GUIDING PRINCIPLES IN ASSESSING CHILD SEXUAL ABUSE CASES

1. GUIDING PRINCIPLESIN ASSESSING CHILD SEXUAL ABUSE CASES L. Dennison Reed, Psy.D.

2. Psychologists who work with children will almost certainly encounter some children who are known or suspected victims of sexual abuse • Concerned parents often consult with psychologists in this regard • Psychologists who evaluate or treat children for issues unrelated to CSA may come to suspect sexual abuse • Psychologists who know or have a reasonable cause to suspect that a child has been sexually abused are legally mandated to notify the Child Abuse Hotline

3. Guiding Principle #1:Children’s Safety and Welfare Always Come First! The law and APA guidelines make it clear that when children are involved it is the children’s best interests that should always be given top priority The child’s best interests and safety are more important than: The wishes of the adults involved in the case The therapeutic relationship

4. Guiding Principle #2 The Goal of Every Child Sexual Abuse Evaluation Should be to Arrive at the Truth

5. The “Alicia” Case What is ‘the truth’ in this case?

6. Background information: Alicia is 8 years old. Her mother brought her to her pediatrician because Alicia was complaining of vaginal pain. Alicia’s mother told the pediatrician that when Alicia woke up that morning, she told her mother that her pee-pee hurt “real bad.” Alicia’s mother told the pediatrician that she thought that a yeast infection might be causing Alicia’s vaginal pain since Alicia has a history of yeast infections.

7. Medical Findings:When the pediatrician examined Alicia, he found evidence of severe acute trauma to Alicia’s vaginal area; she also had a dilated anal sphincter. The doctor told Alicia’s mother that the injuries were so severe that Alicia would need to undergo emergency surgery.

8. The Pediatrician Questions Alicia and contacts the Abuse Hotline: When the pediatrician asked Alicia what had happened to her pee-pee, Alicia was quite avoidant and did not volunteer any information. The pediatrician then contacted the Abuse Hotline. Since this is a high priority report, law enforcement and DCF were required to respond the same day.

9. Law Enforcement and DCF Interview Alicia at the Hospital:Initially, Alicia was quite reluctant to discuss what had happened. However, after some encouragement, she admitted that ‘someone’ had, in fact, ‘hurt her pee-pee and her bottom.’ When asked who had done this, Alicia said it was “a man,” but claimed that she did not know who the man was . . .

10. (continued):Law Enforcement and DCF Interview Alicia at the Hospital In response to further questioning, Alicia claimed that, during the night, this stranger had entered her bedroom while she was sleeping, had taken her somewhere in a car, had raped and sodomized her, and then brought her back home and put her in her bed and left. Alicia said that after the stranger put her back in her bed, she went back to sleep and did not wake up until the next morning.

11. Law Enforcement and DCF Interview Alicia’s Father:Law enforcement and DCF then spoke to Alicia’s father individually. Alicia’s father is an 18-year veteran of the Navy. He has no known history of abusing Alicia, nor any record of abusing any children. He does, however, have a history of alcohol-related problems. Alicia’s father claimed that he heard nothing unusual during the night; and that when he checked on Alicia at about 7 AM this morning on the way to work at the naval shipyard, she appeared to be sleeping peacefully.

12. Law Enforcement and DCF Interview Alicia’s Mother: Alicia’s mother denied that she heard anything unusual during the night and reported that Alicia woke up about 8:30 AM. When questioned, Alicia’s mother reluctantly admitted that she was incestually abused as a child. When the investigators suggested that Alicia’s account was questionable and started asking questions about the whereabouts of Alicia’s father during the previous night, Alicia’s mother became quite defensive and angry . . .

13. (continued)Law Enforcement & DCF Interview Alicia’s Mother:She insisted that her husband is a good father and not a “pervert” and that he would never sexually abuse Alicia or any other child. When the investigators said that it might become necessary for Alicia’s father to leave the home at some point if further evidence suggested that her father was a suspect, Alicia’s mother said that there was “no way” that she would make her husband leave the home because he had done nothing wrong.

14. Psychological Evaluation of Alicia’s Father:The court ordered that Alicia’s father undergo a psychological evaluation. The court-appointed psychologist did a battery of testing and determined that Alicia’s father did, in fact, have the psychological profile of an incest offender.

15. Alicia’s subsequent disclosures while in therapy and foster care:The court ordered that Alicia be placed in foster care and that she begin therapy immediately to provide emotional support for Alicia and to see whether she would reveal any further information about her abuse. In the beginning, Alicia continued to tell her therapist and foster parents that she had been abducted by a stranger, sexually abused, and then returned to her bed, even though they were quite skeptical of her story . . .

16. Alicia’s subsequent disclosures while in therapy and foster care (continued): Eventually however, after months of support by her therapist and her foster parents, Alicia finally admitted to her therapist and to her foster parents that it was actually her father who had sexually abused her and not the ‘unknown man,’ as she had originally claimed

17. What was ‘the Truth’ in the Alicia case?

18. What Are the Costs Associated With Mistakenly Concluding that Abuse Occurred or that the Wrong Person was the Abuser? An innocent person could lose their freedom (prison); their money (defense costs/job loss); their relationships (marriage, children, friends); their reputation; their sanity. An innocent child could lose a loving parent; their mental health; their standard of living. Other family members are adversely impacted, e.g., the non-offending parent, siblings, etc.

19. What are the Costs Associated With Failing to Detect Sexual Abuse? The identified victim continues to be abused. The victim fails to receive support and appropriate services. The perpetrator is likely to abuse other children.

20. Mistaken Judgments in Either Direction are Extremely Costly!

21. What was the major mistake that the investigators made in the Alicia case ? _____________ __ ______________ From the very beginning of the case, they thought they already “knew” what happened. So there was no reason to investigate other possibilities The investigators’ “BIAS” led them away from the ‘truth’

22. Examples of “Jumping to Conclusions” and Evaluator BIAS in the Alicia Case • Assuming that “improbable” allegations can’t be true: • No one would abduct and rape a child then return her to her own bed! • A child who was brutally raped by a stranger would immediately tell her parents! • A mother who was an incest victim, and is uncooperative, and insists her husband is innocent must be covering up for her guilty husband/herself • Alcohol problems cause men to sexually abuse kids • There are ‘psychological profiles’ that accurately identify incest offenders

23. Other common misconceptions that cause Psychologists and others to ‘jump to conclusions’ in CSA cases • CSA allegations that come forth during child custody disputes are always bogus • Children never make false allegations of being sexually abused • Children under 6 years old are so easily led that they aren’t capable of providing accurate information about sexual abuse • The suspect is such a ‘jerk’ that he must have molested the child • The suspect is such a likeable guy that he couldn’tpossibly have molested the child • No medical evidence of abuse = no sexual abuse

24. When Evaluators focus on only ONE THEORY, they run the risk of completely ignoring the CORRECT THEORY (the ‘truth’)

25. Evidence that was IGNORED in the Alicia case because investigators focused on only ONE theory • Alicia’s initial allegations • A pattern of similar crimes in the neighborhood • Failure to collect/examine physical evidence: • The semen in Alicia’s panties • Physical evidence at Alicia’s home, e.g., signs of entry through her bedroom window, fingerprints, foot prints, dirt/grass on window sill, hair, blood, etc. • Physical evidence at the crime scene • Failure to interview neighbors to determine whether they saw anything suspicious, e.g., an unfamiliar vehicle in front of Alicia’s house

26. WHEN ARE PSYCHOLOGISTS MOST LIKELY TO ‘LEAD’ CHILDREN? • When they ‘jump to conclusions’ and are BIASED: • Their questions focus only on their pet theory and they fail to ask questions about other theories • They ask leading questions based on what they assume happened • They don’t take ‘no’ for an answer and keep repeating the same questions until they get the answer they ‘think’ is correct • Psychologists who ‘lead’ children will be attacked in court!

27. TYPES OF BIASES WHEN EVALUATING FOR POSSIBLE CSA “Confirmatory Bias” “Disconfirmatory Bias” Both types of bias involve jumping to conclusions, then seeking to prove that those conclusions are correct Objectivity is lost and ‘the truth’ is obscured when this happens

28. CONFIRMATORY BIAS • Jumping to the conclusion that the child was sexually abused then seeking information that confirms that conclusion, while ignoring information that does not support that conclusion • The child is displaying abnormal sexual behavior so she must have been sexually abused • Ignoring the possibility that the child may be imitating something she saw her parents doing when they thought she was sleeping

29. DISCONFIRMAORY BIAS • Jumping to the conclusion that the child was not sexually abused then seeking information that disconfirms sexual abuse, while ignoring information that the child was sexually abused • The child’s allegations came forth during an acrimonious custody battle, therefore the child must have been ‘coached’ by her angry mother to make false allegations against her father • Ignoring the fact that neither the mother nor the child had anything to gain by making false sexual abuse allegations

30. Mistaken Beliefs can be Contagious! Ceci, et al. (2007) commenting on their review of the findings from research regarding children’s suggestibility: • “These studies have found that children who are interviewed by an individual who has been misinformed [or who has a mistaken belief] about what has occurred begin to report this misinformation themselves.”

31. How can Psychologists avoid “Jumping to Conclusions” during forensic interviews? Always consider MULTIPLE theories about what might have happened Develop at least three theories for every case and explore the merits of each one

32. Some Possible Theories When Child Sexual Abuse is Suspected The child was sexually abused as suspected There was a misunderstanding between the child (typically a preschooler) and the reporter: 3-year-old tells mother: “Daddy hurt my pee-pee!” Mother assumes child is referring to sexual abuse Possible ‘innocent’ explanations: Daddy may have put medication on child’s irritated vaginal area; or wiped or bathed her in a manner that was painful to her

33. More Possible Theories WhenChild Sexual Abuse is Suspected • The child (almost always a preschooler) was inadvertently led to make false allegations: Concerned mother observes 3-year-old rubbing her vagina and says: “Why are you touching your pee-pee? Who taught you to do that?” It’s okay, you can tell me. Was it daddy?” Child feels compelled to say, “Yes.”

34. More Possible Theories WhenChild Sexual Abuse is Suspected • The child was deliberatelycoached or pressuredby an adult to make false allegations • During a forensic interview, a 7 year old stated, “Daddy put his mouth on my pee-pee.” The interviewer then asks, “Did somebody tell you to say that?” The child responds, “Yes. My mommy did.” • Is the child’s statement powerful evidence that the mother deliberately coached the child to make a sex abuse allegation that the mother knew was false?

35. More Possible Theories WhenChild Sexual Abuse is Suspected • The child is deliberately fabricating allegations of abuse • This appears to be very rare among pre-teens; however, there have been ‘some’ documented cases in which teenagers have made false allegations to ‘cover their tracks,’ e.g., explaining why they came home late, or how they became pregnant. But it is far more common for sexually abusedteenagers to refuse to tell anyone that they were abused

36. The Facts about Custody Cases • The actual number of true/false CSA allegations coming forth during custody litigation is UNKNOWN • There is no good reason to assume that such allegations are any more likely to be false than true • Sometimes true allegations of sexual abuse come forth during custody litigation because, after the parents separate: • (1) The sexually abused child may feel it’s ‘safer’ to disclose the abuse • (2) The sexual abuse may begin or escalate once the perpetrator is ‘alone’ with the child—without mom around

37. KEY POINTS IN EVALUATING CSA CASES Children’s safety and welfare are paramount The goal of every CSA screening/evaluation is to arrive at the truth The greatest obstacle to arriving at the truth is the natural tendency to “jump to conclusions” (Evaluator BIAS) Developing at least three theories at the outset and investigating the merits of eachis a powerful antidote to jumping to conclusions and Evaluator BIAS