Interviewing the Child Victim-Outline

Determining the Ability to Interview the Young Child

Unable to Interview:

• Usage of one to two words
• Unintelligible speech and language
• Short attention span
• Play not representational

Transitional Period for Child:

• Some vocabulary
• Sufficient capabilities
• Teach correct words for body parts
• Teach concepts (touching, hurt, tickle)

Interview Appropriate:

• Has good attention span
• Knowledge of appropriate concepts (Where do you sleep?)
• Intelligible speech and language
• Capable of some representational play

(Source: "Evaluating the Young Child," Sandra Hewitt, Ph.D.)

Preparation

• Review developmental information on children the same age as the child you plan to interview.
• Reframe your thinking from "interview" to communication with the child.
• Select and organize interview aids recommended for this age group.
• Use concrete props for these concrete thinkers.
• Be prepared to conduct more than one interview. With this age child, ten minutes of pertinent information may emerge within a 30 to 45 minute session. Long interviews are counterproductive and frustrating for a young child.

Phase I: Introductions, Rapport, Informal Developmental Assessment

Introduce yourself as someone who helps children and comment on something positive/attractive about the child's appearance, behavior, or demeanor. Children are responsive to complimentary comments about their shoes, clothes, or general appearance. Ask the child if she knows why she is there. This evokes a variety of responses, usually "no" or "I don't know," but provides an opportunity to clarify any misconceptions the child has about who you are and what you do. Point out the communication aids and say something like, "We use these things to help us talk, draw, or show and tell about things we need to figure out," "Kids come to see me (I go to see them) when things happen that make them or someone else upset or something makes them feel sad, mad, or scared."

It is important early in the interview to establish that you are interested in the child as more than a source of evidence. Children are very "feeling" people and if you ignore their feelings, they won't think you know very much about kids.

Ask what the child wants to be called. Names are very important to children. You may say, "Let's write it down." This provides introduction to paper, markers, crayons-a young child's favorite media. As the child engages with the media, you can proceed with an activity that will provide developmental information while establishing rapport.

Markers are a good technique to assess the child's capacity to provide the kind of information you will need during the interview. You can say, "Let's use these markers for a game" to identify colors, and establish understanding of concepts. Use primary colors. Some young children cannot distinguish shades.

Concepts important to the interview are:

• Positions: on/off, under/over, in/out, top/bottom, up/down
• Prepositions: next to, with, by, for
• Action words: hug, hit, bite, pinch, pull, pat, poke, stick, stroke, lick, rub, kiss, hold, tickle
• Numbers: more, less, twice, counting

Examples of how to use the markers to assess the child's knowledge of numerical concepts:

• Place three markers in a vertical line and ask which is on top, bottom, middle.
• Which color is under another color.
• Add several markers and ask how many; take away one marker and ask again.
• Slowly place the markers in a horizontal line one at a time and ask the child which one you put down first, third, last.

The child's understanding of these concepts is important because the interviewer will be asking about the number and sequence of events during the interview (Levy, 1991).

Approaching the Topic of Touching

An animal puppet can be used to clarify action concepts. A turtle puppet is ideal because it can go inside its shell if it does not like a touch. The interviewer can ask the child to demonstrate touches on the turtle, if the child has gotten any of the touches, which ones, which ones she liked and did not like, which was best, worst, and scariest, who gave the touches, and if the child had gotten any other touches she did not like or felt bad, mad, sad, or scared. If the talk gets uncomfortable, the interviewer should respect this avoidance and offer to return to the turtle when it can talk again.

"Feeling Faces" can be introduced (or can be used to begin the interview) to identify the child's feelings about self, family, school, friends, talking to the interviewer, the (alleged) offender, why they are there, etc.

Have a minimum of four faces depicting the four basic feelings most children have and are able to identify: happy, sad, mad, and scared. Other faces can include: surprise, worried, confused, and other ambiguous ones for the child to label. Use the faces to ask where, when, and with whom the child gets the feelings, and move to:

• What is:
• The best feeling you ever had
• The best thing that ever happened to you
• The worst thing that ever happened to you
• The worst thing that ever happened to your body
• The best and worst touch you ever had.

The faces can be used in this way to approach the fact-finding phase of the interview. If the child becomes anxious, games reduce anxiety. Introducing activities as games can reduce anxiety to a manageable level before proceeding with the activity to transition to Phase II where the subject may be pursued in a more focused way.

Phase II: Gathering Informational About Possible Abuse

The following techniques may be used either in sequence or selectively to encourage disclosure, depending on the child's response.

1. Tell the child that lots of kids talk to you about touches and introduce the three kinds of touching: good, bad, and secret, as described by Jan Hindman in her book, A Very Touching Book (Hindman, J., 1983). If the child avoids touching topics, offer drawing materials.
2. Draw-A-Person (DAP). As a first choice, children often draw people. They can usually draw "tadpole" figures by age 4 or 5 and these tadpoles can be considered people drawings. Ask the child to try and draw a "whole" tadpole (person) with the four major body parts: head, body, arms, and legs. If the child omits a body part (after age 6) the interviewer can ask what happened to it. Exaggerated or omitted body parts can indicate concern about or an (unconscious) effort to hide or draw attention to those parts. This is not a definitive indicator but the interviewer can explore the child's reactions to the parts with other media such as body drawings, anatomical dolls, clay/play-doh people, etc. The child may simply be rushing through a task and omitting parts. Use a past drawing inquiry to ask who the drawing is and what (s)he is thinking, feeling, doing, wants to do, is afraid to do, one good thing about her/him, and one not-so-good thing (if it is not a self-portrait). Ask about good and bad things that have happened to the person and who (s)he goes to for comfort and to feel safe.
3. Family drawings. Ask the child to name the (tadpole) people in the drawing and write them down as they are named. Then ask the child to draw where (s)he lives.
4. House drawings. Most children like to draw houses, but young children need help with producing a diagram of the inside of the house. They can usually draw a box and show the interviewer where to put the kitchen, bedrooms, and other rooms. Children usually become very involved in this joint activity and loose their reluctance to participate in the interview.
5. "Put the people in the house" is used with the family list. First, ask the child to draw, or make a different color "X" for each person to show where each one eats, sleeps, plays, has privacy. This can provide information you will want to pursue. If not, ask if anyone in the house bothers anyone else, or if anyone ever gives "turtle touches" to anyone else. The turtle touches can be positive and/or negative and should be recorded as described by the child.
6. Dollhouses. The above technique is productive with some children, others prefer using a dollhouse to demonstrate interactive behaviors. The interviewer tells the child to make the playhouse like his/her house (or location of the abuse if known), and to choose playhouse dolls to be him/herself and the people who "are there" or "come there". Ask the child to show where everybody eats, sleeps, plays, and what they do together. Remind the child that this activity is "show and tell" about real people and things that really happen, not about pretend.

Often, dollhouse people do not have removable clothes and larger dolls can be introduced to demonstrate activity shown within the context of abuse. For example, if dolls are placed or moved about in suggestive motions, the interviewer can ask what is happening and clarify the action by using anatomical or larger dolls for demonstration purposes. The child is asked for verbal identification of the people and a description of their activity as the demonstration proceeds. Any questions asked by the interviewer during the demonstration follow the recommended Continuum of Questioning (See Best Practices Approaches) and should be carefully documented for the case record.

It is important to get verbal identification of the people involved in a doll demonstration and the child's perception in words of what is happening. Demonstrations are "behavioral language" and should be carefully documented. They are a young child's statement of who did what to whom and also where, if provided with contextual props like a playhouse, school house, car, or other possibilities. Playhouses often do not have bathrooms, but children can easily improvise with props such as blocks for bathtubs, sinks, toilets, etc. Construction paper can be cut to use as furniture and facial tissues as covers for demonstration of activity in other rooms.

7. Using Anatomical Dolls

Kindergarten-age children are able to "show and tell" in detail. They have a larger vocabulary and a better sense of time than young preschool-age children. They have usually mastered representational play and can use dolls to represent themselves and other people.

There are two ways to introduce anatomical dolls. One is to help clarify and provide details after the child has said or done something that indicates sexual activity. The other is to present a "structured" introduction of the dolls.

In clarification situations, the child selects the dolls (s)he needs to show what happened. (S)he is then asked to name them, where they are, and to show what happened. The dolls should be fully clothed when selected by the child and the child can remove clothing as needed to reproduce the activity (s)he is demonstrating. If the child demonstrates activity with clothing on the dolls during the entire demonstration, the interviewer can ask after the demonstration if they had their clothes on all the time. If the child says no, ask them to show which times they did not, how the clothes "got off", and what the clothes looked like. Check to see if the child's description matches the clothes on the dolls, or is a memory of an event.

If the child has not disclosed abuse, a structured introduction of the dolls may be conducted to obtain a "body parts and functions inventory" and to explore body touching. Introduce the dolls as being like people because they have all the same body parts. Tell the child you want to get her names for the parts so you can use the same names.

Starting with the doll that the child chooses to represent her/him, have the child identify the hair, eyes, nose, and mouth and the function of each. Proceed down the body from arms and hands to legs and feet. Then say, "There are some parts we can't see because they are under the clothes." Ask the child if (s)he would like to undress the doll or have you do it, or help her/him. Most children undress the dolls themselves, but if the child is hesitant to do so, undress the top part of the doll and get the terminology and function for the breasts/nipples. Then remove the remainder of the clothes and get the names for "bellybutton", genitalia, buttocks and back anal opening. Comment that boys and girls are different and ask the child to choose a child doll of the opposite sex. Use the same process for the child, adult male, and adult female dolls. After the child has given the function of a particular part, it is appropriate to ask if it can be used for anything else, if (s)he has ever seen one or anyone seen hers/his, or if anyone asked to see or touch it.

If no information about body touching emerges from the inventory/function inquiry, the interviewer can proceed with an evaluation of general body experiences (unless the child becomes upset or avoidant of the dolls). This process was developed to address general issues of hurt or touch to the body from general to more specific activity.

General Body Experiences

1. Have you been hurt on any part of your body or asked to hurt a part of someone else's body?
2. Have you been touched on any part of your body, or had to touch a part of anybody else's body?
3. Has anyone done something you didn't like to your body? Asked you to do something you didn't like to someone else's body?
4. Has anyone put anything on or in any part of your body?
5. Have you ever been without your clothes?
6. Has anyone else asked you to take off your clothes?
7. Have you seen anyone else without clothes?
8. Has anyone asked you not to tell something about your body, or tell you something might happen to you or to someone else if you told something about your body?
9. Has anyone ever kissed you?
10. Has anyone taken your picture?
    (White, S. et. Al. 1987)

If the child uses his/her own body spontaneously to describe a touch, accept the action and suggest that (s)he can use dolls or anatomical drawings to give details about the touching. Have the child choose a doll or anatomical drawing that looks most like the person who did the touching. Ask the name and if they are a grown-up, teenager (between grown-up and child), or a child. If dolls are chosen to demonstrate the touching, put the clothes back on before the demonstration. After the demonstration is over, talk with the child about who had on what, and whether the clothes were on or off during the touching.

Having the anatomical dolls available during the interview is important because research and experience indicate that concrete props and cues are more effective memory prompts in young children than verbal cues or questions (Perlmutter, 1984). Anatomical dolls are concrete anatomy props and can evoke body memories that are not evoked by other interview aids.

The Body Parts Inventory/Function process can be used with all ages of children. Do not neglect this task even with the older child. It can be used to establish a "business" tone to discussing bodies, and to show the child that you are not embarrassed with the topic. Also, others may later claim that the child doesn't ordinarily use those words for body parts, and you need to establish clearly what the child does use.

The task of identifying body parts can be presented at different levels of difficulty. From easier to harder, they are:

Below two years: Show me your hair. (child's own body)

Two years: Show me the doll's hair. (real object)
Shoe me the girl's hair. (picture)

Three years and up: What is this? (interviewer points to part on picture and child must give name of part.)

If the child you are interviewing is functioning at a lower level than her chronological age, or is excessively shy, drop back to an easier level for the neutral body parts and then see if the child will produce the words for the private parts. If not, give the words the parent has said the child uses and ask the child to point.

Do not ask for body parts by presenting their functions, such as, "What do you see with?" Many younger children will not know functions, others will get lost in the long descriptions. Older children will be embarrassed by the description of toileting activities or feel tricked as they see you working your way around from neutral functions to private ones.

Do not, except for the very young child (usually under 2 years old) who can't use a doll, use the child's own body for identification of parts. This is embarrassing and disrespectful, making the child's body an object just as abusers do.

It is a good idea to ask the child what her various caretakers call the private parts of the body. The child may be receiving different words from different people, and this can become a source of confusion in court, i.e., "She doesn't call it that," or "She doesn't even know that word."

8. Anatomical drawings are used for the same purpose and introduced in the same way as anatomical dolls. The child is asked to select a drawing for herself and name the body parts from head to toe. If the child has disclosed abuse, ask her to also select the other individual(s) who was (were) involved in the touching and mark where (s)he was touched and mark on the offender's picture what body parts were used to do the touching. Use two other pictures to have the child mark what parts of her body she had to use to touch the offender's body and what parts of his/her body were touched. If the child can write, ask her to write her name and the offender's name on the picture. Then date the drawings and record any information provided by the child as she uses the drawing. The drawings can be used as an alternative, or an addition, to the dolls for checking consistency or providing additional details.

Phase III: Closing the Interview

Even young children realize some of the consequences of being "interviewed" and need time to deal with the overload of anxiety raised by talking about touching or struggling not to talk about it. Going over feelings about what has been said and done during the interview will help the interviewer identify the child's fears and expectations. If the child has disclosed abuse, ask him to tell you in his own words what he said or showed you during the interview. Ask about what (s)he wants to happen next, does not want to happen, what she is afraid of, who knows what happened ("What did mommy say when you told her about this?") who (s)he wants to know about it, and what (s)he thinks should happen to the offender. Reassure the child that she did the right thing to tell because it usually does not stop and gets worse, and it's not good for children to worry about what will happen next.

If the child has not disclosed, thank him/her for trying to help you find out if she needed help with anything. Express your understanding of how hard it must have been to talk to a stranger about things like being touched or hurt. Reduce any sense of blame and shame by saying that sometimes it takes more than one time to talk about it, or that maybe (s)he didn't have exactly the right thing to help that day. Ask what you could have, or do, or say next time to help more. Tell the child you will be talking with him/her again because some kids remember things after they leave. Have a toy telephone available to practice how to call you if she needs to talk to you before she's scheduled to return.

Preparation

Although it is generally assumed that school age children are more able to verbally give information, experience cautions against depending largely on verbal expression as the primary mode of communication. The child's established personality and the type of traumatic experience will greatly influence the response of each child. Nonverbal techniques are still needed to bypass defenses that are more established by this age, and to avoid overemphasis on verbal questioning.

By school age, children are resistive to telling something "bad" about themselves. They are more aware of the ramifications of disclosure. It does work to the interviewer's advantage, however, that they want to do the "right" thing, and they are accustomed to doing what adults expect of them.

Phase I: Rapport and Explanations

During Introductions, explain the purpose of the interview and how you plan to go about conducting it. Include the explanations, or options, the child has when answering questions, and point out communication aids the child can use throughout the interview.

Drawings are especially effective with this age group because they bypass defenses and tap suppressed material. They take the emphasis off of talking and reduce anxiety because the child can concentrate on the drawing while adjusting to the interview process.

While drawing, the interviewer can engage the child in conversation about things that interest children such as school, sports, movies, friends, etc. While gaining information about the people, places, and events in the child's life, the interviewer can gauge his/her ability to provide narrative descriptions of these events. If encouraged to describe things in detail, the child will have practice in how you want him/her to respond throughout the other phases of the interview (Lamb, M. & Steinberg, K. 1999).

Phase II: Gathering Information

Techniques for Introducing the Topic of Concern

1. Draw/List
• Draw family doing something.
• Draw people or an event with bubble thoughts and let child fill in the bubble.
• Draw different houses for child to demonstrate with whom he/she feels most safe.
• Draw feeling faces-mad, sad, happy, scared (What makes you mad? When do you feel sad?)
• Draw or list the worst thing(s) that ever happened.
• Draw or list the best thing(s) that ever happened.
• List of worries (use colorful markers).
• List of people you feel safe with.
• List or draw things you like about Mom, Dad, etc.
• List or draw things you don't like about Mom, Dad, etc.
• List of people who give different touches using the Touch continuum (anyone tickled, hurt, touched you in the front [point to vagina], or the back where you go to the bathroom?)
2. Photographs
• Understand child's ability to identify people in his life.

1. Dolls
• Identify body parts and functions (Is there a place you're not supposed to touch? Can you show me? Do you know someone that has happened to? Has it happened to you?)
• Use as a demonstration aid:
1. To walk through event slowly.
2. To be more simplistic, "Show me". Did someone touch you there? If so, by whom, and in what way?
2. Demonstration Aids
• Desitin
• Lotion
• Wash cloth/soap
• Bathtub
• Bed
• Phone
• Puppet
• Doctor kit
3. Questions to use with Props
• How does Mom/Dad show you she/he loves you?
• Show me bath time with Mom, with Dad. [Walk through slowly.]
• Show me bedtime.
• Show me what Mom and Dad do when angry.
• When young child makes concerning statement regarding a person, follow-up with, "Can you show what ____________ does?" Let child demonstrate.
• Show me what the doctor did.

1. Broad questions regarding the child's life.
2. What would happen if you talked about …?
3. Does Mom/other know your worries …?
4. What does she say or do ….?
5. Are there reasons you don't feel safe …?
6. What happens if you talk about your worries?
7. What would Dad say if I asked him?
8. What should I ask Dad? Is it okay with you if I ask him?
9. Are there things Mom told you to talk about today?
10. Are there things Mom said not to talk about (What are they, so I won't get you in trouble?)
11. Do you have bad dreams? When? What happens? Who helps you?
12. What would make this easier?
13. How would you like to tell? (Write, draw, computer, back turned, alone, tape, etc.)
14. What does Mom do when she is mad at Dad/sister/you?
15. What does Mom do when she is happy with you?
16. Sometimes adults or big kids want kids to touch them. Is there someone who wants you to touch them? Look at them?
17. Have you been to the doctor lately? Was there a reason? Were you sick? Show me where he checked you. Ask focused questions regarding genitals.
18. Who do you feel safe with? Where?
19. Define touching problem. Ask child if he/she has had a touching problem. Did touching used to happen? How did it feel?
20. If child has been in hospital, ask about suicidal thoughts, self-mutilation, and is there someone he/she is upset with.

Avoid using questions such as:

• Did he touch you?
• Did it happen last night?
• Why didn't you tell?
• Why didn't you leave?
• Why were you alone with him?

Use questions such as:

• What did he do? Show me.
• When did it happen?
• What is the reason you didn't tell?
• Was there a reason you stayed?
• Young child: Where was ____ when this happened?
  Adolescent: Is there a reason you were alone with him?

Good phrases to gain further clarification:

• I'm mixed up. Can you help me?
• I'm confused. Tell me one more time.
• I wasn't there and I want to make sure I understand.
• I didn't see, I didn't hear, I wasn't there. I need you help.

Adapted from Language and Questioning, p. 25, "Interviewing for Child Sexual Abuse." Steinmetz, ACSW and presented by Nancy Bolson at the Georgia Council on Child Abuse Annual Conference, 1999, Atlanta, Georgia.

How to Use Drawings in Forensic Interviews

Do not interpret drawings. They are used as communicative aids and for forensic purposes. They mean only what the child says they mean.

Drawing "Sequence or Select"

The following techniques can be used in sequence for progressive disclosure or can be used selectively, depending on the child's response.

Two types of "free choice" (non-directed) drawings have a high index of suspicion for two kinds of sexual trauma.

1. the drawing is a shift from age appropriate drawing and is so fragmented and disorganized it requires an explanation from the child of what it is. This kind of drawing is often produced by children who have been unexpectedly sexually assaulted, as in rape. The disorganized stage of the Rape Trauma Syndrome decreases with crisis intervention and counseling and the child's drawings show reintegration with age appropriate figures.
2. The drawing is sexually explicit, a person with genitalia and/or stylized sexual figures and scenes. These drawings are typical of children who are victims of ongoing molestation and associated preoccupation with the unresolved trauma (Burgesss, McCausland, Wolbert, 1981).

If the child produces either of these kinds of drawings, ask him/her to name the person or people, the location, what is happening, has just happened, or is going to happen to them. Trauma drawings are a form of trauma reenactment and reflect the specific type and source of the trauma (Terr, 1997).

If the drawing is a person drawing, the interviewer can suggest that since the person does not have any clothes on, the child can name the body parts and proceed with a body parts inventory and abuse evaluation. Even if the child does not appear to be traumatized, it is unusual for children to draw genitalia and should be considered pictorial language that needs to be explored.

If a child becomes overstimulated or exhibits re-experiencing symptoms while drawing or processing a drawing, ask, "Who/What are you thinking about when you feel like/do that?" The question provides a cognitive interruption of the affective reaction, calls for a verbal response, and regrounds the child in the "here and now". The interviewer can say that sometimes when kids think about what happened to them it makes them feel like it is happening again. If the child confirms the revivification, ask what (s)he usually does to feel better and try to find a neutral activity or comfort object. If the child can verbally describe what is happening in a picture, give her/him a chance to do so, but respect the defensive resistance if (s)he rejects the opportunity to do so.

Asking children to draw a picture of, "What you see in your mind" can produce a picture of what is "on the verge" of the mind at that time. Traumatized children retain very visualized memories of their traumas and these picture memories can build a bridge to unexpressed information.

For follow-up, consider referral to a clinical forensic evaluator at a Child Advocacy Center or other child abuse center where an extended abuse/trauma assessment can provide a safe pace and place to revisit the trauma.

2. Self Drawings

Ask the child to name and describe her/himself and what (s)he is thinking, feeling, doing in the picture. Expand the communication by asking for a "thoughts in your head" drawing and ask the child to fill it in with "everything going on in there."

By school age, children usually draw their own sex first in a person (DAP) drawing. If they draw the opposite sex, have them name the person and tell you all about him/her in order to probe the significance of the person being paramount in their minds. Then ask for a drawing of the child's own sex and another drawing of the two people doing something together. The drawing may reflect a child in foster care longing to return home, or it could be a child with a "burned in the brain" image of a perpetrator or sexual trauma, a characteristic of traumatic memory.

3. Family Drawings

Use the same process described in the guidelines for the young child and add a request for a picture of the family doing something together (Kinetic Family Drawing). These drawings are often reflective of family relationships and dynamics of isolation, depict bedrooms and sleeping arrangements, and sometimes depict abusive acts or stereotyped sexual figures. Record the child's description of the drawings in her own words. Date the pictures, have the child sign them, and record any spontaneous comments the child makes about the pictures. This is especially important for first disclosures and can have legal ramifications, ie., admissibility of the information as evidence in court.

Always give children the opportunity to "draw the abuse", but let them know that there are other ways to provide details about what happened.

4. House Drawings and House-room Diagrams

School age children can make very good location (crime scene) drawings and diagrams. If the child identifies a room as the scene of abuse, have her/him mark the scene and fill in surrounding furnishings, and identifying objects, mark the place in the room where the abuse occurred, and draw the abuse if possible. If reassured that they can depict the abuse in any way they want to with lines and arrows, stick figures, or how they usually draw, children often produce very explicit drawings.

Have the child include what the offender said, what if anything (s)he said, and her feelings at the time (Meyer, 1983). When going over the drawing, the interviewer can introduce cognitive interview techniques to expand the child's memory.

Diagrams

These drawings provide hard evidence that can be used in court.

Phase III: Closing the Interview

1. If you take notes, be sure they are accurate and allow the child to correct and to elaborate. "Let's go over my notes on what you've told me. I want to be sure I have it right."
2. Talk about how the child feels about her situation - concerns, fears, expectations regarding what will happen to her and to her family. Make no promises you can't keep. Be sure the child doesn't have unrealistic ideas about your power as an adult authority.
3. Go over the guilt-blame issue. Emphasize that the child is not to blame and that the child did the right thing by disclosing.
4. Handle concerns about the abuser. What would the child like to have happen regarding the abuser. Emphasize that what does happen to the abuser is not up to you or to the child, but "is the job of other people like judges." Point out that if something happened to the abuser (like removal from the family or incarceration), it is the result of what the abuser did, not the result of the child telling.
5. Convey your desire to help the child and provide as much information as you can about what you intend to do, what will happened next to the child.
6. Reassure the child as much as you can. Invite further contact if the child needs it. "We will all do everything we can to be sure that nothing like this happens to you again. If anything else ever happens to you that scares you or worries you, please tell us."
7. Let the child know that her reactions and feelings are normal. Reassure her about healing and the benefits of therapy. Encourage her to go on with her everyday life again.
8. Thank the child for talking with you. Acknowledge that it was difficult. Praise all the effort the child made during the interview.
9. End the interview by playing (younger child) or neutral conversation (older child). End on a positive, non-sexual subject so the child knows you are interested in him/her as a whole person, not simply as a sexually abused victim.

(Rutter, B., 1988)

Preparation

There is a tendency to lump all adolescents together into one dynamic and developmental group. In fact, young, middle, and late adolescents communicate in some very different ways because of different stage tasks.

In the first three years of adolescence, teens are likely to be averbal. They are psychologically marked by difficulty expressing thoughts and feelings. At puberty they suppress various physical means of expressing strong feelings (i.e., hitting or crying) and begin to try to use words. "Talking" interviews are difficult under any circumstances. Add the issues of sexual victimization and the young teen becomes verbally frozen. The interviewer must supply suitable words for expression without putting words in the teen's mouth. This can be accomplished by providing checklists, sentence completions, and other kinds of writing techniques. Some of this age group still respond to drawing and art techniques. Dynamically, the abused young teenager has lost an important part of her childhood and is driven to keep trying to find it, even in destructive relationships. This age adolescent is especially vulnerable to father figure molesters and pedophiles.

"Middlers" can talk better but have developed strong resistance to disclosure in incest situations. The developmental task of breaking remaining bonds to parents is often complicated by having to separate from a parent they have not bonded to in a healthy way. Trauma bonding is very strong and explains some of the protective attitudes encountered toward offenders. In cases of long-term non-familial abuse, the bond is to the offender as a substitute parent. As in incest, a bad parent is better than no parent at all at this time in the teens' lives. Awareness of the strength of this dynamic can help the interviewer temper personal reactions or comments when asking and talking about the abuser.

The final task of developing the capacity to love, accept, and engage in an intimate relationship has been interrupted by victimization, with all the related factors of shame, mistrust, and avoidance of relationships. The interviewer's task is to stay focused on interview goals while relating to the adolescent within these dynamics.

Recognizing the needs of each subgroup of adolescence can help the interviewer individualize the selection of tools and techniques needed by that group to stay focused on the interview tasks.

Phase I: Introductions, Explanations, Rapport

All ages of adolescents still need and appreciate expressive aids. During rapport and explanations, comfort and distancing techniques help mediate teens' ambivalence about establishing communication. Having something to do with their hands helps discharge anxious energy, and at the same time can provide information. Writing techniques provide for both distancing and informational needs. Prepared writing instruments also help avoid "prescripted" responses, avoidance, and defensive maneuvers. (See section on Extended Assessment.)

Remember that choices equal control and there is no age group more concerned with being in control than adolescents, especially older adolescents. They respond favorably to choosing the pen and paper technique they will use first. Their choices reflect the level of responsiveness to avoidance of the information each technique pulls for, and directs the interviewer on how to proceed with the interview.

Going over a completed writing task generates a "give and take" format that stimulates thinking and evolves naturally into an interview format. As the teen becomes involved in conversation (not a verbal question and answer format at this point in the interview), options for answering questions can be offered. (S)he can say:

1. I don't know or remember.
2. I don't understand.
3. I don't want to answer that.
4. Correct the interviewer if needed.

Transition to the abuse-focused phase is eased by allowing this control, and the comfort level is often increased sufficiently to shift the conversation to the report, or reason for concern.

Phase II: Gathering Information about Possible Abuse

Some information about abuse may have been obtained with the written material. If the response to those techniques has been productive, the interviewer can offer the option to continue in that mode and provide paper for a written narrative statement. Within this context, the Cognitive Interview technique may be introduced. (See Part III). After this approach has been explained some teens can participate in a "practice" interview about an event of their choice, or the interviewer can suggest subjects like their last telephone conversation with a friend, the last movie they saw, or their favorite memory.

Whether written or verbal, the narrative should not be interrupted by questions from the interviewer. This does not mean that the interviewer sits rigidly silent and uninvolved. Verbal and nonverbal encouragers can be offered to help the narrative along. After the narrative is exhausted, specific questions may be asked about the information that has so far been provided.

Following the practice run through, the same approach to the abuse experience can be continued, or offered in another way. Repeat the instruction to mentally picture the scene of the abusive event with contextual details and associated sounds, smells, and colors. Suggest that the teen draw the location scene and fill in contextual details, including a depiction of the abusive acts. This adaptation of the cognitive interview-reconstructing the context and cueing memory by writing or drawing-has been successful in producing detailed disclosure information, even with non-disclosing teens. (Amacher, 1999).

Phase III: Closing the Interview

When reviewing the interview, ask the adolescent to evaluate what was the most helpful, least helpful, most upsetting. Ask what you could provide in the follow-up interview to help address all the things that still need to be discussed and/or dealt with. Co-write a "next step" list. If there has been a disclosure, check to see if you have all the following information.

1. Description of the offender, his vehicles, and his house (if applicable) in great detail.
2. Determine the number and specific acts committed by the offender.
3. Determine how the offender induced the child to perform or submit to such acts.
4. Determine if pornography or erotica was used and/or present. If so, what kind and where it is kept.
5. Determine if drugs were used and, if so, what kind and where were they kept.
6. Determine if the child was photographed, and if so, what kind of camera was used and where it is kept.
7. Ask if the child saw photos of other children and obtain their descriptions.
8. Determine if other children were involved in or present during any of the acts and attempt to identify them.
9. Determine if the child knows any other adults who participated in the acts or know the offender.
10. Determine if the child has been victimized by more than one person and, if so, who the other offenders are.
11. Ask the child if he/she ever gave their name, address, or phone number to the offender and, if so, how the offender recorded it.
12. Determine if the child saw other children give such information and, if so, how it was recorded.
13. As if the offender has a diary or computer.
14. Ask if the child played with any toys or books at the offender's home and, if so, obtain detailed descriptions.
15. Determine if the child left any personal belongings in the offender's possession.
16. Ask if the offender gave the child any gifts.

(National Center for Missing and Exploited Children. (1992). Child Abuse and exploitation: Investigative techniques. Chapter 4, Appendix C, p. 181.)

Close the interview by clarifying who the adolescent wants, and does not want, to know about the abuse and how this fits with the realities of the investigation. There is sometimes an assumption that pseudo-sophisticated teens are knowledgeable about the legal system. Some are, but some are not. Date-rape victims especially need supportive crisis intervention and education about "the system" because many of them are very resistant to reporting and charging the rapist. (See the following section on Date Rape.)

"Date" rape is defined as "forced sexual contact during dating or in the context of arrangements surrounding dating" (McIvor & Hasting, 1990). The majority of adolescent rape victims are victims of date-rape.

Information to Consider when Interviewing Adolescent Date-Rape Victims

Rape is especially traumatic to adolescents who are in the process of forming their identities and sexual behavior patterns. Typically, date-rape victims do not conceptualize it as sexual assault and do not report it. The victim blames herself for being too sexy, not saying "no" soon enough, or clearly enough putting herself in the position for it to happen, not resisting more, or not seeing it coming. The self-blaming is often reinforced not only by the rapist but by society in general, and sometimes professionals and parents. Some victims who do not report feel they are in a double bind: they are supposed to be sexually attractive but not sexually active. They know boys like friendly girls, but are not sure how friendly to be without giving the wrong message.

Understanding these common feelings of date-rape victims, and reflecting them back to the victim goes a long way toward establishing rapport and getting the interview off to a good start.

Another confounding aspect of date-rape dynamics is that some victims continue to date the person who raped them. Victims from dysfunctional families may want to be loved so much that they would rather have an abusive boyfriend than no boyfriend, or they may not see forced sex as unusual. If they have previously been sexually abused, the response to the rape is also shaped by the response to the earlier sexual assault. The date-rape may trigger repressed memories and result in "double whammy" trauma. Extreme responses can include suicide, homicide, blocking, and dissociative disorder. If the victim blamed herself for her prior molestation, the rape may confirm the self-blame and lead to feelings of worthlessness, promiscuity, and despair.

Victims who get help with prior molestations are more likely to report date-rape and have the best prognosis for recovery. They should not be stigmatized or prejudged because of previous sexual assault experiences. A large percentage of date-rape victims have had previous abuse experiences.

This information needs to be conveyed to the victim by the interviewer as part of a victim sensitive approach to interviewing that can help reduce shame and self-blame.

The date-rape victim is also at risk of less than supportive reactions and behavior from her parents. Their responses often reinforce her self-blame and hesitancy to report. She is often somewhere she is not supposed to be, doing something she is not supposed to be doing (drinking, drugging, smoking) when the rape occurs. Experienced rapists and molesters know this and plan accordingly. Alcohol is commonly used and some teens are afraid that if they report, the police will arrest them for drinking. Remember, they are not as sophisticated and knowledgeable as they appear and another reason for not reporting rape is the belief that the justice system will not protect them.

A final factor in not reporting rape is fear. The threats of a rapist to kill the victim, and/or her family has real force because of the force involved in the reality of the rape.

How does the investigator or other professional interviewer use this information to help date-rape victims?

1. Educate the victim and her family about the Rape Trauma Syndrome (Burgers & Holmstrom, 1974).
2. Develop a list of common reactions of victims.
3. If immediate crisis resources are not available, do not make the victim wait for a counselor/therapist to offer crisis information like:
• She did not surrender her right to say "no" when she went on a date, had a drink, or flirted.
• She can say "no" at any point.
• "No" means no. "Stop" means stop.
• If the rapist continues, it is a crime.
• Rape is a serious crime.
4. Clarify the victim's rights. This kind of clarification up front can reduce self-blame and focus the victim's attention on necessary issues. While law enforcement clarifies investigative requirements, the victim's legal rights and associated procedures, the CPS investigator can help the parents "ventilate" but not blame the victim even though (s)he was guilty of disobedience and/or poor judgment. Remind them that poor judgment is a normal characteristic of adolescence. Rape is a crime.

Note: Most of the information in this section is taken from, "Working with Female Adolescent Date-Rape Victims" by McIvor, D.L. & Harting, C. (1990). Article condensed and adapted by Amacher, 2000.

The following information applies to interviewing all rape victims.

Expand the interview process to incorporate PFA, a technique developed for law enforcement to improve response to sexual assault victims. The purpose of providing PFA before trying to interview an assault victim is to remove the emotional barriers between the interviewer and the information (s)he needs to get from the victim.
Two contrasting styles of victim response are encountered by interviewers:

1. Expressive style-with full outpouring of emotional pain, fear, and confusion.
2. Controlled style-non-responsive with strong defensive structure to protect from overwhelming emotion. (Burgess, Holstrom, Groth, & Segroi, 1978).

PFA is a process of encouraging expression of the overpowering emotion found in both of these styles by:

1. Asking if the victim is all right and then really listening to the outpouring of feeling and confusion without interrupting with questions.
2. If the victim is in shock, controlling or repressing feeling, ask her to name any emotion she is feeling.
3. Validate whatever response the victim expresses by explaining it is a normal reaction.
4. Congratulate her on surviving.
5. Review the Interviewing Implications for Type I Trauma (See Section on Childhood Trauma) and structure the interview accordingly.
6. Anchor for safety by providing concrete plans and services to support verbal reassurances.
7. Refer to a Rape Crisis center or counseling service, make the appointment if possible, and arrange transportation to/from the referral resource.

References - Chronological order

1. Summit, R., (1983) Child sexual abuse accommodation syndrome, Child Abuse and Neglect . 7, 177-193
2. Summit, R. (1992) use and misuse of the child sexual abuse accommodation syndrome in court testimony of child sexual abuse. Vol 4, Hayworth Press.
3. Sorenson, T., & Snow, B. (1991) How children tell: the process of disclosure. Child Welfare 70(1) pp.3-15.
4. Werner, J., & Perlmutter, M. (1979 Development of visual memory in infants. Advancement in child development and behavior. Vol 14, pp. 1-50, New York Academic Press.
5. Perry, N., (1992) how children remember and why they forget. APSAC advisor, Vol. 5, no.3, summer 2..
6. Carey, S. (1978) A case study - Face recognition in E. Walker (Ed.) Explorations in the biology of language (pp. 175-201), Montgomery, VT. Bradford Books.
7. Fisher, R., Amador, M., Geiselman,R., (1989), Field test of the cognitive interview enhancing recollections of actual victims and witnesses of crime. Journal of Applied Psychology. 74, 722-727
8. Marin, R., Holmes, D., Guth, M., & Kovac, P. (1979) The potential of children as eyewitnesses - Law and Human Behavior. 3, 295-306.
9. Milton, G. (1980) Children's competency to stand trial. Law and Human Behavior , 5, 186-190.
10. Nelson, K. (1986) Event knowledge: Structure and function in development. Erlbaum, Hillsdale, N.Y.
11. Hewitt, S., (1994) Preverbal sexual abuse: what two children report in later years. Child Abuse and Neglect. Vol. 18, No. 10, pp. 821-826
12. Terr, L., (1988) What happens to early memories of trauma? A study of 20 children under age five at the time of documented traumatic events Journal of American Academy of Child and Adolescent Psychiatry, 27, 96-104
13. Peters, D. (1987) the impact of naturally occurring stress on children's memory . In S.J.Ceci, M.P. Toglia, & D.F. Ross. (Eds). Children's Eyewitness memory. pp. 122-141. N.Y. Springler-Verlag.
14. Fivash, R., Gary J. From Hoff, F. (1987) Two year olds talk about the past. Cognitive Department 2, 293-409. Price, D. & Goodman, G., (1990) Visiting the wizard: children's memory for a recurring event, Child Development.
15. Everson, M and Boat, B. (1990). Sexualized doll play among young children: Implications for the use of anatomical dolls in sexual abuse evaluations, Journal of Am. Academy of Child & Adolescent Psychiatry, 29, 736-742
16. Saywitch, K., Goodman, G., Myers, J. (1990). Can children provide accurate eyewitness reports? Violence Update. Summer
17. Clarke-Stewart, A., Thompson, L., Goldman, J., (1989) Manipulating children's testimony through interrogation. In G. Goodman (chair) Can children provide accurate eyewitness testimony? Symposium & Society for research in Child Development Meetings, Kansas City, MO.
18. Myers, J., Bays, J., Becker, J, Berliner, L., Co. D. & Sayw???K. (1989) Expert testimony in child sexual abuse litigation. Nebraska Law Review. 68, pp. 1-34.
19. deYoung, M., (1986) A conceptual model for judging the truthfulness of a young child's allegation of sexual abuse. AM. J. Orthopsychiatry. 56 (4) Oct.
20. Amacher, E., (2000) Interviewing child and adolescent sexual abuse victims. Prevent child abuse South Carolina Annual Conference, presentation, Columbia, S.C.

21. Fuller, K., (2000) Child interviews when sexual abuse is suspected-presentation handout, p.10. National Symposium Child Sexual Abuse. Mar. 11.
22. Terr, L., (1991) Childhood Trauma: an outline and overview. Am. J. Psychiatry 148:1. January pp.
23. Erickson, E. (1950) Childhood and Society. Basic trust vs. basic mistrust. Chpt. 7. pp. 247-251.
24. Amacher, E., (1998) Victimization trauma assessment (V.T.A) Intern Training Program, Children Hospital Intervention and Prevention Program (CHIPS), Birmingham, AL.
25. Levy, H., Kalinowski, N., Markovic, J. Pittman, M., Ahart, S., (1991) Victim sensitive interviewing in child sexual abuse, a developmental approach to interviewing and consideration of use of anatomically detailed dolls. Monograph. Department of Pediatrics, Mt. Sinai Hospital Medical Center, Chichago, IL. pp. 41, 57.
26. American Professional Society on the Abuse of Children. (1995). Use of anatomical dolls in child sexual abuse assessments. Chicago, Author
27. Groth, N., Stevenson, T., (1984) Anatomical drawings for use in the investigation and intervention of child sexual abuse cases. Forensic Mental Health Associates, Newton Center, MA
28. American Professional Society on the Abuse of Children. (1995) Guidelines for psychosocial evaluation of child sexual abuse. Chicago, Author.
29. American Professional Society on the Abuse of Children (1999) Investigative Interviewing Guidelines. Chicago. Author. (in press)
30. Rutter, B., Guidelines for the investigative interview in child sexual abuse cases. (1988) A training manual for the Children's Advocacy Center, Honolulu, Hawaii.
31. Hindman, J., (198.) A very touching book, AlexAndria
32. Amacher, E., (2000) Child and Adolescent Forensic Interview Guidelines. A step-by-step process for using interview tools and techniques. Child sexual abuse investigations. Multidisciplinary Collaborations. An Internet Resource for Forensic Invesstigations of child sexual abuse cases. Children's Justice Act and Georgia Department of Human Resources. university of Georgia Center for Continuing Education, Athens, GA.
33. White, S., Strom G., Santilli, G., Quinn, K., (1987) Guidelines for interviewing preschoolers with sexually anatomically detailed dolls. Case Western Reserve School of Medicine, Cleveland, OH.
34. Perlmutter, M., (Ed) Children's Memory (pp. 33-48). New Directions in Child Development (Vol. 10), San Francisco. Jossey-Bass.
35. Lamb, M., Sternberg, K., (1999) Eliciting accurate investigative statements from children. Presentation given at the 15th. National Symposium on Child Sexual Abuse. Mar. 11 ______________J., Hunter, R., Jaffee, R., & Zaparniuk, J., (1993) Interviewing Children in sexual abuse cases. In G. Goodman & B. Bottoms (Eds) Child Victim Witnesses: understanding and improving children's testimony. Clinical developmental and legal implications. N.Y. Guilford Press
36. Terr, L., (1997) Trauma: Assessment and Treatment. workshop presentation. Atlanta, GA.
37. Meyer, A., (1983) Incest: A treatment manual for therapy with victims, spouses and offenders. Learning Publications, FL. p. 228.
38. Rutter, B., (1988) Closing the interview: Guidelines for the Investigative Interview in child sexual abuse cases. Children's Advocacy Center on Honolulu, Hawaii.
39. McIvor, D., & Harting, C., (1990) working with female adolescent date-rape victims. Canadian Journal of Psychiatric Nursing. Vol. 31. No. 3. pp. 8-9, 15. July/Sept.
40. Burgess, A., & Halstrom, L., (1974) Rape Trauma Syndrome, Am. J. of Psychiatry. 131:981-986.

Additional Interviewing Resources

This section includes:

1. Summaries from four interview guidelines that provide sequential steps/techniques for assessing if a child has been sexually abused.
2. References on using anatomical dolls in forensic interviewing.

The Cognitive Interview is not an entirely new approach to interviewing. It incorporates concepts present in the general guidelines. What is new is the use of four specific memory retrieval strategies in a structured step-by-step process in one interview.

Memory enhancement techniques were developed by two psychologists investigating standard police interviews with adult rape victims. They are based on two basic principles of memory:

1. The effectiveness of a retrieval cue depends on the degree of similarity between the cue and the original event. The more they resemble or "overlap" each other, the more information will be retrieved.
2. There may be more than one route to an encoded event. If memory of an event cannot be cued by one means, it may be reached by another.

After a lengthy period of experimentation and evaluation with adults, the results showed an increase in information with no more inaccuracies than in standard interviews.

Adaptations of the method were made with child victims with an increase of 26% to 45% in accurate information (Saywitz, 1992). The process provides a "guided memory search" to help children ages 7 to 17, who have disclosed or are willing/ready to disclose abuse, to elaborate on their experiences.

Phase I: Rapport, Explanations of the Approach and Options for Answering Questions

The child is told:

1. If you don't know or remember the answer, say you don't. It's important to tell only what you really remember.
2. If you don't understand, just say you don't understand and ask to have the question asked another way.
3. If you don't want to answer, we can come back to that question later.
4. If asked a question more than once, it doesn't mean there was anything wrong with your answer. I just want to make sure I heard what you said correctly. Also, sometimes I may forget what I asked or how you answered.
5. If I don't get it right when I repeat your answer, tell me I got it wrong.

Phase II:

Step 1: Reconstruct the setting. The child is told to mentally picture that time when something happened as if (s)he were there, to think about where (s)he was, what it looked like, smelled like, who was there, how (s)he felt.

Then the child is instructed to tell everything (s)he can remember from beginning to the middle to the end and to tell even the things they don't think are important.

The narrative should not be interrupted but can be facilitated by nonverbal encouragers like paying attention, and nodding the head. Verbal encouragers like "what next?" "Un huh," "and then what happened" can also be used.

Step 2: After the narrative is completed, open-ended questions can be asked to clarify information given in the narrative. Focused questions can be asked next to provide more detailed information about the event and the abuser.

Several specific questions about the abuser are reported to increase details about him/her/them by 50%. They are:

1. Does _____ remind you of anyone? If so, why? How? Who?
2. Are there any unusual aspects about their speech or conversation?

Phase III:

Steps 3 and 4, asking the child to recall and relate events in reverse order and describe them form another perspective are not recommended for children. These two cognitive tasks are developmentally impossible for many young children, and very difficult for older children and adolescents (and adults).

Advantages of the Cognitive Interview Technique:

• The technique uses the type of memory aids that are conducive to children's recall (Faller, K, 2000). This contributes to the completeness of children's reports and to the validation process.
• Explanation of how questions may be answered can reduce possibilities for suggestion.
• It can be used with demonstrative aids to produce strong evidence that comes predominately from the child.

Limitations of the Cognitive Interview Technique:

• It is not appropriate for young children due to developmental limitations.
• Unless the child is in active disclosure or ready to disclose, follow-up will be needed to prepare the child for the structured approach.

For more information on the Cognitive Interview:

• Articles:
1. Olsen, L. & Wells, R. (1991). Cognitive interviewing and the victim/witness in crisis. The Police Chief, February, Glynco, GA
2. Westcott, H.L. (1992). The cognitive interview: Tool for social workers? Social Work, 22, 519-533.
3. National Institute of Justice Research in Brief. (1992). A new approach to interviewing children. Washington, D.C.: US Dept. of Justice, National Institute of Justice.
• Books:
1. Fisher, R. & Geiselman, E. (1992). Memory-enhancing techniques for investigative interviewing: The cognitive interview. Springfield, IL: Charles Thomas Publisher.

Note: The following two guidelines incorporate principles and procedures of the Cognitive Interview and add several helpful techniques for introducing the topic of concern.

Available from John Yuille, Ph.D., Department of Psychology, University of British Columbia.

These guidelines describe the process of nine contingent steps structured to maximize narrative responses and minimize interviewer "contagion". The principle steps are:

1. Rapport building-conducted much the same as other guidelines with addition of a "teaching" component.
2. The child is asked to describe two specific past events (birthday party, school outing, etc.) to predict the child's response style in the following fact finding part of the interview. It also allows the interviewer to model expectations, re: the focus of the interview.
3. Agreement to tell the truth throughout the interview.
4. Introducing the topic of concern.
• Do you know why we are talking here today?
• I'm a (police officer/social worker) and I talk to kids all the time about things that happen to them. Do you want to talk to me about anything that's happened to you?
• Kids tell me about good things that have happened to them and bad things that have happened to them. Do you want to tell me about something good that has happened to you? And later… Do you want to tell me about something bad that happened to you?
If not successful:
• Questions about names and roles of various adults in the child's life.
If not successful:
• Body parts and functions - questions related to who has seen and/or touched various parts of the child's body.
If not successful:
• Direct questioning paired with open-ended questions ("Did someone touch your pee-pee? Tell me about that.")
5. Free narrative. When/if the topic of sexual abuse has been introduced, the child is encouraged to provide a free narrative. The cognitive interviewing approach and continuum of questions is continued in the following two steps.
6. General questions for more information.
7. Specific questions for more clarification if necessary and follow-up on any inconsistencies.
8. Interview aids (if necessary) may be used with young children with language or "emotional" difficulties at this stage in the interview but anatomical dolls are used only after the child has disclosed abuse to clarify not obtain the disclosure.
9. Concluding the interview. Regardless of conclusions, the child is thanked for participating and receives information on what to expect next.

(Yuille, J.C., et.al., 1993).

Advantages of the Stepwise Interview:

• Provides practice for expectations during the interview and information on the child's response style.
• Specific sequence for introducing the topic of concern.
• Good "hand signal" in Step 6 to indicate knowledge but not readiness to talk about it.

Limitations of the Stepwise Interview:

• Too structured for some children.
• Limited use of communication aids deprives young children of their most natural and effective communication process.
• Restriction on use of anatomical dolls to assist disclosure is not empirically based and deprives all age children of an opportunity for disclosure.

This structured, entirely verbal questioning protocol uses no communication tools and allows no deviation from the scripted format. Like the Stepwise Interview, it does include several helpful components that can be applied within other interview guidelines. During the rapport phase, the interviewer asks three open-ended questions about school, family, and a recent holiday rather than the short-answer questions often asked during this phase. This "trains" the child how to elaborate his/her answers during the remainder of the interview.

Introducing the Topic:

1. "Now that I know you a little better, I want to talk about why [you are here/I am here] today."
2. "I understand that something may have happened to you. Tell me everything that happened from the beginning to the end, as best as you can remember."
3. "As I told you, my job is to talk to kids about things that might have happened to them. It is very important that you tell me why [you are here/I am here]. Tell me why you think [your mom, your dad, your grandmother] brought you here today [or "why you think I came to talk to you today]."
4. "I've heard that you talked to [a doctor/a teacher/a social worker/any other professional] at [time/location]. Tell me what you talked about."
5. "I see [I heard] that you have [marks/injuries/bruises] on your _______. Tell me everything about that."
6. "Has anybody been bothering you?"
7. "Has anything happened to you at [location/time of alleged incident]?"
8. "Did someone do something to you that wasn't right?"
9. "Did someone [briefly summarize allegations or suspicions without specifying names of alleged perpetrator or providing too many details]." (For example, "Did somebody hit you?" or "Did something touch your pee-pee [private parts of your body]?)
10. "Your teacher [the doctor/psychologist/neighbor] told me/showed me ["that you touched other children's pee-pee"/ "a picture that you drew"], and I want to find out if something may have happened to you. Did anybody [briefly summarize allegations or suspicions without specifying the name of the alleged perpetrator or providing too many details]. [For example: "Did somebody in your family hit you?" or "Did somebody touch your pee-pee or other private parts of your body?"]

(Lamb, M. & Sternberg, K., 1998).

Advantages of the Scripted Interview:

• Introducing the open-ended questioning format in the rapport phase that will be used throughout the interview accomplishes two helpful things:
1. If the format works, it can increase the amount of words/details provided.
2. If the format doesn't work, it tells the interviewer that the interview will have to be adjusted to a more directed interplay of the continuum of questions.

Limitations of the Scripted Interview:

• Too structured for very young children to follow; does not allow them to move around or in and out of phases as they often need to do.
• Does not include communication aids to assist in following the structure or provide/demonstrate details for consistency with verbal descriptions.
• The lack of flexibility in the format may exclude participation by some victims due to age, type of trauma, or developmental limitations.

Friedman, V. & Morgan, M. (1985). Interviewing sexual abuse victims using anatomical dolls: The professional's guidebook. Eugene, OR: Shamrock Press.

This guidebook provides two step-by-step processes for focusing on the topic of abuse. The first is a series of eight steps assisted by a writing technique. The authors emphasize that the steps should be followed in order, but if a disclosure occurs in any step, the disclosure is pursued at that point without pursuing the following eight steps:

1. "I am a helper." The interviewer describes his/her job as helping children and families with problems they can't solve by themselves, and asks if the child or family needs help.
2. Persons in household. The child makes a list or draws the people who live with her/him.
3. Favorite things. The child lists the favorite and least favorite things about each of these people.
4. Privacy. The interviewer asks about privacy in the home and if the people on the list allow him/her privacy.
5. Safety rules (children 4 to 12 years of age). The child is asked to list all the safety rules in the home, including personal safety, and ask if anyone does not follow the rules.
6. Problems. The interviewer tells the child that some children talk to her/him about problems they have in their homes, like hitting, fighting, touching, yelling. The child is asked if any of these kinds of problems happen in his/her home.
7. Touching. The interviewer tells the child, that some children talk about touching that happens at home or somewhere else. This touching is usually by someone older (or bigger) that makes them feel uncomfortable. Has anything like that happened to them?
8. Paraphrase. The interviewer refers to the report of abuse omitting the identity of the alleged abuser and details about any alleged sexual act. This is paraphrased as a concern expressed for the child. If the child affirms the need for concern, (s)he is asked to tell what kind of touching.

If the child has not disclosed sexual abuse, it is possible that no abuse has occurred. The child is thanked and told to contact the interviewer, who is still concerned and available. The child is asked to name three people who would call if the child needs to talk again.

The Guidebook also provides a sequence of steps to use with anatomical dolls or puppets:

1. Tell the child the dolls/puppets have body parts like people and can help children explain what did or did not happen to them.
2. Ask the child to pick up a doll/puppet.
3. Do a body parts inventory. Start with nonsexual parts, move to sexual parts and back to nonsexual parts. Use the names the child gives and, if the name for a sexual body part is a "street" name, ask who told them that name.
4. Use a doll of the opposite sex and do another body parts inventory. Ask which is a boy and which is a girl and how the child knows.
5. Next, ask the child to pick a doll/puppet to be her/him and one to be the person named as an abuser.
6. Ask the child to show what happened and proceed with questions like: What happened next; what else happened; or explain a little more.
   
   If the child wants to explore the dolls with his/her back turned or behind some barrier, allow that privacy and continue to talk and elicit verbal responses. Explain that it is hard to understand what is happening because you can't see him/her and ask if you can sit behind him/her and watch.
   
   After the demonstration, ask if the child has any questions of you. Review any notes made during the interview and thank the child for his/her hard work.

Additional Anatomical Doll Interviewing Guidelines:

1. Using Anatomical Dolls: Guidelines for Interviewing Young Children in Sexual Abuse Investigations. Barbara Boat, Ph.D. and Mark Everson, Ph.D., Department of Psychiatry, University of North Carolina, Chapel Hill, NC.
2. Victim Sensitive Interviewing in Child Sexual Abuse: A Developmental Approach to Interviewing and Consideration of the Use of Anatomically Detailed Dolls. A Monograph. Howard Levy, M.D., Noel Kalinowski, M.Ed., John Markovie, Mary Pittman, M.S.W., Sharon Ahart, M.C., Mt. Sinai Hospital Medical Center. Victim Sensitive Interviewing Monograph Dept. of Pediatrics, 15th St. and California Ave., Chicago, IL. Copies of the monograph by be obtained by writing to the address above.
3. Step by Step: Sixteen Steps Toward Legally Sound Sexual Abuse Investigations. Jan Hindman, Alexandria Associates. 911 S.W. 3rd. St. Ontario, OR.
4. Guidelines for Interviewing Preschoolers with Sexually Anatomically Detailed Dolls. Sue White, Ph.D., Gerald S. Strom, M.S.W., Gail Santelli, MSSA, Kathleen Quinn, M.D. Case Western Reserve University School of Medicine. Cleveland Metropolitan General Hospital, 3395 Scranton Road, Cleveland, OH.