remember him touching you at all down
there?
- Child - Yeah, well I guess so.
Inviting Speculation
- An investigator using this technique asks the child to guess about
something that may have happened. As a tool to elicit allegations, the child is asked to pretend or
use his imagination. The interviewer in this situation might make comments such as "Let's
pretend and see what might have happened," or "Can you try to close your eyes and imagine
what he did to you."
Other people
-
Here the child is told that the interviewer has already received
information from someone else regarding the subject to be discussed. The following exchange
illustrates this technique:
- Interviewer - Your mommy told me Johnny touched
you.
- Child - Uh, huh.
Positive consequences
- In this situation, the interviewer provides praise or approval, or
communicates to the child that he is being helpful or smart when making an allegation. For example,
an interviewer who tells a child that he is "so smart" or "a really good kid"
after the child has answered that he was abused is providing a verbal reward for the child's
response. Giving a child a gift (such as a teddy bear or toy) following a disclosure also
communicates to the child that he is being rewarded when he accuses others of inappropriate sexual
behavior.
Negative consequences
- This technique uses responses that are the opposite of positive
consequences. The investigator communicates to the child that the answers the child is giving are
not ones that are desirable. This suggest to the child that he is not being truthful or that the
investigator is disappointed with the child's responses to questions.
Although these poor interview techniques were observed
in the McMartin interview tapes, do such techniques actually elicit false allegations? Current research
on this topic provides a clear answer: yes.
In one study, Yuille and colleagues examined the effects
of using social influence and reinforcement on preschool children's immediate reports of an event
they had witnessed in class. In this study, a male graduate student was introduced to the daycare class
as Manny Morales. He wore a large silly hat and after introducing himself, he read from a book, placed
a sticker on the back of each child's hand, handed out a napkin and cupcake to each child, and then
said good-bye to the class.
One week later, children were interviewed about their
experience with this entertaining visitor. One group of children was assigned to the social incentive
group. In this group, statements were made to the children that they could be helpful and show good
memory by reporting what Manny had done. Another group was assigned to the suggestive control condition
in which suggestive questions alone were used. Researchers found that after a brief use of
reinforcement and social influence techniques, nearly 60% of the children alleged that Manny had
committed acts that he had not, such as breaking a toy, throwing a crayon, or stealing a
pen.
A subsequent study of children aged 5 to 7 years
examined whether inappropriate interview techniques could have a lasting effect on children's
statements. This study involved a classroom visitor named Paco, who read a story, put on a pair of
goofy glasses with a large plastic nose and mustache, handed out treats, then left the room after
placing a sticker on each child's hand.
When interviewed a week later, children were asked about
mundane but untrue events (such as "Did Paco tear a book?) and fantastic events (such as "Did
Paco take you on a helicopter ride?") 52% of children who received reinforcement made false
allegations that they had experienced fantastic events compared with 5% made by controls. In a second
interview 2 to 3 weeks later, the children making fantastic claims maintained their allegations even
when the reinforcement was discontinued.
The authors concluded that reinforcement quickly induces
children to make persistent false allegations of wrongdoing. Corruptive effects on children's
statements have also been noted when children are asked to guess or speculate on what might have
happened or when a question that they have already answered is repeated.
Findings from these studies indicate that children will
report false information when questioned suggestively about events that occur in a school setting. But
will children also falsely report instances of being physically or sexually touched when, in reality,
they were not? Current research indicates that children can and do make false allegations of being
touched when misleading or inappropriate questions are used.
In a study by Saywitz and associations, 5 and 7-year-old
girls had an external genital and anal examination as part of routine pediatric examination.
Thirty-five girls in the same age range were not exposed to this type of touching as part of the
pediatric examination. Of those girls not touched, 8% provided a false report that they were touched in
their vaginal or anal area when they were asked directly if this occurred.
In a subsequent study of 3-year-old girls who also
underwent a pediatric examination, researchers asked strongly suggestive questions about a doctor
touching their anogenital regions, such as "Show me on the doll how Dr. F touched your
genitals." Among girls whom the doctor did not touch, 50% falsely claimed that the doctor had
inserted objects into their anogenital cavities. Both of these studies indicate that children can and
will make false allegations if inappropriate interview techniques, such as leading questions, are
used.
Forensic Interviewing of Children
- When interviewing children who are suspected of being victims of
abuse, there are several important factors to consider. First, videotaping is strongly recommended
to preserve the content of questions and answers. Videotaping is particularly important when the
child is being interviewed to assess allegations that may lead to criminal charges or civil
damages.
- In general, the evaluator begins the interview process by
establishing a rapport with the child while assessing his developmental level. At this early point
in the interview, the examiner can ask the child basic questions with easily verifiable answers,
such as the child's age, where he goes to school, and the names of family members. The examiner
should also ask the child about a known event, such as his age, birthday, or recent holiday, to
ascertain the accuracy of the child's recall.
- A child's understanding of basic spatial orientations such as,
"in," "on," "behind," "on top" are important to establish
during the initial phases of the interview in the event that a child later describes sexual
activity in which such details may be particularly relevant. To demonstrate a child's ability
in this regard, the examiner can ask the child to place a crayon in a box, on top of the box, under
the box, or partially in the box.
- The interviewer should also speak to the child in language that the
child can understand while emphasizing that the child is the only one who has all the information.
The interviewer reminds the child that the interviewer was not present at any event that took place
and therefore cannot possibly know what may have happened. Important ground rules to review with
the child are outline in Table 1.
- The interviewer will usually test the child's understanding of
these ground rules in different ways. For example, the interviewer may ask what the child ate for
breakfast and then ask the child what the interviewer had for breakfast. Some children will provide
an answer regarding what the interviewer ate for breakfast when there is no possible way for the
child to know this information. The interviewer then explains that the child should say "I
don't know" when he does not actually know the answer.
- The child's ability to distinguish the truth from a lie can be
established through a series of questions that would obviously be either true or untrue. For
example, an evaluator could hold up a pencil and ask the child if the object was a banana. The
child would answer that this was either true or false.
- To assess a child's understanding of taking an oath to tell the
truth (which may later be required in court), the examiner can ask the child what happens to a
person who tells a lie. Statements that lying would be wrong and could get the child into trouble
with his parents or teacher indicate that the child understands there may be negative consequences
for not telling the truth. However, a child's understanding that it is wrong to lie does not
guarantee that he will not provide inaccurate information. Before investigating any specific
allegation, the investigator should ask the child what names he gives to various parts for both
boys (men) and girls (women). This task is often accomplished by showing the child a picture of the
front and back of a boy and girl figure and then asking the child to label each body part from head
to toe.
- When first approaching the issue of possible abuse, the interviewer
should begin with open-ended, non-leading questions about the child's experience without
providing specific content that may be part of the allegation. Simple open-ended questions include
such statements as "Tell me what happened," or "Describe what you remember," or
"What happened next?" Forced-choice questions are those that provide preselected options
for the child. In general, this type of questioning should be avoided when investigating abuse. For
example, asking a child whether he was "kissed on the mouth or on his private parts"
allows the child to pick an answer imbedded in an extremely leading question. This approach makes
it very difficult to know whether the child is simply guessing from options presented or whether he
is providing an accurate answer.
- When closing the interview, the evaluator can thank the child for
coming in and then recap the information gathered. This process provides the child an opportunity
to correct the interviewer's summary. In addition, the evaluator may wish to provide the child
with a name and contact telephone number, let the child ask any remaining questions, and spend a
few moments on more neutral topics before the interview formally ends.
- Many children who have made allegations of abuse are referred to
mental health counseling for treatment and supportive therapy. It is important that treatment
providers also avoid using suggestive techniques during therapy. Such techniques pose a significant
risk of contaminating the child's memory and potentially tainting his testimony should criminal
proceedings or civil litigation follow.
Evaluating abuse allegations
- A child's allegation of abuse can result in serious
consequences that include criminal charges against the alleged perpetrator, removal of a family
member from the child's home, and/or civil litigation alleging some type of resulting harm. A
forensic expert may be retained by an attorney or appointed by the court to evaluate such
allegations. The evaluator should collect all statements and videotapes of the child regarding the
alleged abuse to include any accounts provided to the police, medical providers, teachers, social
workers, treatment providers, or other third parties. It is common for many children to delay
disclosing abuse; however, abuse recantations are not typical of those children who are actual
victims of abuse.
- Additional questions to answer when evaluating the credibility of a
child's allegations are highlighted in Table 2.
Summary
- When well-intentioned but misguided individuals use questioning
techniques known to increase the risk of false allegations of sexual abuse, a cascade of
unfortunate events can follow. Consequences of corruptive interview techniques include the risk of
innocent individuals being falsely accused as well as abused children not being believed. Mental
health evaluators and investigators have an obligation to conduct child abuse investigations in
accordance with current research and best practices. Failure to do so results in a process that
fails to protect our children and places the quest for truth and justice in peril.
Table 1 - Ground rules for a forensic interview of
children
-
During the forensic interview, the evaluator should emphasize to the
child the importance of:
- Telling the truth.
- Providing information in as much detail as
possible.
- Answering "I don't know" if the child does not
know the answer to the question.
- Letting the interviewer know if the child does not understand a
question.
- Understanding that if the interviewer asks a question more than
once it does not mean that the question was answered incorrectly.
- Correcting the interviewer if the interviewer states something
that is not correct.
- Reminding the child that he or she is the one who will be doing
most of the talking, not the interviewer.
Table 2 - Evaluating the credibility of a child's
sexual abuse allegation
- What was the context in which the allegation was made?
- Who first forwarded the allegation?
- Did the allegation originate from the child, or from a parent or a
third party?
- Is there a circumstance (such as contentious child custody battle)
that is associated with the course of the allegation?
- Were inappropriate interview techniques used by any of the
investigators?
- Has a treatment provider used inappropriate techniques or
suggestive memory recall during therapy?
- Has the other parties been involved in asking questions or coaching
the child regarding his or her allegations?
- Has the child retracted the allegation at any time?
- Has the child made allegations in the past? If so, were any of
those allegations false?
- Is there evidence that someone else has abused the
child?
- Does the child have any type of emotional or developmental
condition that impairs his ability to accurately observe, store, or recall events?
References
- U.S. Department of Health and Human Services, Administration on
Children, Youth and Families. Child Maltreatment 2006, Washington, DC. US Government Printing
Office 2008.
- Perlmutter M. Myers N. Recognition memory in two to four year olds.
Dev. Psychol 1974;10:447-450.
- Lindsay DS, Johnson MK. The eyewitness suggestibility effect and
memory for source. Mem Cognit. 1989;17:349-358.
- Foley MA, Santini C. Sopaskis M. Discriminating between memories;
evidence for children's spontaneous elaborations. J Exp Child Psychol.
1989;48:146-169.
- Ceci SJ. Bruck M. Suggestibility of the child witness: a historical
review and synthesis. Psycho Bull. 1993;113:403-439
- Yuille JC, Tymofievich M. Marxsen D. The nature of allegations of
child sexual abuse. In: Ney T. Ed. True and False Allegations of Child Sexual Abuse Assessment and
Case Management. New York: Brunner/Mazel;1995:34-35
- Garvin S. Wood JM, Malpass RS, Shaw JS 3rd. More than suggestion:
the effect of interviewing techniques from the McMartin Preschool case. J Appl Psychol.
1998;83:347-359
- Garven S. Wood JM, Malpass RS. Allegations of wrongdoing: the
effects of reinforcement on children's mundane and fantastic claims. J appl Psychol
2000;85:38-49
- Ceci SJ, Huffman MLC, Smith E, Loftus EW. Repeatedly thinking about
non-events: source misattributions among preschoolers. Conscious Cogn. 1994;3:388-407
- Krahenbuhl S, Blades M. The effect of question repetition within
interviews on young children's eyewitness recall. J Exp Child Psychol.
2006;94:57-67
- Saywitz KJ, Goodman GS, Nicholas E, Moan SF. Children's
memories of a physical examination involving genital touch: implications for reports of child
sexual abuse. J Consult Clin Psychol. 1991;59:682-691
- Bruck M, Ceci SJ, Francoeur E. Children's use of anatomically
detailed dolls to report genital touching in a medical examination: developmental and gender
comparisons. J Exp Psychol Appl. 2000;6:74-83
- London K, Bruck M, Ceci SJ, Shuman DW. Disclosure of child sexual
abuse: a review of the contemporary empirical literature. In: Pipe ME, Lamb ME, Orbach Y, Cederborg
AC, eds. Child Sexual Abuse: Disclosure, Delay, and Denial. Mahway, NJ: Lawrence
Eribaum;2007:11-35
Evidence Based References
- Garven S. Wood JM, Malpass RS. Allegations of wrongdoing: the
effects of reinforcement on children's mundane and fantastic claims. J Appl Psychol.
2000;85:38-49
- London K, Bruck M, Ceci SJ, Shuman DW. Disclosure of child sexual
abuse: a review of the contemporary empirical literature. In: Pipe ME, Lamb ME, Orbach Y, Cederborg
AC, eds. Child Sexual Abuse: Disclosure, Delay, and Denial. Mahway, NJ: Lawrence
Eribaum;2007:11-35
The information on this webpage was prepared and
provided by Charles L. Scott, M.D. Dr. Scott is professor of clinical psychiatry, chief of the Division
of Psychiatry and the Law, and director of Forensic Psychiatry Residency at the University of
California, Davis.
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