THE DISCLOSURE PROCESS AMONG VICTIMS OF CHILD SEXUAL ABUSE

1. THE DISCLOSURE PROCESS AMONG VICTIMS OF CHILD SEXUAL ABUSE L. Dennison Reed, Psy.D.

2. Questions about the Disclosure Process Among Victims of CSA • What proportion of CSA victims do not disclose their sexual abuse? • Why are some victims of CSA reluctant or unwilling to disclose their abuse? • Which CSA victims are least and most likely to disclose during a forensic interview when screened for abuse?

3. Information about the Disclosure Process Is Drawn From Two Sources • Retrospective studies of adults who reported that they were sexually abused as children • Children whose abuse was ‘confirmed’ (e.g., by child protective services, law enforcement, the court system)

4. There are Major Limitations in our Knowledge About the Disclosure of CSA Due to ‘Sampling Bias’ • Our information about the disclosure process is limited to samples of identified victims only • Many unidentified victims are excluded: • Children who do not disclose their abuse • Children who disclosed to ‘someone’ during childhood but whose abuse was never reported to the authorities • Reported cases that were erroneously classified as “unsubstantiated” • Adults who were sexually abused as children but who deny their abuse during retrospective surveys

5. What proportion of CSA victims disclose their sexual abuse? • Because many victims of CSA are never identified as victims, the actual rates for non-disclosure cannot be determined • Data from known and likely victims, however, suggest that non-disclosure rates are probably quite substantial

6. DISCLOSURE DATA FROM ADULT SAMPLES(Retrospective Studies)

7. Retrospective studies have found that NON-DISCLOSURE of CSA during childhood is very common • Approximately TWO-THIRDS [60-70%] of adults who reported (during retrospective studies) that they were molested as children say they did not disclose their abuse to anyone during childhood (e.g., not even to a friend or a parent) London, et al (2007)

8. Even ‘severe’ child sexual abuse is rarely reported to the authorities during childhood • A nationally representative retrospective survey of over 4000 American women, found that only 12% of childhood “rapes” were reported to the authorities • “Rapes” were defined as nonconsensual sexual penetration of the victim’s vagina, anus or mouth by the perpetrator’s penis, finger, tongue or an object that involved the use of force or the threat of force or coercion. Rochelle F. Hanson et al (1999). Factors Related to the Reporting of Childhood Rape, Child Abuse & Neglect, 23, 559- 569

9. Which children were most likely to disclose their abuse to “someone” during childhood? • Retrospective studies have found that adults who experienced CSA during adolescence were more likely to have disclosed their abuse to someone than those who were abused at a younger age. • They most commonly disclosed to a peer. (Bruck, et al, 2007)

10. DISCLOSURE DATA FROM CHILD SAMPLES IN HIGH CERTAINTY CASES • Diagnostic medical evidence of CSA (e.g., STDs) • Audiovisual evidence (e.g., videotapes of the abuse) • Offender confession

11. Even When There Is Diagnostic Medical Evidence of Sexual Abuse, Many Children Still Fail To Disclose Their Abuse • Across 21 studies examining gonorrhea in children, the average disclosure rate was only 43% • Having an unsupportive parent was a strong predictor of non-disclosure • Thus, when screened for sexual abuse, MOST children with gonorrhea denied they were abused

12. A substantial proportion of sexually abused children failed to disclose their abuse even though there were VIDEOTAPES of the abuse • Videotapes were discovered depicting a man sexually abusing 10 different children (9 boys, 1 girl) • None of the children disclosed their sexual abuse to anyone prior to being interviewed by the police • Half denied the abuse when interviewed by the police. Those who did disclose minimized the extent of the abuse

13. Even when the offender confesses, some children fail to disclose their abuse—at least initially • Sorenson & Snow study (1991) • 116 cases: 80% offender confessed; 14% criminal conviction; 6% medical evidence • When initially interviewed, 72% did not disclose their abuse • Over time (while in therapy), 96% eventually disclosed

14. Although many children are reluctant to disclose abuse initially, many do so after a period of time, or after repeated questioning • Delayed disclosure is common bothin retrospective studies of adults and in child samples • Disclosure is often a ‘process’ that occurs over time rather than being a single ‘event’ • Multiple interviews may be necessary with some children; however, this also increases the risk of leading some non-abused children to make false allegations

15. What do children’s denials of abuse mean about the likelihood of abuse? • “. . . to the extent that denial rates are surprisingly high, an expert can justifiably testify that that denials are surprisingly weak evidence against abuse” (i.e., that abuse did not occur) Lyon, T. (2007). False denials: Overcoming methodological biases in abuse disclosure research. In Child Sexual Abuse: Disclosure, Delay and Denial. Pipe, et al. Ed.

16. Why Are Many Victims of Child Sexual Abuse Reluctant to Disclose their Abuse?

17. SEXUAL NAIVETÉ -Youngand sexually naïve children may not even realize that they have been abused. Molesters who target younger children often misrepresent the abuse as something innocent: Game or playful activity, i.e., tickling, wrestling display of affection hygiene practice massage educational, i.e., swimming lessons, sex education

18. SEXUAL MODESTY Children receive “modesty training” about sexual topics early on. “Private” Parts

19. NON-ABUSED CHILDREN’S REPORTS OF VAGINAL AND ANAL TOUCHING DURING A MEDICAL EXAM5 and 7 year old girls(Saywitz, Goodman, Nicholas & Moan, 1991)

20. SampleN = 72 females5 & 7 year-olds Half (36) of the children received a routine medical exam, including a vaginal and anal exam. The other half received a routine medical exam, but with a scoliosis (spinal) exam instead of a vaginal and anal exam.

21. STAGE 1OPEN-ENDED QUESTIONINGNO ANATOMICAL DOLLS“Tell me everything you remember about your visit to the doctor.” • 22% Disclosed Vaginal touching • 11% Disclosed Anal touching

22. STAGE 2OPEN-ENDED QUESTIONING WITH ANATOMICAL DOLLS“Show and tell me what happened when you went to the doctor’s” (using anatomical dolls and medical props) • 17% Disclosed Vaginal touching • 11% Disclosed Anal touching • Note: Lower rate of disclosure of vaginal touching when anatomical dolls were used (22% vs. 17%)

23. STAGE 3SUGGESTIVE QUESTIONING WITH ANATOMICAL DOLLS“Did the doctor touch you there?” (pointing to various body parts on anatomical dolls) • 86% Disclosed Vaginal touching • 69% Disclosed Anal touching

24. False Reports of Genital and Anal Touching by 5 & 7 year olds(Scoliosis Condition) Anatomical dolls + option-posing questions • One of the 36 children (< 3%) erroneously answered “yes” when asked if doctor touched vaginal area. • Two (< 6%) erroneously answered “yes” when asked if doctor touched anal area. • Only one of these three children were able to provide anydetail about the alleged touching.

25. MISPLACED GUILT • Many sexually abused children feel at least partially responsible for their own abuse • “It was my fault” (e.g., It was because I dressed that way; It was because I didn’t lock my door; It was because I was too pretty) • “I should have stopped him/her” • “I should have told the very first time” • Many sexually abused children feel guilty for having become sexually aroused during their abuse

26. For many sexually abused children, disclosing their abuse feels more like confessing a sin, than reporting a crime Their misplaced sense of guilt is a powerful motivator for keeping their abuse a secret

27. STIGMA and SHAMEPre-teen and teenaged BOYS are often extremely reluctant to disclose abuse by a MALE • “Homophobia” is rampant among boys this age • This sense of shame can be reinforced by the victim experiencing an erection during the abuse • Male molesters who target boys are also masterful at befriending their victims and ensuring that they remain ‘loyal’

28. Compliant Teenaged Victims • Teens are naturally interested in sex and often seek out sexual experiences • Teens often want to engage in ‘adult’ behaviors and may feel flattered and more ‘mature’ when an adult shows a sexual interest in them • The burgeoning independence of teens creates opportunities for those who would molest them, i.e., unsupervised activities, chat rooms, etc.

29. FEARS OF SEPARATION & REJECTION • Victims may fear that if they tell they will be separated from loved ones--including the perpetrator who is oftentimes a beloved relative or friend. The child may be confused or repulsed by the abuse, but still love or care for the abuser • The victim may fear that if she discloses the abuse, loved ones will be angry with her and will blame her for : • Lying/making false allegations • Not telling earlier; “seducing” the perpetrator • Causing family hardships by disclosing the abuse

30. Secrecy Pacts • Child molesters sometimes directly ask or entice the child to keep the abuse a secret • This is our little secret so don’t tell anyone else, ok? • Here’s a new video game because you’ve been doing really good at keeping our secret

31. Analogue Studies have shown that children can often be persuaded by adults to “keep secrets” • During a magic show for 6 &10-year-olds, the magician ‘accidentally’ spilled ink on the child’s ‘magic gloves’ then hid the gloves and warned the child not to tell because this was their ‘secret.’ When asked about the magic show, only 25% of the 6-year-olds and 66% of the 10-year-olds volunteered information about the ‘accident’ (Wilson & Pipe, 1998) • Mothers of 49 kids from ages 3 to 6 ‘accidentally’ broke the head off of a Barbie Doll and asked their children to keep this a secret. When specifically asked what had happened to the Barbie Doll, only one child betrayed her mother and told (Bottoms et al., 1990)

32. THREATS OF PHYSICAL HARM • To the victim • To the victim’s loved ones, i.e., parents, siblings, pets • BUT, threats of physical harm are rarely needed to maintain secrecy

33. Dissociation and PTSD-related Amnesia This is far more likely when the abuse is terrifying, painful, repetitive and emotionally or physically intolerable for the child. “Whenever he did that, I went to the pink forest.” “I left my body and hid in a crack in the wall.” “I watched Mickey Mouse cartoons in my head when it started to hurt real bad.” “I think I was sleeping. PTSD and Dissociative amnesia can give rise to delayed memories and flashbacks

34. Factors that Inhibit Disclosure • Sexual Naiveté • Sexual Modesty • Misplaced Guilt • Stigma and Shame • Fears of Separation and Rejection • Secrecy Pacts • Threats of Physical Harm • Dissociation and PTSD-related amnesia

35. Factors Associated with Disclosure during Forensic Interviews • Having made a prior disclosure • Being an older victims • Perpetrator is not a relative • Parental support

36. The best predictor of disclosure during a forensic interview is the child having made a prior disclosure to someone (e.g., a parent, a therapist, a teacher)

37. Older Children are more likely than younger children to disclose their abuse during forensic interviews • Younger children are more likely to make ‘accidental’ or spontaneous disclosures, without realizing the significance of their abuse Example: 4 year-old being bathed by mom spontaneously says, “Uncle Joey likes to lick my pee-pee.”

38. Age-related Trends in Disclosure During Forensic Interviews in Israel(Hershkowitz, et al, 2007) • Sample: All child abuse investigations conducted in Israel from 1998 – 2002;N = 26,325 3- to 14 year old alleged victims of sexual and/or physical abuse • Percent making no abuse allegations: • More than half of 3-6 year olds • One-third of 7-10 year olds • One-fourth of 11-14 year olds

39. Cognitive Factors and Sexual Naiveté Are Likely to Contribute to Lower Disclosure Rates Among 3 – 6 year-olds(Hershkowitz, et al 2007) • Very young children may not understand that what they experienced was sexual abuse • Very young children are disproportionately likely to misunderstand the purpose of the forensic interview; they might be willing to disclose the abuse if they understood that this was the purpose of the interview

40. Children were much more likely to disclose abuse by a non-relative than a relative(Hershkowitz, et al, 2007) • This was true for children of all ages; however, the 3- to 6-year olds were especially reluctant to implicate a close family member

41. Parental Support • Children with STDs (e.g., gonorrhea) were questioned about possible abuse during a forensic interview • When their parents rejected the possibility that they were sexually abused, only 17% disclosed • 67% of children whose parents were open to the possibility that their child had been sexually abused disclosed their sexual abuse Lawson, L. & Chaffin, M. (1992).

42. Some Sexually Abused Children Disclose Their Abuse But Later RECANT Their Valid Allegations

43. Why Do Sexually Abused Children Sometimes Recant Their Valid Allegations of Abuse? • For the same reasons that children fail to reveal their sexual abuse in the first place • Also, negative reactions to the disclosure can be a very potent cause of recantation: • Parent appears overwhelmed, hysterical, angry and “out of control” -- this is especially upsetting for younger children • Parent blames victim for not resisting the abuse; for ‘seducing’ the abuser; or for not disclosing earlier • Family members are angry at victim for creating hardships for the family

44. Other Reasons Sexually Abused Children Sometimes Recant Their Valid Allegations of Abuse • The child is separated from the family, e.g., placed in foster care • Threats/enticements by perpetrator or others to recant • To protect or ‘rescue’ the perpetrator • Stress associated with involvement in the legal system, e.g., having to testify

45. Recantation Rates Are Also Affected by the Length of Follow-Up

46. Only 4% of “confirmed” victims recanted when interviewed only one time by investigators (Bradley & Wood,1996) But children who recant when initially interviewed by investigators are not likely to be classified as “confirmed” victims 22% of confirmed victims recanted at some point while in therapy—often after a period of months (Sorenson & Snow, 1991) Longer Follow-Up Periods Often Result In Higher Recantation Rates

47. Recantation Can Occur At Any TimeAfter the Initial Disclosure • When pressured by the perpetrator, family members, etc. • When interviewed by investigators • While in therapy • In anticipation of testifying • While testifying during a deposition • While testifying at trial • After the trial

48. A Case of Recantation Occurring During a Deposition

49. St. of Florida vs. James HeussBackground Information • Molested several young girls while he was in the Navy -- General Discharge • Moved to Texas. Convicted of molesting several young girls -- Outpatient sex offender treatment--“model patient” • Moved to southern Florida. Penetrated a 3-year-old girl. There was medical evidence -- Case dropped when victim’s parents refused to subject child to the legal process • While in Ft. Lauderdale, Heuss molested three female cousins ages 4 & 5. Perpetrated oral sex, digital-vaginal penetration. Medical evidence of penetration.

50. All three girls Disclosed the Abuse • One girl came home with blood in her panties and her mother questioned her. • This led to acknowledgment by the other two girls that ‘Jimmy’ had abused them, too. • Despite being very young, they all gave credible statements to the police