Charles L. Scott, MD

Of the nearly 3.6 million children who were the subjects of a Child Protective Services 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.


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, 

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.

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.

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.

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.

 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 Manhattan 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”

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 on your privates?” represents a highly leading question if the child had not mentioned any type of inappropriate touching.

This tech­­­nique consists of asking the child a question that he has clearly just answered. The transcript excerpt from the McMartin case illustrates this particular technique:

      Did your teacher touch you in your private area?


                No, he didn’t.


     Do you remember him touching you at all down there?


                Yeah, well, I guess so.

 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?”

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:

      Your mommy told me that Johnny touched you when she left the kitchen.


 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 behaviors.

 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 suggests 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.

 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 day-care 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 childrens’ 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?”). Fifty-two percent 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.

 5- and 7-year-old girls (n = 36) had an external genital and anal examination as part of a 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.


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 outlined in 

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 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.


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 allegation are highlighted in 


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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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.


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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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. 

Author | Charles L. Scott, MD

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Forensic Issues in Child Sexual Abuse Allegations