Interviewing the Child Victim

The Child Interview is at the core of the multidisciplinary team investigation of child sexual abuse. The child is often the only "eye witness" to the abuse and his/her recollection of the experiences is crucial to identifying the offender and describing the type and extent of the assault.

A forensically dependable case requires that child victims report their recollections in reliable ways, not influenced by externally imposed ideas or interview practices. Ability to accomplish this depends on the interviewer's ability to provide care and comfort to the child while seeking information with objective, non-suggestive interview approaches and techniques. Achievement of this two-fold purpose of the child interview begins before the interview is conducted by having a working knowledge of factors that contribute to successful interviews of children. These factors include:

1. Child sexual abuse dynamics.
2. Process of disclosure.
3. Developmental factors that effect the interview process.

"The Child Sexual Abuse Accommodation Syndrome," Roland Summit, M.D. (1983).

The Accommodation Syndrome is used to explain the child's position in the dynamics of sexual victimization. Dr. Summit describes how child sexual abuse (CSA) occurs in families, how it requires survival strategies from victims, and how the victims face secondary trauma during disclosure. The most typical reactions of children are called the Child Sexual Abuse Accommodation Syndrome (CSAAS). The reactions are:

• Secrecy
• Helplessness
• Entrapment and accommodation
• Delayed, conflicted, and unconvincing disclosure
• Retraction

The five categories explain the denial, delayed disclosure, and subsequent system response in CSA cases. The "Child Sexual Abuse Accommodation Syndrome," (Summit, 1983), the seminal paper on CSA dynamics, also applies to out-of-home abuse because the abuser is usually known and trusted by the child. The efficacy of the information is now supported by years of empirical research and experience.

Dr. Summit also wrote a follow-up article entitled, "Uses and Misuses of the Child Sexual Abuse Accommodation Syndrome in Court Testimony", (1992). Both of these articles are excellent resources for court preparation.

A definitive study conducted by Sorenson and Snow (1991) supports the growing body of evidence showing that disclosure is not a one-time event. Follow-up sessions are needed to provide time for the tentative, but eventual full disclosure. The design of the study included an analysis of 116 cases of confirmed sexual abuse (confession 80%, conviction 14%, and medical 6%). Ninety percent of the cases involved multiple incidences; 74% were abused by family member; 26% made purposeful disclosures; and 76% made accidental disclosures.

Almost 75% of the victims denied abuse at the first interview. Only a few (7%) of those who denied the abuse moved directly to active disclosure during the interview and only 11% were able to give full disclosure without denial of tentative features. (Twenty-two percent recanted abuse during the interview). Ninety-six percent went on to disclose.

The commonly held presumption that children can immediately provide active disclosure by giving a coherent, detailed account in a single investigative interview is not supported by this data. The implications for interviewing are:

1. Guidelines should reflect understanding of how children disclose abuse.
2. Validation and videotaping decisions should consider if the child was in active disclosure at the time of the interview and if not, provide follow-up interview(s) for full disclosure. (Sorenson and Snow, 1991)

Memory

"When children are interviewed skillfully and patiently, they can remember what they know. The key to unlocking children's secrets lies not in improving [their] memory but in improving the skill of adults who talk to children." Myers, (1992), p.1.

A child's memory like, that of an adult, has three functions: acquisition, storage and retrieval. The first requirement for remembering an event is to perceive it. If children pay attention at the time an event occurs, they are quite capable of perceiving and storing it. Ability to store information does not seem to be greatly associated with age (Werner & Perlmutter, 1979).

The interviewer's challenge is to help the child retrieve a memory that may be there but is not easily communicated. Young children may have trouble translating the existence and content of a memory into a verbal description (Perry, 1992).

In order to assist in the retrieval of a memory, it is important to know the three types of memory retrieval.

1. Recognition Memory

Recognition memory is the simplest form of memory recall. It only requires recognition that an event, person, or object has been previously experienced. It is within the capacity of infants and improves with age, with one interesting exception. Several studies have shown that face recognition improves with age through age 10, declines from 11 to 12 years, and picks up again at 13 (Carey, 1978; Goodman & Reed, 1986). This is a good example of why knowledge of memory development research can improve interviewing practice. The practice of using photo and "line-up" identification in assault cases would be contraindicated for children 11 to 13-years-old because of this developmental factor.

2. Reconstruction Memory

Reconstruction memory recall is a more sophisticated form of recognition that involves reconstructing the context (where, when and under what circumstances an event occurred). It requires mentally recreating a previous experience within the context of the physical and psychological surroundings. Research supports that using context reconstruction when interviewing increases the amount of detailed information that can be retrieved. This memory enhancement technique can also be facilitated by prompts and props that cue the victim's memory of the original event. The more "feature overlap," i.e., the more the prompts resemble each other or have factors that overlap the original context, the more details are retrieved. For young abuse victims, the doll house often represents the scene of the crime, stimulates memory, and provides a means to reconstruct and demonstrate what happened. Older children and adolescents can use drawings and house/room diagrams to create the context and content of their abusive experiences. This cognitive interview technique is based on this principle of "context re-instatement" (Fisher, Amador, Gesselman, 1989).

3. Free Recall

Free recall is the most complex form of memory and requires retrieval with few or no prompts. It is strongly age related. Without prompts and cues, preschool and young children can only recall one or two facts about an event, 3rd and 4th grade children about three facts, 7th and 8th grade children about six, and adults about seven or eight (Marin, Holmes, Guth & Kovac, 1979).

Young children are not proficient at free recall and applying the context reconstruction principle provides an effective memory retrieval approach. Using verbal and nonverbal prompts and props as tools for applying the approach is an integral part of Best Practice Interviewing.

Using Memory Research to Improve Interviews with Children

There is now a considerable body of knowledge/research regarding children's ability to provide accurate accounts of events. The research supports the idea that even very young children have memory skills necessary for providing accurate reports (Melton, 1980). It is the interviewer's job to help them use these skills.

It is important to know that young children can retain both familiar and novel events (Nelson, 1986). Traumatic events like sexual assault can be communicated by very young children. There is convincing evidence that children 18 to 36 months retain memories of abuse. If they lack sufficient language to report at the time of the abuse they can give detailed accounts of the abuse at a later age (Hewitt, 1994; Terr, 1988). In fact some studies have found that memory for stressful events is stronger than that for non-stressful ones (Peters, 1987).

A consistent finding is that young children can remember more than they can spontaneously recall and need verbal and nonverbal cues and prompts (Fivash, et.al, 1986; Price & Goodman, 1990; Dent, (1990). This is a compelling reason for including interviewing aids in interviewing guidelines. If excluded, young children are deprived of their most developmentally appropriate and helpful means of describing their experiences.

Older children are better at free recall memory, i.e. they can give a narrative account in response to an open-ended question like, "What happened?" They have a larger vocabulary while young children may simply not have the necessary words to describe an event (Sawitz, Goodman, & Myers, 1990).

Older children and adolescents, however, also need facilitative interview tools. (See Interview Guidelines)

Additional Resource:
Warren, Hunt, & Perry (1996). It sounds good in theory…but: Do investigative interviewers follow guidelines based on memory research? Maltreatment, 1 (3).

Suggestibility

Much attention has been given to whether children's memories and reports of sexual abuse are influenced by suggestions or coaching from interviewers, parents, and others. Research shows that children under age four may be more susceptible to suggestion when interviewed in an intimidating atmosphere, but their answers to specific questions about the reported abuse remain accurate (Clarke-Stewart, et.al., 1989). It is important to establish rapport to offset any possibility that a child might be more suggestible in deference to an adult authority figure. In one study, three- and four-year-olds interviewed by a friendly adult, compared to a cold, neutral adult, were less susceptible to leading questions (Myers, et al, 1989). Other studies indicate four-year-olds do not necessarily make more false reports by answering "yes" to questions than older children (IBID).

Young children's reports may have even more reliability in relation to deliberate, forced, or coached lying because most young children do not have sufficient knowledge of adult sexual activity to maintain a convincingly detailed lie about sexual activity (Goldman & Goldman, 1988). This developmental lack of sexual knowledge also argues against fantasy based reports from young children (deYoung, 1986).

Research consistently finds that children 10- to 11-year-old are no more suggestible than adults (Saywtz, Goodman, & Myers, 1990). Even though research suggests that professionals should be more concerned about false negatives than false positives, it is prudent to avoid the possibility of suggestion by:

1. Reducing the number of questions and "rapid fire" questioning that could intimidate the child. Also avoid repetition of the same question as if the previous response was not acceptable. Ask the question in a different way or seek the information in another form.
2. Avoid "selective reinforcement" of a particular response style (answering "yes" or "no" or "not sure" to all inquiries) that could influence a weak memory by implying adult approval of that response.
3. Reduce the status differential between the child and the interviewer by friendly vs. authoritative demeanor, and by telling the child she/he knows what happened and the interviewer does not. That is why the information needs to come from the child.
4. Emphasize that there are no right/wrong answers like at school. The interviewer only wants to hear what the child remembers, no guesses.
5. Limit the number of interviewers, all of whom may have different styles and ask different questions. This could seem contradictory, confuse the child, and result in responses that appear inconsistent.
6. Leave prior information and/or presumptions about the case outside the interview to control internal and external bias and unintentional leading questions.
7. Avoid referencing prior disclosure, if possible, to ensure the child is disclosing information about the event and not about the previous disclosure.

TABLE 1: COMPARISON OF DEFINITIONS OF LEADING QUESTIONS IN THE CHILD'S FORENSIC INTERVIEW

© Mark D. Everson, Ph.D., University of North Carolina at Chapel Hill, 1999. Permission given to duplicate with author citation.

TABLE 2: TYPOLOGY OF LEADING AND SUGGESTIVE QUESTIONS

© Mark D. Everson, Ph.D., University of North Carolina at Chapel Hill, 1999. Permission given to duplicate with author citation.

Saywitz, K., Goodman, G., Nicholas, E., & Moan, S. (1989). Children's memories of genital examination: Implications for cases of child sexual assault. Paper presented at the biennial meeting of the Society for Research on Child Development*

Sample: 72 middle and upper-middle class white females 36 5-year-olds; 36 7-year-olds.

Method: All children received a well-child exam; half received a genital and anal exam; half received a scoliosis exam. Children were questioned either one week or one month later, in 3 successive conditions: in free recall, using anatomical dolls, and with direct yes/no questions.

Results: 8 (22%) children receiving the genital exam mentioned it during free recall; 4 (11%) children receiving the anal exam mentioned it during free recall; 36% (100%) scoliosis exam children mentioned it during free recall. Anatomical dolls were not superior to free recall in facilitating description of the exams. 31 (86%) children receiving the genital exam responded affirmatively when asked a direct question; 25 (69%) children receiving the anal exam responded affirmatively when asked a direct question; there were 3 (8%) children in the scoliosis condition who said they had received a genital (1) or anal (2) exam.

Conclusions: A minority of children will give information about private parts touching when asked an open-ended question. A minority of children will not reveal private parts touching even when directly questioned. A small number of children (8%) will make commission errors to direct questions.

Steward, M. (1992). Preliminary findings from the UC Davis child memory study. The APSAC Advisor. 593):11-13.

Sample: 130 boys and girls, ages 37 to 84 months who came to an outpatient medical clinic.

Method: Children received medical care that involved body touching, 50% included genital touching. Subjects were interviewed shortly after, one month and 6 months after medical procedures. Children interviewed in four conditions: 1. verbal only; 2. anatomical dolls; 3. anatomical drawings; and 4. computer assisted interview.

Results: In the first interview, the condition did not differentiate in accuracy or amount of information. Children were very accurate (94%) but the amount of information recalled was sparse (25%). The enhanced interviews (e.g. anatomical dolls, etc.) were more effective than the verbal only a 1 month and 6 months, the computer assisted interview being the most useful.

Conclusions: Children's memory is quite accurate, but sparse. Props can be helpful in facilitating recall over the longer term.

Clark-Stewart, A., Thompson, W., & Lapore, S. (1989). Manipulating children's interpretations through interrogation. Paper presented at the Society for Research on Child Development, Kansas City.*

Sample: Seventy-five 5- and 6-year-old boys and girls.

Methods: Each child was in a playroom with a "janitor" (Chester the Molester) who engaged in activities with toys which he described. There were 3 conditions: 1) Chester said he was cleaning; 2) He said he was really playing; and 3) He said he was really playing and keep it a secret. Then each child was questioned or interrogated by "Chester's boss" in one of three conditions: 1) neutral; 2) incriminating (he was playing and not cleaning); 3) exculpatory (he was cleaning and not playing). Conditions were systematically varied. There was a second questioning by another confederate that might be the same or different from the first.

Results: When questioning was neutral and the interpretative questions (i.e. playing or cleaning) were consistent with the child's experiences, responses were accurate. All children who were subjected to interrogation inconsistent with their scenario eventually agreed with the interrogator. 64% of children in the "secret" condition said that Chester had cleaned or were noncommittal unless they received biased interrogations, in which case they went along with the interrogation.

Conclusion: Children can be pressured to change their interpretations of ambiguous events. If instructed to keep something a secret, a majority of children will do so.

Ceci, S. (1992). Preschool children's suggestibility. Paper presented at the American Psychological Association Annual Meeting. **

Sample: Children ages 3 to 5 years.

Method: For one month, children were given negative information about " Sam Stone", that he was clumsy, messy, etc. Sam entered their classroom for 2 minutes and behaved appropriately. Immediately afterward, children were shown a ripped book and dirty teddy bear, and asked leading questions, e.g. "didn't Sam do this?" Children were then subjected to 10 to 12 sessions in which they were told repeatedly that Sam was messy and dirty and tore the book and dirtied the bear. Children were again interviewed regarding Sam's culpability.

Results: When asked leading questions immediately after Sam had been in the classroom, the majority of the children said Sam had not torn the book or dirtied the bear. After programming sessions, 72% of the 3 - 4 year olds said Sam did it; 25% said yes when asked if they really saw this. After programming, 40% of 5 year olds said Sam did it; 11% said they saw him.

Conclusions: The majority of preschool children will not wrongfully implicate a person is guilty, even if given predisposing information and asked leading questions. Some children can be programmed with repeated sessions to falsely state an adult committed acts he did not. This is especially a problem with 3 to 4 year olds.

*Studies are published in Doris, J. (Ed.) (1991). The suggestibility of children's recollections. Wash., D.C.: American Psychological Association.

**A copy of the research is available from S. Ceci, Ph.D., Cornell University, Department of Psychiatry, Ithaca, NY.

Language

Understanding age related language capacity is crucial to victim specific interviewing. If interviewers know what they can expect from children of different ages, it takes the "guesswork" and anxiety out of the process and frees them to approach the interview in a more relaxed and focused way. Language is usually the first cue the interviewer has for how to proceed with the interview and select the tools to facilitate the interview.

Things to Remember about Language when Interviewing the Young Child

1. Avoid asking questions in language too complex for the child to understand. Listen to how the child communicates and try to accommodate to his/her style.
2. Use simple sentences with approximately the number of words the child uses. The younger the child, the shorter the sentence is a good rule of thumb.
3. Use simple grammar.
4. Use visual, concrete words and terms (policeman vs. law enforcement officer; gun vs. weapon; car vs. vehicle).
5. Don't use professional jargon.
6. Don't expect the young child to understand concepts of "measurement" of time, or length, or ordinal numbers. If asked these kinds of questions, the child may guess or exaggerate to try and answer the question.
7. Since there is some evidence that children under five may be more suggestible, at least about peripheral details, be careful not to infer or suggest any preconceived knowledge of the case through questioning. Tell the child that if you put a "guess" in any of your questions to tell you if you're wrong and tell you the right, true answers.
8. Young children are not proficient at free recall but should always be given a chance to tell what happened to them in their own rambling, free-style way. If some of the words are unintelligible they can be clarified with demonstrative aids, focused questions, and by asking then child to "show and tell about the part when you and daddy went into the bathroom." Children are familiar with this format for sharing information.

Cognitive and Language Development for Investigative Interviewing

Interviewing Children in Language They Understand

When eliciting a sexual abuse history, it's important to take into account the child's grasp of language and of concepts such as time. These guidelines will help.

1. Recognize that many children don't understand the concept of before and after. To find out if the child understands, ask a question like "Do you eat breakfast before or after lunch?"
2. Recognize that children are very literal. For example, many of them associate the word "touch" only with hands. If you ask, "Did he touch you in any other way?" the child is likely to say No, even if the abuser did touch her with his penis or mouth.
3. Children are bad at estimating. Don't ask "How many times did that happen?" Instead try asking "Did this happen one time or more than one time?"
4. Children can't give dates. Instead of asking "when did Daddy start touching you like that?" Ask, "What grade were you in?"
5. Don't use pronouns. Instead of, "What did he do next?" ask, "What did Daddy do next?"
6. Establish that the child understands prepositions before using them. Show her an object, such as a stapler, and ask, "Can you put your hand on the stapler? Under the stapler? Inside the stapler?"
7. Avoid the word "story". Don't say, "Tell me your story." Many children associate the word with make-believe or lies.
8. If you're going to change the topic, signal that change is coming. Say something like "Now, I want to switch and go to talking about who you told first."
9. Allow children to use their own words. If you teach the proper anatomical terms, the defense attorney is likely to make much of the that fact at trail asking, "What else did you teach this child to say? What other words did you put in her mouth?"
10. Don't ask leading questions. As in, "He took your clothes off, didn't he?"

Marx, S., & DeJong, A., (1994). When you suspect sexual abuse. Pediatric Management, March, 24-32.

This section is designed to guide interviewers through all phases of the interview process with professionally sound interviewing approaches and practices.

Although there is no one "right" way to interview child and adolescent victims, there is consensus among experienced interviewers on best practice approaches to conducting child victim interviews.

Best Practices Approach #1:

Narrative disclosures based on children's free recall memory provide the most reliable information. They do not, however, always provide the kind of detailed information needed for substantiating abuse.

Best Practices Approach #2:

A continuum of questions from general to specific can provide more definitive information, and be used to expand the narrative account and focus on the subject matter. The continuum begins with open-ended questions to elicit a narrative account and proceeds with focused, and then detailed inquiry to clarify the information given by the child.

Focused questions are asked to focus on the topic of concern: people, surrounding circumstances, and behaviors. In CSA investigations focus is on body touching behaviors. Questions focused on body parts are usually part of, or follow a body parts inventory. They may also be used later in the interview as information unfolds. Anatomical dolls and drawings are often used with behavior-focused questions. Person-focused questions are used to identify significant people in the child's life, including the alleged offender(s). Questions focused on the circumstances provide the context in which the behavior occurs (Faller, 2000).

See the following Table for a comparison of the completeness, accuracy, structure, and risk involved when using the types of questions in the continuum.

© Mark D. Everson, Ph.D., University of North Carolina at Chapel Hill, 1999. Permission given to duplicate with author citation.

Best Practices Approach #3:

Children respond with more information to friendly interviewers in child friendly environments. Interviewing aids contribute to a non-authoritative atmosphere and support the impression that the interviewer is there as a helper. If a child interview room is not available, the investigator can transport a "tool box/bag" with dolls, paper, markers, toy telephone, and puppets to the interview site.

Best Practices Approach #4:

Knowing what to expect during the interview increases the child's participation and the amount of accurate information obtained. Research has found that young children are less suggestive when they are told that the interviewer does not know what happened and only the child can tell what really happened. Pre-interview explanations of what to expect in the interview are standard practice and are included in the Interview Guidelines provided in this manual. Pre-interview explanations should be provided for all school-aged and adolescent victims, and may be adapted to the cognitive and linguistic capabilities of younger children.

They give the child permission to say the following when answering questions:

1. I don't know or remember.
2. I don't understand.
3. I don't want to say.

Emphasis is placed on telling everything the child can remember but only the truth as the child remembers. A fourth permission allows the child to correct the interviewer.

Another inoculation against leading questioning is to tell the child if you ask the same question twice, it does not mean there was anything wrong with the first answer. You may forget you asked it or just want to make sure you heard it right.

Best Practices Approach #5:

More than one investigative interview is usually needed to determine the details and extent of the child's abuse and have sufficient information to make a forensically acceptable case. Disclosure as a process is now a recognized dynamic. Efforts to reduce trauma by not over-interviewing led to many protocols being structured for a single interview.

Current practice calls for a balance between over- and under-interviewing. It is the number of interviewers, not interviews, that seems to be potentially problematic for the child and case consistency.

It is also recognized that where the interview comes in the disclosure process determines the approach and selection of materials to be used in the interview.

Best Practices Approach #6:

The specific type of trauma experienced by each child should determine the interviewer's expectations and procedures for the interview. The effects of childhood psychic trauma on how children remember and report abuse is recognized but not always incorporated into child interview guidelines.

The important question for the interviewer is, "Do I have enough historical information to know:

1. If the child has any of the defining characteristics of childhood psychic trauma
2. Which type of trauma has the child experienced

If the answer is NO, the interviewer lacks sufficient information to make an informed decision about what to expect from the child and how to structure the interview accordingly.

The following section provides information on how to recognize and respond to traumatized victims in an empathic and productive way.

Childhood Trauma: Extreme Fright in Childhood

"We must organize our thinking about childhood trauma or we run the risk of never seeing [it] at all." Lenore C. Terr, M.D., 1991.

Terr, L. (1991). Childhood Traumas: An outline and overview. American Journal of Psychiatry, 148:1, 10-20.

The following information is taken from Dr. Terr's overview; condensed and adapted for this manual by Ethel Amacher, 2000.

Childhood trauma is the result of one sudden blow, or a series of blows, that leave the child/adolescent temporarily helpless because of the breakdown of ordinary coping and defensive strategies. The central point is that it is externally imposed. It is not a mental illness. It includes events marked by intrusive surprise and shock, like sexual assault, and those associated with anticipated, prolonged horror like ongoing sexual abuse.

Four Characteristics of Childhood Trauma:

1. Detailed, visualized, repetitive memories.
2. Repetitive behaviors.
3. Trauma specific fears.
4. Changed attitudes about people, life, and future.

Detailed, visualized, repetitive memories. Visualized memories are most strongly stimulated by reminders of the event but can also emerge spontaneously. Children tend to "see" their traumas at leisurely times like bedtime, watching TV, or when bored. Even very young children who cannot recall or verbally relate their traumas tend to play out, draw, or "re-see" elements of their experiences. These reenactments can be cued in an interview through drawing or acting out what a child "sees" in his/her mind. (See Interview Guidelines for examples.)

Repetitive behaviors. Post-traumatic play and behavioral reenactments of single or multiple traumas are compulsive repetitions that lack the freedom and lightheartedness seen in playing for fun. They can be single or repeated episodes and children are generally unaware they are repeating part of the original event. If the behavioral reenactments recur frequently over time, they may become personality traits and behaviors. Many sexually aggressive children are reenacting their own victimization.

Trauma specific fears. The content of the fear points to or almost "tells" the source of the trauma. Going over fears and worries is an important part of investigative and assessment interviewing.

Changed attitudes about people, life, and future. Ordinarily, children have great interest and ideas about "the future." The shattering of "basic trust" (Erickson, 1950) in people, the present and the future is characteristic of traumatized children.

Along with these identifying characteristics of childhood trauma, there are two distinct types of trauma that effect how the child victim recalls and reports the traumatic event.

Type I: Trauma, Acute

• Single
• Unanticipated
• Visual memory
• Omens
• Misperceptions

Type II: Traumas, Chronic

• Anticipated
• Inevitable
• Ongoing
• Defensive structure
• Personality changes

Type I

Single, unanticipated trauma leaves "etched in the mind" memories of the traumatic event. "Omens" refer to mentally reworking the events in an effort to answer "why?" and "why me?" There is an absence of the massive denial and numbing or personality problems typical of type II traumas. The child just can't forget. The memory stays alive in an especially active way as the child tries to deal with a totally unexpected psychological shock (s)he has no time to prepare for or defend against.

Verbal memories of the experience are available at 28 to 36 months of age. Behavioral memory is evidenced in preschool, preverbal victims.

There are some misconceptions of time and detail due to the nature of the sudden onslaught of terror.

Type II

The anticipated inevitability of ongoing (sexual abuse) trauma creates the need for strong defenses against disintegration of self. Massive denial and numbing, and identification with the aggressor or aggression turned against the self are common defensive reactions. The feelings underlying the behaviors are:

• Rage and its negative-extreme passivity.
• Unremitting sadness.
• Absence of feeling.

Flat affect and efforts to appear "normal" are common faces presented to interviewers by these victims.

Type II trauma victims tend to "forget" large segments of time. They may disclose abuse and forget/deny it later.

The most extreme traumatic experiences result in extreme numbing. Childhood physical and sexual abuse are two of these extremes.

Type I Trauma:

1. Rote phrases, responses, and disclosures always repeated in exactly the same words have sometimes been considered a possible indication of fabrication by children because they typically do not communicate that way. Understanding that Type I trauma reports are characteristically delivered by children in a detailed, robotic way requires another view of "rote" accounts. If the child is a victim of Type I trauma, (s)he "sees" the same memory each time it is cued or revisited. Since it is encoded so clearly it remains clear and consistent over time. Consistency over time is considered an indicator of reliable disclosure. The investigator can count on Type I trauma victims to be good witnesses because they do not seem to easily forget these memories or change details about them over time.
2. Repetitive intrusion of traumatic memory is one of the indicators of Post Traumatic Depression Syndrome (PTDS). Traumatic memory cannot be fabricated and is strong validation evidence.
3. Clear, consistent accounts of the abusive experiences can be obtained by the interviewer in fewer sessions.
4. Misperceptions about time and details are expected because of the sudden unexpected onslaught. The child remembers that "experience," not the context.
5. Memories are cued by "faces" and positioning because of the attacking nature of the assault. However, it is important to remember the developmental factor of age related face recognition.

Type II Trauma:

1. Less information is available to the victim because of the extension of abuse over time. Memory fades, is repressed, or becomes merged and "spotty" rather than total recall as in single event traumas.
2. Less clarity and detail is expected in defensive memory. The interviewer should not view this lack of clarity as indicative of unreliable memory, just as incomplete recall.
3. More interviews will be needed to retrieve the memories.
4. More facilitative aids and tools will be needed to bypass defenses and tap into the memories.
5. Respect for the child's need for protective space and pace in the interview is essential to establishing trust in the interviewer. The greatest fear of Type II victims is that if they talk about the abuse they will re-experience it. Referral for an extended abuse assessment may sometimes be necessary to provide the time necessary for the child to "risk" re-visiting the trauma. Even in those cases, however, the initial interviewer's empathic, victim sensitive interviewing approach will greatly enhance the child's ability/willingness to begin talking about the traumatic experience (Amacher, 1998).

Why use tools?

"Interview" is an adult concept with little or no meaning for child victims. All the child knows is that s(he) has to "be interviewed" by a stranger about something they do not want to remember, admit, or talk about.

Included in some adult conceptions of the term "interview" is the idea that it is merely a process of questioning. The question/answer format is still an integral part of child interviewing, but with increased understanding of child development concepts, most guidelines now provide a combination of verbal and nonverbal interviewing techniques. Having age appropriate interview aids promotes a more child-friendly environment that the child can understand and participate in. It is helpful to think of the interview as a communication process.

Repetitive, one-way questioning can seem accusatory to children, or demanding of a "correct" answer. It also usually means the interviewer is doing most of the talking, a practice that reduces the amount, and possibly the accuracy of the information.

Age appropriate interview tools help the child communicate more easily, reducing the need for questions and the possibility of leading the child. They also encourage spontaneous information and opportunities for narratives descriptions, both of which are believed to increase reliability of information.

Using interview aids sometimes referred to as "play techniques" requires understanding - and accepting - their inherent value in making the interview process easier for both child and interviewer.

Investigators who have not received specialized training in conducting child interviews are sometimes uncomfortable using "play" aids. The rationale for using play techniques for interviewing children clarifies their importance and appropriateness for conducting investigative interviews of children and adolescents. The information can also be used for explaining and defending their use in court.

Rationale for Using Play Props as Interviewing Aides

Play represents an essential aspect of development and should be thought of as a child's work. It is the child's natural medium of expression and is used in interviewing children as "play with a purpose", not for imaginary fun.

Play contains several components that can provide significant information for investigative interviews: Imitative play occurs most frequently between the ages of 2 and 8 and is frequently used by children to reproduce events that are significant in their lives. Behaviors portraying aggression and antisocial behavior are most easily imitated, and events that are most incongruous with normal life experiences are among the most frequently imitated (Levy, et.al., 1991).

Observation of these imitative behaviors and exploration of what/who the child is imitating can begin the disclosure process. Play also reduces anxiety and contributes to more involvement in the interview by the child.

Selection of Tools

The function of all interview aids is to provide and/or clarify information. It is important to remember they are tools to be used in conjunction with verbal information provided by the child.

Interviewers should base their selection of tools on knowledge of their advantages and limitations with different age groups. All of the tools described below can assist children in providing information they may not be able to express verbally, or can help clarify verbal expressions. Direct expression is using tools to illustrate an alleged event. Indirect expression occurs when children spontaneously act-out or verbally express sexual content when using the tool for rapport, body parts inventory, drawing or demonstrating people and events, or even during the final phases of the interview as described in the Interview Guidelines.

Frequently Used Tools

• Dollhouses and family dolls
• Anatomical dolls
• Drawings (anatomical and other)
• Puppets
• Toy telephones

Dollhouses

Dollhouses as a professional tool are being used increasingly because they are favorite play objects of children, male and female, and are ideal for establishing contextual information about reports of abuse. They cue memory and enable narrative descriptions with less questioning by the interviewer. If the child does not spontaneously choose the dollhouse during the interview, the interviewer may suggest to the child that (s)he may show what his/her house is like, where everybody eats, sleeps, likes to be, and what they do together. Dollhouse dolls are chosen to represent "whoever" lives or comes there. The child is reminded that she should show what really happens there, and not pretend play. Even young children know the difference.

If the child engages in suspicious or ambiguous activity, larger dolls or other facilitative aids can be introduced to provide more detailed exploration of the activity. (See Interview Guidelines for a detailed description of use of the dollhouse and dolls.)

Anatomical Dolls

Used by investigators since 1978, the anatomical dolls help children show the type and extent of their victimization. Although concerns and cautions have been debated about use of the dolls from an evidentiary perspective, there is no research to prohibit interviewers from using them as communication and assessment tools.

The interviewer's responsibility is to be aware of professional guidelines for their use and use the dolls within those parameters. (APSAC Guidelines for Use of Anatomical Dolls in Child Sexual Abuse Assessments, 1995.)

Advantages of Anatomical Dolls

1. For young children the dolls may be a more familiar medium than speech. Children use dolls before they have language.
2. They provide concrete cues for concrete thinkers.
3. The dolls' anatomy can serve as a stimulus to memory of sexual activity.
4. The dolls' specific body parts allow a more precise description than non-detailed dolls.
5. For many children with adequate language, demonstrating with the dolls may be easier than a totally verbal description.
6. Demonstration with the dolls reduces the need for questions and possibilities for suggestion.
7. Children can project strong emotions onto the dolls and talk about sensitive information in a more depersonalized way.

General Guidelines for Using the Dolls

1. Introduce the dolls after the child has verbally disclosed, or to assist reluctant, nonverbal children to talkabout their experiences.
2. Offer minimal or no instructions on how to use the dolls except to have the child select and name a doll as herself and any other real people involved in the activity to be demonstrated.
3. Use information from doll demonstrations as part of the total assessment of the interview information.
4. Never position or manipulate the dolls and ask, "Is this what happened?"

Dolls are one tool and should not be used exclusively in a "Doll Interview," but they should not be excluded from use when needed to help a child describe abusive activity.

(See Interview Guidelines for more information on using anatomical dolls.)

Drawings

Drawings may be used simply to relax a child and give him/her something to do with his hands. However, the act of drawing seems to release the ability to verbalize and help the child involve themselves in the interview process.

Types of Drawing

1. Free drawings are drawings of the child's choice used in all phases of the interview. They include people, family, house, contextual, and abuse drawings. They can be used for:
…
• Reducing anxiety while establishing rapport and providing assessment information.
• Gathering abuse information.
• Re-establishing equilibrium and refocusing at any time during the interview.
• Providing a means of expression beyond words, and a focus for exploring details of a picture.
2. Anatomical drawings, the drawings of nude male or female adults and children showing both front and back positions, are used as body maps for the child to provide:
• Body parts inventory/function to obtain the child's terminology and knowledge of sexuality.
• Specification of location and type of body touches.

The most frequently used source of these drawings is "Anatomical Drawings for Use in the Investigation and Intervention of Child Sexual Abuse Cases," by Nicolas Goth, Ph.D., with illustrations by Thomas N. Stevenson, Jr., a medical illustrator (Groth & Stevenson, 1984.) The drawings from this source have been universally accepted in legal proceedings and are standard procedure in sexual abuse investigations. (See Child and Adolescent Forensic Interview Guidelines: Young Child for detailed description on the use of these drawings.)

Advantages of drawing:

1. Children like to draw.
2. Drawing tools are easily transportable.
3. Drawings are a good distancing and transitional tool for approaching and providing sensitive material. (See Interview Guidelines.)
4. Drawings are hard to falsify.
5. Drawings provide documentary evidence. This list of advantages can be used for court testimony in explaining the use of drawings in investigative interviewing.

This list of advantages can be used for court testimony in explaining the use of drawings in investigative interviewing.

Puppets

Puppets are used to aid communication by having the interviewer's puppet talk to the child's puppet. They are helpful with nonverbal and reluctant children in establishing rapport and moving the subject to fact-finding. If the puppet "discloses" abuse, the child has not broken a pledge not to tell. It is important, however, to move from the puppet's disclosure to the child saying that (s)he experienced what was described by the puppet. (S)he should also name a real life offender. The usual investigative interview questions can then provide the "w's": where, what, who, when. Other clarifying questions and facilitative aids can provide elaboration of details.

Toy Telephones

Telephones, like drawings, seem to release a propensity for verbalization. They are good tools for embarrassed or shy children struggling with verbal expression, or with giving detailed descriptions of abuse. They provide distancing from the interviewer and encourage more narrative elaboration.

Privacy is offered by the interviewer asking how the child wants the two of them to sit as they dialogue. Some children want to turn their back, or have the interviewer do so.

Note: Some telephone companies will provide telephones so the child can choose to use the real or toy model. Each choice given the child increases a sense of central and shared responsibility and facilitates communication.

An effective way to use the telephones is to ask the child if (s)he would like to call the offender(s) and tell him/her what (s)he thinks about what happened. Using the telephone in this way can provide additional information about the abuse, and sometimes about additional abusers.

This section provides detailed guidelines for interviewing child victims with formats for preschool and school-aged children and adolescents. The formats are structured around child development concepts and professional requirements for forensic interviews (APSAC Guidelines, 1999,1995, 1995). They reflect a balance between structure and flexibility, recognizing that while guidelines provide direction and reminders of what needs to be covered in the interview, children do not always respond to them in predictable ways. They tend to jump back and forth from one phase of the interview to another. Interviewers must be prepared to respond to the child's imposed shifts and follow the child's spontaneous behaviors and information. Spontaneous material tells the interviewer what is on the child's mind at that moment and provides important entrees to additional information.

Strict adherence to specific, sequential steps in a protocol does not allow the interviewer to follow the child's "clues" about how the child can best provide information.

They following guidelines are based on practice and research regarding interviewing child victims. The techniques were developed over more that fifteen years of experience by the author and/or adapted from methods used by other experienced practitioners in the field. Their contributions are cited in the References and Resources.

General Preparation

The following information in this section is adapted from:

Kanfer, R., Eyber, S.M., & Krahn, G. (1983). "Interviewing strategies in child assessment". In Handbook of Clinical Child Psychology, Walker, C.E. & Roberts, M.C. Ed. John Wiley & Sons: New York.

Handout condensed and adapted by Barbara Rutter, Ph.D. 1988, Guidelines for the Investigative Interview in Child Sexual Abuse cases Children's Advocacy Center of Honolulu, Hawaii.

Guidelines condensed and adapted by Ethel Amacher, MSW, 2000.

Surroundings

The interview room should be comfortable, private, and non-distracting. Do not have visible any materials you do not want the child to use. Disconnect phone.

Sitting, feet dangling in a big chair, directly facing a strange adult and being continuously gazed at, is NOT a safe position. Use comfortable, "child size" furniture, if possible, or better yet, sit together on a soft carpet. Allow the diversion of toys, don't excessively hamper freedom of movement, and look away from the child at times.

Preschoolers

Preschoolers are very "biological" creatures. Their responsiveness is greatly influenced by factors such as hunger, fatigue, need to go to the bathroom, illness, and restlessness. Do not try to interview a sick, tired, or hungry preschooler.

Very young children do not generally sit for a long, verbal exchange with an adult, especially about externally imposed topics. They are interested in moving, exploring, handling things, and asking you questions or looking at you. Expect to conduct several, brief interviews with this age rather than one long interview.

The interviewer's efforts to establish rapport should be gradual. Preschool age children cannot be hurried. This age is also still wary of strangers.

General Communication Skills

There are five general "process" skills helpful throughout an interview in establishing rapport and maintaining the child's cooperation:

1. Description
This is a simple way to give attention to the child and to focus on things that are likely to be interesting to the child. Children are egocentric; describing their behavior to them lets them know you share their perspective.

"I see you brought a doll." (behavior)
"That's a wonderful dinosaur shirt." (appearance)
"You're looking kind of tired." (demeanor)
2. Reflection
These are statements that "echo" or "mirror" what the child is saying or doing or feeling. They may be literally the same or provide some elaboration or interpretation.

Child: "Here is the Daddy Bear." (anger face, stomping the bear's feet)
Interviewer: "Here's the Daddy Bear." (literal)
Interviewer: "Here is the Daddy Bear, stomping his feet!" (elaboration)
Interviewer: "Daddy Bear seems angry." (interpretation of emotion)

Reflective statements provide clarity and help to organize the child's behavior, thoughts, and feelings. Generally, reflections results in increased verbal interchange between interviewer and child.
3. Labeled Praise
These are statements that indicate approval and specify the act or event that is being encouraged.

"You're doing a good job of telling me what happened."
"It's hard to talk about this, and I like how you keep trying."

Labeled praise guides and encourages the child in the direction the interviewer desires.

Give approval for effort rather than for particular responses. Praise for particular responses leads to fear that any non-praised response was somehow not as good or wrong and may actually inhibit the child. Praise for particular responses can also inadvertently "lead" the child.

4. Avoidance of Critical Statements
Critical statements indicate disapproval or imply in some way that what the child says, thinks, or does is wrong or bad.

"You can try harder."
"You can remember more than that."
"Sit still."
"Stop throwing the toys."

Critical statements generate negative emotional reactions such as anger, resentment, and frustration, and are detrimental to rapport and motivation.

When a child does exhibit negative or aggressive or destructive behavior that must be stopped, some of the ways to do that and avoid direct, critical statements are the following:
1. Restate the rule. "One of the rules in this playroom is that the toys can't be broken."
2. Direct the child to an incompatible behavior. Child is running around: "Come play at the table with me." Child is throwing blocks: "Let's put the blocks in this bucket."
3. Ignore the inappropriate behavior.
   Child: crawls under chair
   Interviewer: ignores
   Child: comes out and stands looking at Interviewer
   Interviewer: "Hi! I like it when you're up here."
5. Open-Ended Questions
An open-ended question is any question which cannot be answered with a simple yes or no.

"Do you like school?" (closed-ended)
"What do you like best about school?" (open-ended)

"Do you remember anything else about that?" (closed-ended)
"What else can you remember about that?" (open-ended)

"Were you scared?" (closed-ended)
"How did you feel?" (open-ended)

Open-ended questions produce more information and minimize "leading"of the child. A caution: Don't ask "why" questions. Children usually get why questions when they are in trouble. Why questions will lead to defensiveness or to rationalization.
6. Use Age Appropriate Communication
• Use clear, simple vocabulary.
• Each statement or question should be short and contain only one idea.
  NOT: "When do you go to Dad's house and what do you do with him?"
  INSTEAD: "When do you go to Dad's house?"
• Avoid qualifying phrases.
  NOT: "What is it you usually do at Dad's house?"
  INSTEAD: "What do you do at Dad's house?"
• Avoid adult "feeling words" like depressed, anxious, guilty. Stick with the basics: sad, mad, happy, scared.
• To get at the affective experience, have the child describe behaviors.
  NOT: "What is it about your Uncle that scares you?"
  INSTEAD: "What does your Uncle do that scares you?"
• The use of silence (waiting a while for a response) is not recommended for interviewing children. This tends to be very aversive to a child and leads to resistance. Moments of silence during a play interaction, of course, are fine.
• If you are unfamiliar with the interested of children of today, you need to make a point of learning about their world. Times change. Watch children's T.V., browse through children's clothes and toys sections of stores, talk with friends who are parents. Learn about media heroes, clothing fads, games, toys and hobbies. Being able to talk about areas of interest to the child can go a long way in establishing that you are someone who understands children.

Definition: Rapport (Webster's Dictionary) "relationship, especially a close or sympathetic relationship; agreement; harmony."

1. Relieve any anxiety the child may have about "being in trouble." Give a clear message about who you are and why you are there.
2. Ask the child if they know what a police officer, social worker, or assessor does. Let them explain in their own words. Then help them understand that part of your job is talking to children and that you talk to lots of children all the time.
3. In an informal, conversational way, assess the child's understanding of key concepts as you look at toys together, draw, do clay. This is important so you know at what level to pitch your questions and also to establish the child's credibility as a reporter. See Interview Guidelines for specific methodology.

Gathering Information

1. Prepare in advance a brief outline of the information you wish to obtain.
2. Use the outline only to remind yourself of areas to cover. Remain flexible. Follow the child, not the outline.
3. In general, most interviews will cover, in some way, topics in three main areas:
Environment: Family, School, Peers
Self: Interests, Wishes, Fears
Referral Problem: Child's perception of presenting problem(s)

Introducing these areas in the sequence listed above allows a degree of rapport and trust to develop before the most difficult issues are addressed.

4. Within each topic area, move from positive, non-threatening areas toward the more threatening areas.
Example: In exploring self perception, one might ask a child first to tell three things they like about themselves, then to tell three things they do not like.
5. Acknowledge your source of information before asking questions in threatening areas.
Your mom said lately you have been crying a lot. What things are making you feel sad?"
"You told me earlier that you don't like to go to your Dad's house. What things don't you like at your Dad's house?"
6. Avoid "leading questions." A leading question is any question that has the answer in it. Leading questions usually result in yes or no answers only and are particularly troublesome in court involved cases.
LEADING: "Did Daddy hit you on the legs here?"
NON-LEADING: "Tell me what happened about these bruises?"
LEADING: "Was Mom pretty upset about what happened?"
NON-LEADING: "What did your Mom say about what happened?"

1. When a threatening topic is approached, the child will frequently display resistance by:
• Saying, "I don't know"
• Becoming silent
• Changing the subject
• Changing the activity
• Changing affect
• Becoming fidgety


Preschooler will typically:
• Cry
• Run around
• Need to go to the bathroom or a get a drink
• Return to the parent

This resistance is usually internally generated, is not necessarily conscious or purposeful behavior, and is designed to protect the child from embarrassment, exposure, or disapproval.

2. There are several strategies helpful in reducing a child's anxieties during interviewing:
1. Allow the child to play simultaneously with a toy while talking to you. This allows both you and the child to go back to description of the play whenever things get tough and then return to the difficult topic without having to change topics altogether.
2. Let the child talk to you through a puppet, doll, or toy telephone.
3. Explicitly acknowledge the child's discomfort. "It's alright if you don't feel like talking about that yet."
4. Direct the child back to a non-threatening topic and gradually approach the threatening topic in a different way.
3. When a child appears to have been told not to talk, as in some abuse cases, this needs to be approached directly.
   "Sometimes kids I talk with have been told not to talk to me about certain things. Were you told not to talk to me about something?" (This is a closed-ended question in this case to provide the child the safety of a yes or no nod.)

   Discussion of the situation then needs to take place even with the very young child. What will happen, who will be talked to, your purpose of helping, but also the realistic limits of your power, all need to be explained. The child should be supported and acceptance given for talking and for not talking.

Closure

1. Acknowledge any efforts the child has made during the interview.
2. Summarize for the child your perception of what (s)he has shared.
3. See if the child has any additional information to offer or suggestions for solving the identified problem(s).
4. Ask if the child has any questions for you.
5. Convey your desire to help and provide as much information as possible about what you intend to do.
6. Thank the child for meeting with you.