What They Can Tell Us and What We Need: The Intersections of Children’s Abilities to Disclose and the MDT’s Need for Information.

What They Can Tell Us andWhat We Need:

The Intersections of Children’s Abilities to Disclose and the MDT’s Need for Information

Learning Objectives

1. Highlight the inevitable tension between “needs of the child” and needs of the MDT” and how to balance these

2. Review developmental considerations and trauma considerations which impact this tension point and are critical to the protection and well-being of children

3. Identify practice considerations relative to these issues which can and should be discussed within each MDT

Why should we conduct a forensic interview?• Did a crime occur?

• Has someone hurt other children?

• Is this part of another case?

• Is a child at-risk for harm? Self-harm?

• Does a child have special needs which need to be addressed?

• Does a child clearly need some type of services?

• Was a child a victim of exploitation?

• Who else needs a forensic interview?

Why should we conduct a forensic interview?• Do we need to refer this case to another

jurisdiction?

• Do we need to have a medical exam conducted?

• Is there evidence we should seek?

• Is a search warrant indicated?

• What corroborative evidence might be found?

• Who else do we need to talk to regarding the allegations?

• Is the parent/caregiver supportive/protective?

Why should we conduct a forensic interview?

• What about from a kid-perspective? I want to feel safe

I want my siblings/friends to be safe

I want to get help and not feel this way anymore

I am worried I might get hurt if this continues

Needs of the Child• Do no harm

Rule of Keri

• What is most important if it is your child?How do you view success?

Needs of the MDT• Forensic Interviewer – it’s my job

• Law Enforcement – has a crime been committed?

• Child Protective Services – is the child safe?

• Prosecutor – can I make a case?

• Medical personnel – does child need medical care?

• CAC – what can we do to help this child/family?

• Victim Advocate – what can we do to support those involved?

Who is our client?• Child?

• Parent/Caregiver?

• MDT?

• Investigation vs. Therapy vs. Prosecution?

What do we know about the disclosure of child abuse?

Lippert, T, Cross, T.P., Jones, L. & Walsh, W.

(2008).

Telling interviewers about sexual abuse: predictors of child disclosure at forensic interviews. Child Maltreatment, 14(1),

100-113.

What is he/she going to say?

• Time of forensic interview from onset of abuse:

Within one year of onset – 65%

Between 1-7 years of onset – 29%

More than 7 years after onset – 4%

• Disclosure rates:

Full - 73%

Partial – 12%

No Disclosure – 10%

Denials – 5%

What is he/she going to say?

• Girls were significantly more likely to make a full disclosure than boys

• Disclosure rates were much higher for older children

• Children with an extrafamilial relationship with the suspect were slightly more likely to make a full disclosure

• A higher percentage of children who had experienced more severe abuse made full disclosures than those with less severe abuse

What is he/she going to say?

• Full disclosure rates by prior disclosure status:No prior disclosure – 60%

Prior disclosure by child – 81%

• Caregiver actions which were related to children’s full disclosure:Contacting law enforcement

Contacting another person about the allegations

Restricting suspect contact with the child

Removing the suspect from the home

Hershkowitz, I., Lamb, M.E., Katz, C., & Malloy, L.C. (2013).

Does enhanced rapport-building alter the dynamics of investigative interviews with suspected victims of intra-

familial abuse?. Journal of Police and Criminal Psychology, 1-9.DOI 10.1007/s11896-013-9136-8

Importance of Rapport-Building• Revised Protocol included changes to Rapport Building

(RB)

Preceded (rather than followed) explanation of the ground rules and expectations

Inviting free-recall narratives about recent experience(s)

Prompting children to provide more details about personally-meaningful topics using open-ended invitations

Express interest in the child’s experiences

To use children’s names

To echo children’s feelings

To acknowledge feelings

To explore feelings the child relates

Importance of Rapport-Building• Children interviewed using the Revised Protocol:

showed less reluctance than children interviewed using the Standard Protocol

• Using the Revised Protocol was associated with: Increased support in the rapport-building and transitional

phases of FI

Decreased child reluctance in the rapport-building and substantive phases of the FI

Hershkowitz, I., Lamb, M.E., Orbach, Y., Katz, C., & Horowitz, D. (2011).

The development of communicative and narrative skills among preschoolers: Lessons from forensic interviews

about child abuse. Child Development, (00) 1-12.

Interviewing the young ones – can the child do this?• Purpose

to explore the ability of young children (between ages 3-6) to respond informatively to various questions or prompts used in forensic interviews

to explore age differences in patterns of response to various types of prompts.

• 299 alleged victims of child abuse between the ages of 3-6 who disclosed either sexual (128) or physical (171) abuse.

3-3.11 – 46

4-4.11 - 98

5-5.11 – 96

6-6.11 – 59

Interviewing the young ones – can the child do this?• Interviewed by a total of 61 child investigators using the

NICHD protocol.

110 of the children were abused a single time

189 disclosed being abused multiple times

Most suspects were members of the child’s family

• All interviews were recorded and transcribed, and interviewer prompts were classified into four categories of questions:

Open-ended invitations

Directive prompts

Option-posing prompts

Suggestive prompts

Interviewing the young ones – can the child do this?

• Substantive Phase of the interview – interviewers made 84.59 prompts to the children

Directive prompts were most frequent, followed by invitations, option-posing questions, and suggestive prompts

• 3 year olds were given fewer invitations than either 5 or 6 year olds

• Overall, invitations yielded the greatest number of forensic details, but this is dramatically more likely with the older children

• On average, children provided 1.99 forensic details per response

Interviewing the young ones – can the child do this?

• Children of all ages made some response to 92% of interviewer promptsHowever, only about 63% of these responses were

“on-track”

• Children provided proportionally fewer “on-track” responses to invitations than to directive, option-posing, or suggestive prompts

• 3 and 4 year olds provided significantly more “on-track” responses to directive prompts than to invitations

Why does this happen?

BRAIN DEVELOPMENT AND TRAUMA

Let’s talk about brains…..

• Brain develops from “the bottom up”

• Brain stem – gestation & early months

• Limbic system & cortical areas - early years

• Cerebral cortex - begins wiring up right & left hemisphere (mapping) - begins at 7/8 adolescence beyond

• Pre-frontal cortex – 25 & up (higher order brain)

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Developing Cognitive Skills

• 7th month age 2 – exuberance in growth & organization

• Production & pruning influenced by use

• Critical periods for development of some brain functions

• Speed & efficiency increases with age & experience

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Brain Development in Latency Age

• Cognitive process become more efficient & sophisticated with age

• Accumulation of world knowledge

• Begin to organize info into “chunks”

• “Chunks” become more detailed & categorical

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Brain Development in Teens

• Period of massive brain development & reorganization

• Increase in pruning & myelination

• more efficient & less adaptable

• Becoming specialized in preparation for adulthood

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Impact of Attachment Relationships

• Environment has tremendous influence

• Internal working model for adults

• Memory & language skills

• Attention span

• Ability to regulate & to be soothed

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Suggestibility

The degree to which one’s memory or recounting of an event is influenced by suggested information or misinformation

• Actual changes or distortions in memory

• Alterations in the recounting of the event without an actual change in memory

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Suggestibility

• Not all elements of remembered event are stored

• Susceptible to suggestion about non-existent or non-remembered details

• Executive functioning helps child “evaluate” suggested information

• Search strategies develop over time

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Suggestibility

Risk is greatest

• Non-salient details (for child)

• Lack of rapport or comfort

• Questions that are developmentally inappropriate

• Young / disabilities

• Complicated history

• Trauma

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Impact of Trauma in Children

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What can cause trauma in children?

• Sexual abuse

• Physical abuse

• Neglect

• Natural disaster

• Violence in the home

• Violence in the neighborhood

• Exposure to sexual exploitation

• Substance abuse in the home/by caregiver

• Homeless

• Criminal victimization

• Man-made disaster

• Violent themes in media

• Medical interventions

• Accidents

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Areas of Trauma Impacts in Children

• Attachment

• Biology

• Affect Regulation

• Dissociation

• Behavioral Control

• Cognition

• Self-Concept

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Attachment

• Uncertainty about the reliability and predictability of the world

• Problems with boundaries

• Distrust and suspiciousness

• Social isolation

• Interpersonal difficulties

• Difficulty attuning to other people’s emotional states

• Difficulty with perspective taking

• Difficulty enlisting other people as allies

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Biology

• Sensorimotor developmental problems

• Hypersensitivity to physical contact

• Analgesia (loss of ability to feel pain)

• Problems with coordination, balance, body tone

• Difficulties localizing skin contact

• Somatization

• Increased medical problems across a wide span (e.g., pelvic pain, asthma, skin problems, autoimmune disorders, pseudoseizures)

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Affect Regulation

• Difficulty with emotional self-regulation

• Difficulty describing feelings and internal experience

• Problems knowing and describing internal states

• Difficulty communicating wishes and desires

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Dissociation

• Distinct alterations in states of consciousness

• Amnesia

• Depersonalization and derealization

• Two or more distinct states of consciousness, with impaired memory for state-based events

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Behavioral Control• Poor modulation of impulses

• Self-destructive behavior

• Aggression against others

• Pathological self-soothing behaviors

• Sleep disturbances

• Excessive compliance

• Oppositional behavior

• Difficulty understanding and complying with rules

• Communication of traumatic past by reenactment in day-to-day behavior or play (sexual, aggressive, etc.)

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Cognition

• Difficulties in attention regulation and executive functioning

• Lack of sustained curiosity

• Problems with processing novel information

• Problems focusing on and completing tasks

• Problems with object constancy

• Difficulty planning and anticipating

• Problems understanding own contribution to what happens to them

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Cognition (cont.)

• Learning difficulties

• Problems with language development

• Problems with orientation in time and space

• Acoustic and visual perceptual problems

• Impaired comprehension of complex visual-spatial patterns

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Self-Concept

• Lack of a continuous, predictable sense of self

• Poor sense of separateness

• Disturbances of body image

• Low self-esteem

• Shame and guilt

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Trauma in Childhood

Single Traumatic Event

• Dissociation

• Amygdala involvement

• Event may be stored differently in brain

• Integration of right & left brain may be challenged

Chronic Trauma & Neglect

• “Firing” & “wiring”

• Diminished functioning in many areas of memory & cognition

• Dis-regulated

• Challenges with clarification & corroboration

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PTSD Symptoms

• Re-experiencing the trauma Irrational fears, flashback, nightmares

• Avoidant symptomsAvoid all reminders

Lack of responsiveness, numbing

• HyperarousalExtremely reactive, irritable, sleep difficulty

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PTS / PTSD

PTS

• Natural reaction to viewing or experiencing a traumatic even

• Diminishes over time

• Health attachment & verbal processing facilitate integration

PTSD

• Repetitive traumatic experiences

• Intervention & support not available

Or

• Diminished capacity to receive support & process

• Long-term condition

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A Complex Interaction

• Developmental stage

• Temperamental style

• Attachment relationship

• Environmental influences

• Severity of trauma

• Encoding

• Response &intervention

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It’s About Time

Time

• Time is a complex and abstract subject

• Adults reason backwards through time to determine when something happened

• Children may be able to remember whether events coincided (if salient)

• Legal system cannot depend on children for dates and times

Date

• Clock TimeChildren can tell “clock time” BEFORE they can tell

when something occurred

Date• Accurate memory for content does not correlate

with accurate memory for time

– Can remember partial details

– Take partial details and corroborate – ask mom when they lived in the blue house, get a copy of the rental agreement or school records

• Timing events requires making inferences and knowledge regarding conventional time concepts

– “It was hot outside so it must have been summer”

– “My birthday is in the summer so it must have been around my birthday”

Date

• Yesterday/today have shifting meanings (today is tomorrow’s yesterday)

What can you do?

• Elicit information regarding contemporaneous events

– Where others were (mom was cooking)

– What the child was doing (playing at the park after school)

– Where the child was living (in the yellow house)

Practice Considerations

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Who should be there? Why?

• Child

• Forensic Interviewer

• Law Enforcement

• Child Protective Services

• Prosecutor

• Medical personnel

• CASA

• Defense Attorney

• School

We record interviews. I will watch it later.• What is really lost if I am not there?

Ability to assure all questions are asked

Collaborative, real-time discussions about case specifics

Two heads are better than one

I am stuck, any ideas?

Another opportunity to interface with child and family

Timely acquisition of evidence

Demonstrated interest in case to family

Immediate answers to family

Ability to influence parent/caregiver supportiveness to child

Showing support for the forensic interviewer

Getting the offender to corroborate the child witness!

Pre-Interview Meetings

• Forensic Interviewer, CPS, a law enforcement should meet prior to the interview to discuss:Allegation: sources and circumstances surrounding the

abuse report

Pertinent child and family history, including child’s functioning and possible challenges in interview

Information obtained from CPS/LE/CAC files and Child Interview Intake Sheet

Specific topics which need to be addressed in the forensic interview

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Date

What can you do?

• Use “when” as needed – “When do you go to bed?”

– 9:00 – Temporal Location (Clock Time)

– When my sister does (Simultaneity)

– When my mom tells me (Sequence)

– After I eat dinner (Sequence)

Sequencing

• Child must understand next, before, after

Words used extensively when providing time segmentation cues

Show up in speech before child has mastered their use

Word rules fragile when child is operating in an unfamiliar arena (questioned about/attempt to describe unfamiliar event)

• Children best at narrating a single event in the order in which it occurred

Younger children will often describe events in order in which they occurred, regardless of whether asked about what happened “before” or “after” another event”

Sequencing

• What can you do?Watch how you word your questions – “Before your

father took you to the hospital, where were you?” versus “Where were you before you went to the hospital?

Ask about causal sequences

May need to be specific to action that occurred (e.g. “ Tell me everything that happened the last time.”)

Sequencing

• What can you do?Use a previously mentioned action as a temporal

reference point for prompting additional information about segments of time prior to, following, or during an action

• e.g. “When we were talking you mentioned a “person/object/action”. Tell me everything that happened before you went into the bathroom.”

• e.g. “Earlier you mentioned a “person/object/action”. Tell me everything that happened after you went into the bathroom.”

Frequency

• Children can recite numbers before they can count

• Children can count objects before they can count events in memory

– Making inferences about frequency

– Knowledge about conventional time concepts

• e.g. – “How many times did you do _______ last week?”

– Frequency x duration = Guess

– Compare to “How many times did this happen?”

Frequency

What can you do?

• After initial disclosure of an episode, ask “Did this happen one time or more than one time?”

• If more than one time, ask child what happened during a time they remember the most, what happened the last time, the first time, or another time the child remembers

– New article by T. Lyon suggests asking a child to tell what usually happened then asking about different times the child remembers

Chronic/Repeated Abuse

• Some children will only be able to give script memory (what usually happened)

• What can you do if a child clearly cannot single out separate incidents (i.e., first, last, remember the most)?

Move forward and ask the child what would usually happen

• Forced choice questions may result in a misleading answer

• What would you do/have to do?

• What would happen next?

• Where would he touch you?

Extended Forensic Interviews

• Model has been modified to be much more forensically sound

• Should be considered for:Very young children

Children making concerning statements w/o detail

Children with significant concerns that abuse occurred but no disclosure

Children with significant social engagement challenges

Children with significant trauma

Child Abuse Library Online(CALiO) www.nationalcac.org

Professional Bibliographies

• Children’s Testimony –Issues and Concernshttp://

www.nationalcac.org/images/pdfs/CALiO/Bibliographies/childrens-testimony-bib2.pdf

• Disclosure of Child Sexual Abusehttp://

www.nationalcac.org/images/pdfs/CALiO/Bibliographies/disclosure-bib4.pdf

• Forensic Interviews at Trialhttp://

www.nationalcac.org/images/pdfs/CALiO/Bibliographies/interviews-at-trial-bib.pdf

Professional Bibliographies

• Grooming of Child Sexual Abuse Victimshttp://

www.nationalcac.org/images/pdfs/CALiO/Bibliographies/grooming-bib.pdf

• Interviewing Child Witnesses of Violent Crimehttp://

www.nationalcac.org/images/pdfs/CALiO/Bibliographies/interview-child-witness-violent3.pdf

• Temporal Aspects in Child Forensic Interviewshttp://

www.nationalcac.org/images/pdfs/CALiO/Bibliographies/temporal-aspects-bib.pdf

Chris Newlin, MS LPCNational Children’s Advocacy Center(256)[email protected]

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