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Psychiatric Times. Vol. 25 No. 14
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FORENSIC PSYCHIATRY 

Forensic Issues in Child Sexual Abuse Allegations

By Charles L. Scott, MD | December 1, 2008
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. He reports no conflicts of interest concerning the subject matter of this article.

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 outlined 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.

(MORE: Child Abuse—or Cultural Norm?—in a Developing Nation)

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 body 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, nonleading questions about the child’s experience without providing specific content that may be part of the allegation. Sample 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.13

Additional questions to answer when evaluating the credibility of a child’s allegation 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.

 

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1. US Department of Health and Human Services, Administration on Children, Youth and Families. Child Maltreatment 2006.Washington, DC: US Government Printing Office; 2008.
2. Perlmutter M, Myers N. Recognition memory in two to four year olds. Dev Psychol. 1974;10:447-450. 3. Lindsay DS, Johnson MK. The eyewitness suggestibility effect and memory for source. Mem Cognit. 1989;17:349-358.
4. Foley MA, Santini C, Sopasakis M. Discriminating between memories: evidence for children’s spontaneous elaborations. J Exp Child Psychol. 1989;48: 146-169.
5. Ceci SJ, Bruck M. Suggestibility of the child witness: a historical review and synthesis. Psychol Bull. 1993;113:403-439.
6. 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.
7. Garven S, Wood JM, Malpass RS, Shaw JS 3rd. More than suggestion: the effect of interviewing techheniques from the McMartin Preschool case. J Appl Psychol. 1998;83:347-359.
8. 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.
9. Ceci SJ, Huffman MLC, Smith E, Loftus EW. Repeatedly thinking about non-events: source misattributions among preschoolers. Conscious Cogn. 1994;3:388-407.
10. 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.
11. 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.
12. 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.
13. 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 Erlbaum; 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 Erlbaum; 2007:11-35.


 
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