Legal Issues in Child Abuse and Neglect Practice

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The child protection system across the UK

Belief on reasonable grounds that a child is in need of protection on a ground referred to in Section 1 c or 1 d , formed in the course of practising his or her profession or carrying out the duties of his or her office, position or employment as soon as practicable after forming the belief and after each occasion on which he or she becomes aware of any further reasonable grounds for the belief.

A reasonable belief that a sexual offence has been committed in Victoria against a child under the age of 16 years by another person of or over the age of 18 years must disclose that information to a police officer as soon as it is practicable to do so, unless the person has a reasonable excuse for not doing so. Failure to disclose the information to police is a criminal offence. The Principal Registrar, a registrar or a deputy registrar; family counsellors; family consultants; family dispute resolution practitioners, arbitrators or legal practitioners independently representing the child's interests.

Reasonable grounds for suspecting that a child has been: abused, or is at risk of being abused; ill treated, or is at risk of being ill treated; or exposed or subjected to behaviour that psychologically harms the child. Psychological harm including but not limited to harm caused by being subjected or exposed to family violence. This includes registrars, family consultants and counsellors, family dispute resolution practitioners or arbitrators, and lawyers independently representing children's interests.

Section 67ZA states that when in the course of performing duties or functions, or exercising powers, these persons have reasonable grounds for suspecting that a child has been abused, or is at risk of being abused, the person must, as soon as practicable, notify a prescribed child welfare authority of his or her suspicion and the basis for the suspicion. In all jurisdictions, the legislation protects the reporter's identity from disclosure.

In addition, the legislation provides that as long as the report is made in good faith, the reporter cannot be liable in any civil, criminal or administrative proceeding. Legislation in all jurisdictions except New South Wales requires mandatory reporting in relation to all young people up to the age of 18 years whether they use the terms "children" or "children and young people". In New South Wales, the legislative grounds for intervention cover young people up to 18 years of age, but it is not mandatory to report suspicions of risk of harm in relation to young people aged 16 and 17 years.

Mandatory reporting laws specify the conditions under which an individual is legally required to make a report to the relevant government agency in their jurisdiction. This does not preclude an individual from making a report to the statutory child protection service if they have concerns for the safety and wellbeing of a child that do not fall within mandatory reporting requirements. Any person can make a report if they are concerned for a child's welfare even if they are not required to as a mandatory reporter. Any person making a voluntary non-mandated report is also protected with regard to confidentiality and immunity from legal liability as outlined above.

Although particular professional groups such as psychologists or government agencies such as education departments in some states may have protocols outlining the moral, ethical or professional responsibility or indeed the organisational requirement to report, they may not be officially mandated under their jurisdiction's child protection legislation. For example, in Queensland, teachers are required to report all forms of suspected significant abuse and neglect under school policy but are only mandated to report sexual abuse under the legislation. A common assumption is that mandatory reporting requirements, the legislative grounds for intervention, and research classifications of abusive and neglectful behaviour are the same.

In fact, mandatory reporting laws define the types of situations that must be reported to statutory child protection services. Legislative grounds for government intervention define the circumstances and, importantly, the threshold at which the statutory child protection service is legally able to intervene to protect a child. Researchers typically focus on defining behaviours and circumstances that can be categorised as abuse and neglect. These differences arise because each description serves a different purpose; the lack of commonality does not mean that the system is failing to work as policy-makers had intended.

Mandatory reporting is a strategy that acknowledges the prevalence, seriousness and often hidden nature of child abuse and neglect, and enables early detection of cases that otherwise may not come to the attention of agencies. Mandatory reporting requirements reinforce the moral responsibility of community members to report suspected cases of child abuse and neglect.

The laws help to create a culture that is more child-centred and that will not tolerate serious abuse and neglect of vulnerable children. The introduction of mandatory reporting and accompanying training efforts aim to enable professionals to develop an awareness of cases of child abuse and create conditions that require them to report those cases and protect them as reporters.

Research has found that mandated reporters make a substantial contribution to child protection and family welfare. As the introduction of mandatory reporting requirements within a jurisdiction tends to increase reporters' and the community's awareness of child abuse and neglect, it can result in a substantial increase in the number of reports being made to child protection departments. If there are inadequate resources available to the responsible department to respond to the increased demand, then the increasing number of reports may result in services being overwhelmed with cases to investigate and lacking sufficient staffing to do so.

It is important that mandated reporters receive training and accurate information to ensure that they know what cases they have to report, and what cases they should not report. Since non-mandated reporters make a large proportion of all reports, it is also important for the public to be made aware of the appropriate extent of their responsibility.

It is also essential that child and family support services be adequately resourced to respond to children and families in need of protection and assistance. Further details and information about mandatory reporting can be obtained from the relevant statutory child protection authority in each jurisdiction. Contact and other details for each state and territory office can be found in Reporting Abuse and Neglect: State and Territory Departments Responsible for Protecting Children. For more resources, visit the CFCA mandatory reporting bibliography.

This sheet does not relate to those circumstances but is specific to the reporting of child abuse and neglect to child protection authorities. Copyright information. Information on how to report suspected child abuse and neglect, including key contacts in each state and territory. A practical guide for organisations, professionals and any other person responding to children and young people disclosing abuse.

An overview of child abuse and neglect terminology, including broad definitions of physical abuse, emotional maltreatment, neglect and sexual abuse. A brief overview of child protection legislation across state and territory jurisdictions in Australia. CFCA offers a free research and information helpdesk for child, family and community welfare practitioners, service providers, researchers and policy makers through the CFCA News.

Google Tag Manager. If you believe a child is in immediate danger call Police on Table 1: Key features of legislative reporting duties: "state of mind" that activates reporting duty and extent of harm. Believes, or suspects, on reasonable grounds, or knows Any sexual abuse; physical or emotional injury or other abuse, or neglect, to extent that the child has suffered, or is likely to suffer, physical or psychological harm detrimental to the child's wellbeing; or the child's physical or psychological development is in jeopardy Vic.

Belief on reasonable grounds Child has suffered, or is likely to suffer, significant harm as a result of physical injury or sexual abuse, and the child's parents have not protected, or are unlikely to protect, the child from harm of that type WA Belief on reasonable grounds Not specified: any sexual abuse Australia Suspects on reasonable grounds Not specified: any assault or sexual assault; serious psychological harm; serious neglect Source: Adapted from relevant state and territory legislation.

Who is mandated to make a notification? What types of abuse are mandated reporters required to report? A person who holds a management position in an organisation, the duties of which include direct responsibility for, or direct supervision of, the provision of health care, welfare, education, children's services, residential services or law enforcement, wholly or partly, to children What must be reported? Any person A health practitioner or someone who performs work of a kind that is prescribed by regulation What must be reported?

School staff What must be reported?

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Any adult What must be reported? Belief on reasonable grounds that a child is in need of protection on a ground referred to in Section 1 c or 1 d , formed in the course of practising his or her profession or carrying out the duties of his or her office, position or employment as soon as practicable after forming the belief and after each occasion on which he or she becomes aware of any further reasonable grounds for the belief A reasonable belief that a sexual offence has been committed in Victoria against a child under the age of 16 years by another person of or over the age of 18 years must disclose that information to a police officer as soon as it is practicable to do so, unless the person has a reasonable excuse for not doing so.

Doctors; nurses and midwives; teachers or boarding supervisors; and police officers The Principal Registrar, a registrar or a deputy registrar; family counsellors; family consultants; family dispute resolution practitioners, arbitrators or legal practitioners independently representing the child's interests What must be reported? What protections are given to reporters? About whom can notifications be made? What type of concerns must be reported, and what may be reported?

In what cases can child protection and welfare agencies respond? What are the benefits of mandatory reporting requirements? Are there challenges with the introduction of mandatory reporting? Further reading Cashmore, J. Mandatory reporting: Is it the culprit? Where is the evidence? Drake, B. A response to Melton based on the best available data. These Guidelines have the narrower purpose of providing direction on the use of dolls as an adjunct to the questioning process. It is also not the purpose of these Guidelines to provide a comprehensive discussion of the clinical and empirical rationale for the use of anatomical dolls in child sexual abuse assessments.

Nevertheless, concern has been expressed about possible harm through the use of anatomical dolls in this context. One concern is that anatomical dolls may suggest sexual material, encouraging false reports from non-abused children. Another is that the dolls may be overstimulating or even traumatizing to non-abused children.

Another is that the dolls may be overstimulating or even traumatizing to non-abused children by introducing them prematurely to sexual ideas and body parts. A final concern is that interviewers using the dolls may be poorly trained and overzealous in their search for sexual abuse, eliciting unreliable, if not erroneous, evidence of abuse. When used by a knowledgeable and experienced professional, anatomical dolls can be an effective tool to aid in interviewing children to determine 1 whether an allegation of sexual abuse is likely true, and 2 if so, the nature of the abuse.

Anatomical dolls are, however, only one of many useful interview tools e. Professionals should also be familiar with current research on the dolls. Young children suspected or known to be sexually abused are statistically more likely than presumably non-abused children to engage in explicit sexualized interactions with dolls. Following are empirical findings that provide some guidance for interpreting sexual behavior with the dolls:. The dolls can also serve as visual aids for direct inquiries about the child's personal experiences with private parts.

It is appropriate to use the child's terms for body parts. This caution is based on questions about the cognitive ability of young preschoolers to use dolls to represent themselves in behavioral reenactments DeLoache, and on concerns about the potential of the dolls to distract very young children e. These concerns do not preclude other uses of the dolls with young children.

Furthermore, young children may use an anatomical doll to represent someone other than themselves and may, for example, demonstrate with a doll on their own bodies what they experienced. Sexually abused children are not always able to give a coherent verbal account of sexual abuse for a variety of reasons, including developmental level, language limitations, fear, embarrassment, and guilt. When a child's characteristics allow it, however, interviewers should generally attempt to obtain a verbal description from the child before asking the child to demonstrate with the dolls.

Everson, Ph.

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We gratefully acknowledge the many individuals who contributed their time and expertise to make these Guidelines possible and especially to Kathleen Coulborn Faller, Ph. These Guidelines will be updated periodically. Any comments or suggestions should be directed to Mark E. These Guidelines for mental health professionals reflect current knowledge and an emerging consensus about the psychosocial evaluation of suspected sexual abuse in children. They are not intended as a standard of practice to which practitioners are expected to adhere in all cases.

Evaluators must have the flexibility to exercise clinical judgment in individual cases. Laws and local customs may also influence the accepted method in a given community. Practitioners must be prepared to justify their decisions about particular practices in specific cases. As experience and scientific knowledge expand, further refinement and revision of these Guidelines are expected.

These Guidelines are specific to psychosocial evaluations. Psychosocial evaluations are a systematic process of gathering information and forming professional opinions about the source and meaning of statements, behavior, [Page ] and other evidence that are the basis of concern about possible sexual abuse. The results of such evaluations may be used to direct treatment planning and to assist in legal decision making.

Psychosocial evaluators should first establish the purpose of the evaluation and their role in the evaluation process. Psychological evaluations may be conducted for purely clinical reasons or be forensic in nature. These Guidelines pertain to both situations. Clinical evaluations may be requested by parents, guardians or other professionals to determine whether there is reason to be concerned about possible abuse. It is also customary for clinicians to precede treatment for the effects of sexual abuse with an assessment of the sexual abuse history.

Forensic evaluations have the explicit purpose of contributing to legal decision making or legal proceedings. Such evaluations may be requested by parents or guardians, public child protective services CPS agencies, attorneys, guardians ad litem or court appointed special advocates , or other professionals. The results may be used in civil or criminal proceedings. As noted in these Guidelines, forensic evaluations are different from clinical evaluations in generally requiring a different professional stance and additional components.

In all cases, evaluators should be aware that any interview with a child regarding possible sexual abuse may be subject to scrutiny and have significant implications for legal decision making and the child's safety and well-being. The initial version was the result of a lengthy, iterative process. These revisions are the result of a similar process conducted in The Guidelines will be updated periodically.

He is the author of numerous books and articles discussing legal issues in child abuse and neglect. His writing has been cited by more than courts, including the U. Supreme Court and numerous state supreme courts. In addition, he is a regular speaker at conferences on child abuse. CQ Press Your definitive resource for politics, policy and people. Remember me? Back Institutional Login Please choose from an option shown below.

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Abuse and violence - Working with our patients in general practice

Need help logging in? Click here. Don't have access? View purchasing options. Online ISBN: Online Publication Date: May 31, Print Purchase Options. Copy to Clipboard. Do Mandated Reporters Report? Will Reporting Undermine Therapy? How Serious is the Maltreatment?

What Kind of abuse is it? How Clear is the Law in This Case? How Old is the Child? Spring Commonwealth v. Edleson and Richard M. Resick and Monica K. An Integrated Approach by William N. Karp and Traci L. Karp, Traci L. Butler, and Sage C. View Copyright Page [Page iv]. For permission to reprint copyrighted material the author and publisher gratefully acknowledge the following: Goodman, G.

M94 Analysis of Problems. Bill's Confession Chapter 3. Commonwealth V. Spring Chapter 7. Commonwealth v. Milton Chapter 7. Smith v. Allred and Jones Chapter 9. Uses and Limitations of Guidelines. Specifically, there is little empirical evidence that exposure to the dolls induces non-abused, sexually naive children to have sexual fantasies and to engage in sex play that is likely to be misinterpreted as evidence of sexual abuse. Interpreting Behavior with Dolls Young children suspected or known to be sexually abused are statistically more likely than presumably non-abused children to engage in explicit sexualized interactions with dolls.

Following are empirical findings that provide some guidance for interpreting sexual behavior with the dolls: 1. Explicit sexual positioning of dolls e. When allowed to manipulate the dolls, especially in the absence of adults, a small percentage of presumably non-abused children demonstrate explicit sexual intercourse between dolls or, more rarely, attempt to enact apparent sexual acts between themselves and a doll.

Therefore, while explicit demonstrations of sexual intercourse with anatomical dolls always deserve further exploration, such activities among younger children and children without known prior sexual exposure are of particular concern. This finding suggests that penises on dolls do not encourage most young children to seek oral gratification by sucking them.

Sucking a doll's penis therefore should raise serious concerns about possible prior sexual exposure. When a young child's positioning of the dolls indicates detailed knowledge of the mechanics of sexual acts, the probability of sexual abuse is increased, and further investigation of the source of the child's sexual knowledge is warranted. Such behavior is likely to be more concerning if it is accompanied by distress reactions e.

Additional research is needed, especially examining the various functions anatomical dolls can serve in the assessment process among children of different developmental levels. No predetermined amount of time must expire before dolls are introduced, nor must a predetermined number or type of questions be asked before using dolls. Every child is unique and interviewers should use their judgement to determine when, and if, dolls may be useful.

If possible, the interviewer should be aware of the extent and nature of the child's possible prior exposure to anatomical dolls. This information is important for assessing the likely usefulness of the dolls in the current interview and for better understanding the child's reaction to and behavior with the dolls. Such information is especially important in cases in which children may have had multiple, prior doll interviews or may have been exposed to the dolls in a play therapy format in which fantasy play was encouraged.

The number of dolls presented e. Anatomical Model: The dolls can function as anatomical models for assessing a child's labels for parts of the body, understanding of bodily functions, and possible precocious knowledge of the mechanics of [Page ] sexual acts. This function of the dolls also includes their use to clarify a child's statement after a disclosure of abuse has been made. Whether or not a child experiences difficulty communicating about sexual abuse, dolls are sometimes useful to confirm an interviewer's understanding of a child's description of abuse and to reduce the likelihood of miscommunication between the child and the interviewer.

Memory Stimulus: Exposure to the dolls, and especially to such features as secondary sexual characteristics, genitalia, and articles of clothing, may be useful in stimulating or triggering a child's recall of specific events of a sexual nature. Supporting this use is research suggesting that props and concrete cues may be more effective in prompting memories in young children than are verbal cues or questions e. Typically, the child is given the opportunity freely to examine and manipulate the dolls while the interviewer observes the child's play, reaction, and remarks.

The interviewer can be either present or absent observing through a one-way mirror during this time, although children are likely to be less inhibited in their manipulations of the dolls without an adult present. After a period of uninterrupted manipulation and exploration of the dolls without an adult present, the interviewer asks follow-up questions about the child's behavior with, or reaction to, the dolls e. Icebreaker: The dolls can serve as a conversation starter on the topic of sexuality by focusing the child's attention in a non-threatening, non-leading manner on sexual issues and sexual body parts.

Dolls can also be useful in helping a child feel comfortable about talking about body parts, sexuality, etc. Generally accepted practice is to present the dolls clothed, but exceptions exist.

Excerpt (Michael Wald) - Do We Do Too Little about Child Abuse - or Too Much?

Depending upon individual child characteristics, anatomical dolls can be appropriately used in interviews with children from a wide age range, including with some adolescents. Inappropriate Uses. Specifically, it is not appropriate to draw definitive conclusions about the likelihood of abuse based solely upon interpretations of a child's behavior with the dolls. Interviewers should refrain from making statements that might encourage the child to view the dolls as toys or objects for fantasy play.

The practice of the interviewer placing the dolls in sexually explicit positions and asking the child to relate the depiction to the child's experience e. Like any interview tool or technique, anatomical dolls can be misused. For example, dolls can be used in conjunction with inappropriately suggestive questions. The utility of dolls in the interview process depends in large measure on the presence of certain physical features of the dolls.

Legal Issues in Child Abuse and Neglect Practice

The following are considered to be important features: 1. Genitalia and breasts that are proportional to body size and appropriate to the gender and age of the given doll. Oral, vaginal, and anal openings that will accommodate the adult male doll's penis. Facial expressions that are at least reasonably attractive and devoid of negative emotions, such as fear or anxiety. Clothes, including underwear, that are appropriate to the doll's represented age and gender. The impact of the racial features and skin color of the dolls on the child's response has not been empirically examined.

Preferred practice is to match the dolls with the race of the child. If it is likely that the alleged perpetrator is a different race from the child, the interviewer should consider presenting dolls of both races or a set of race non-specific dolls with neutral skin tones. The interviewer should be familiar with developmental issues in the use of the dolls, appropriate and inappropriate uses of the dolls, and potential problems caused by using leading questions or other suggestive techniques with the dolls.

A formal, structured protocol detailing the use of dolls in interviews is not required and, given the state of our knowledge and the need for flexibility in individual cases, rigid protocols are probably not advisable. However, these guidelines and other general guidelines on the use of anatomical dolls in sexual abuse evaluations are available and may be helpful e.

Detailed documentation of the interview process should be provided. Because of the potential subtlety and richness of the child's behavior with anatomical dolls, videotape recording of the interview may offer advantages. If videotaping is impracticable or contraindicated, the interviewer's questions and the child's verbal, non-verbal, and affective responses regarding sexual abuse allegations or concerns should be documented. This can be done in writing or using a combination of audiotape and written notes.

It is desirable to prepare a verbatim record of all portions of the interview specifically relating to the issue of possible sexual abuse. This includes a description of the child's behavior with dolls, including the child's positioning of the dolls, critical verbal statements, and any verbal, nonverbal, or affective behavior with the dolls, such as avoidance, anxiety, fear, anger, or regression.

Anatomical dolls are a useful and accepted tool for investigative and diagnostic interviews of children in cases of possible abuse. Professionals using anatomical dolls in child sexual abuse assessments should be knowledgeable and experienced in conducting forensically sound interviews with children and in the specific use of anatomical dolls. Interviewers should be prepared to describe how they used anatomical dolls in each specific case and how this use conforms to accepted practice.

Interviewers should be aware of the limitations in the use of anatomical dolls. Specifically, anatomical dolls should not be considered to be a diagnostic test of sexual abuse, nor be over-emphasized in the assessment process to the exclusion of broader interview techniques. American Medical Association. AMA diagnostic and treatment guidelines concerning child abuse and neglect. Journal of the American Medical Association , , — American Professional Society on the Abuse of Children.

Chicago : Author. August , R. A comparison of sexually and non-sexually abused children's behavioral responses to anatomically correct dolls. Child Psychiatry and Human Development , 20 , 39— Boat , B. Interview errors in the use of anatomical dolls in child protective services investigations. Use of anatomical dolls among professionals in sexual abuse evaluation. Interviewing young children with anatomical dolls.

Child Welfare , 67 , — Chapel Hill : University of North Carolina. Britton , H. Use of anatomical dolls in the sexual abuse interview. Bruck , M. Journal of Experimental Psychology: Applied , 1 , 95— Ceci , S. Suggestibility of the child witness: A historical review and synthesis. Psychological Bulletin , , — Conte , J. Evaluating children's reports of sexual abuse: Results from a survey of professionals. American journal of Orthopsychiatry , 61 , — DeLoache , J.

The use of dolls in interviewing young children. Zaragoza , J. Graham , G. Hall , R. Ben-Porath Eds. Newbury Park, CA : Sage. Everson , M. Sexualized doll play among young children: Implications for the use of anatomical dolls in sexual abuse evaluations. Putting the anatomical doll controversy in perspective: An examination of the major uses and criticisms of the dolls in child sexual abuse evaluations. Glaser , D. The response of young non-sexually abused children to anatomically correct dolls. Journal of Child Psychology and Psychiatry , 30 , — Goodman , G.

Children's use of anatomically correct dolls to report an event. Child Development , 61 , — Gordon , B. Children's knowledge of sexuality: A comparison of sexually abused and nonabused children. American Journal of Orthopsychiatry , 60 , — Age and social class differences in children's knowledge of sexuality. Journal of Clinical Child Physiology , 19 , 33— Jampole , L. An assessment of the behavior of sexually abused and non-sexually abused children with anatomically correct dolls.

Katz , S. The accuracy of children's reports with anatomically correct dolls. Developmental and Behavioral Pediatrics , 16 2 , 71— Kendall-Tackett , K. Koocher , G. Psychological science and the use of anatomically detailed dolls in child sexual abuse assessments: Final report of the American Psychological Association Anatomical Doll Task Force.

Psychological Bulletin , , 2. Leventhal , J. Anatomically correct dolls used in interviews of young children suspected of having been sexually abused. Pediatrics , 84 , — Levy , J. Morgan , M. Myers , J. Dolls in court? Nelson , K. New Directions for Child Development , 10 , 87— Realmuto , G. Specificity and sensitivity of sexually anatomically correct dolls in substantiating abuse: A pilot study.

Sivan , A. Interactions of normal children with anatomically correct dolls. Steward , M. In press. Interviewing young children about body touch and handling. Terr , L. Journal of the American Academy of Child Psychiatry , 20 , — White , S. Using anatomically detailed dolls in interviewing preschoolers. Schaefer , K. Sandgrund Eds.

New York : John Wiley. Investigatory independence in child sexual abuse evaluations: Conceptual considerations. Bulletin of the American Academy of Psychiatry and Law , 16 , — Special issue dedicated to child interviewing. Faller , K. Understanding child sexual maltreatment. Garbarino , J. What children can tell us. San Francisco : Jossey-Bass. Jones , D. Interviewing the sexually abused child. Denver, CO : C. MacFarlane , K. New York : Guilford. Legal issues in child abuse and neglect practice. Perry , N. For purposes of this order, tape s means any videotape or audiotape of a child.

Tapes may be viewed only by parties, their counsel and their counsel's employees, investigators, experts for the purpose of prosecuting or defending this action, and the child's guardian ad litem. No tape, or the substance of any portion thereof, shall be divulged by any person subject to this protective order to any other person, except as necessary for the trial or preparation for trial in this proceeding, and such information shall be used only for purposes of the trial and preparation for trial herein.

No person shall be granted access to the tape, any transcription thereof, or the substance of any portion thereof unless that person has first signed an agreement in writing that the person has received and read a copy of this protective order, that the person submits to the Court's jurisdiction with [Page ] respect to the protective order, and that the person will be subject to the Court's contempt powers for any violation of the protective order. Unless otherwise provided by order of this Court, no additional copies of the tape or any portion of the tape shall be made without prior court order.

The tape shall not be given, loaned, sold, or shown to any person except as provided by this order or by subsequent order of this Court. Upon final disposition of this case any and all copies of the tape and any transcripts thereof shall be returned to the Court for safekeeping, except those tapes booked into and kept as evidence by the investigating law enforcement agencies. Those materials subject to this order so kept by any law enforcement agency shall remain subject to this order and those materials shall remain secured in evidence in accordance with the agency's policies and procedures.

This protective order shall remain in full force and effect until further order of this Court. Characteristics 1. The evaluator should possess a graduate level mental health degree in a recognized discipline e. The evaluator should have professional experience assessing and treating children and families, and professional experience with sexually abused children. A minimum of two years of professional experience with sexually abused children is expected; three to five years is preferred for forensic evaluators.

If the evaluator does not possess such experience, supervision is essential. The evaluator must have had specialized training in child development and child sexual abuse. This training should be documented in terms of formal course work, supervision, or attendance at conferences, seminars, and workshops. The evaluator should be knowledgeable about the dynamics and the emotional and behavioral consequences of sexual abuse experiences. The evaluator should be familiar with the professional literature and with current issues relevant to understanding and evaluating sexual abuse experiences.

If the purpose of the evaluation is forensic, the evaluator should have experience in conducting forensic evaluations and providing expert testimony. The evaluator should approach the evaluation with an open mind to all possible responses from the child and all possible explanations for the concern about sexual abuse.

The evaluator should recognize that all sources of information have limitations and may contain inaccuracies. In forming an opinion, the evaluator should consider plausible alternative hypotheses. A written protocol is not necessary; however, evaluations should ordinarily involve reviewing those materials considered relevant for the type of evaluation; conducting collateral interviews when necessary; establishing rapport; assessing the child's developmental status, cognitive capacity, level of functioning and level of distress; and specifically evaluating the possibility of abuse. The evaluator may use discretion in the order and method of assessment.

Forensic evaluations differ from evaluations conducted for purely clinical reasons in that they generally involve reviewing relevant materials and conducting collateral interviews. If information is available prior to the evaluation that meets the respective state's definition of reasonable suspicion for a CPS report, but no CPS report has yet been made, the evaluator should make the report and may choose to defer the evaluation until the CPS investigation has been conducted.

When possible, unsupervised contact between the child and the suspected offender should be strongly discouraged during the evaluation process. Evaluation of the child may be conducted at the request of a legal guardian prior to court involvement. When only one parent has requested the evaluation, evaluators should give careful consideration to informing the other parent about the evaluation whether or not that parent is the focus of concern.

When the other parent is the focus of concern, that parent is likely to request another evaluation; evaluators should consider whether it would be in the child's best interest to have a mutually agreed upon or court appointed evaluator to avoid unnecessary evaluations. If the evaluation is specifically requested or intended for use in a legal proceeding or a court is already involved, the preferred practice is a court-appointed or mutually agreed upon evaluator of the child.

In some circumstances exceptions to this practice are acceptable or are customary practice e. Discretion should be used in agreeing to conduct an evaluation of a child when the child has already been evaluated. Additional evaluations should be conducted only if they clearly further the best interests of the child. When a second opinion is required, a review of the records may eliminate the need for re-interviewing the child.

The evaluation may be conducted by a single evaluator or by a team of professionals. Evaluators may seek and review background materials or conduct interviews as part of the evaluation process. The amount and nature of information reviewed depends on the purpose of the evaluation and the extent to which such information will be helpful in addressing the referral question and understanding the child's presenting problems or concerns. For clinical evaluations, clinical judgment should determine the necessity for additional records, materials, or interviews. Evaluators should request that background material be made available and collateral interviews be permitted for forensic evaluations.

The evaluation report should reflect an objective review of collateral information relied upon in the evaluation or opinion forming process. It is not necessary to interview the accused or suspected individual in order to form an opinion about possible sexual abuse of the child. An interview with or review of the statements from a suspected or accused individual may provide additional relevant information e.

If the accused or suspected individual is a parent who seeks to participate in the evaluation and there are no contraindications e. Suspected abuse should always be reported to authorities as dictated by state law. Except as specified by law, clinical evaluators have no affirmative duty to disclose confidential clinical information.

Permission should be obtained from legal guardian s to request collateral materials and for release of information about the evaluation to relevant medical or mental health professionals, other professionals e. Discretion should be used in releasing sensitive individual and family history that does not directly relate to the purpose of the assessment.

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Feedback about the results of the evaluation should usually be offered to parent s or legal guardian s and may be offered to the child, except where doing so would not be in the best interests of the child. Written documentation is the minimum requirement. Verbatim quotation of significant questions and answers is desirable. Forensic evaluations [Page ] should contain specific documentation of questions and responses verbal and nonverbal regarding possible sexual abuse. Audio or video recording may be preferred practice in some communities.

Professional preference, logistics, or clinical considerations may contra indicate recording of interviews. Professional discretion is permitted in recording policies and practices. When audio and video recording are used, the child and legal guardian should be informed. It is desirable to obtain assent from the child when age appropriate and consent from legal guardian s. Professional discretion is permitted in observation policies and practices. Observation of interviews by involved professionals CPS, law enforcement, etc. Observation by non-accused and non-suspected primary caregiver s may be indicated for particular clinical reasons; however, great care should be taken that the observation is clinically appropriate, does not unduly distress the child, and does not affect the validity of the evaluation process.

If interviews are observed, the child must be informed. The evaluator determines the number of interviews necessary to address the referral question and assess the child's presenting problems or concerns. This does not imply that all sessions must include specific questioning about possible sexual abuse. The evaluator may decide, based on the individual case circumstances, to adopt a less direct approach and reserve questioning about possible sexual abuse for subsequent interviews.

Repeated direct questioning of the child regarding sexual abuse when the child is not reporting or is denying abuse is usually contraindicated. If the child does not report abuse and further direct questioning is judged to be counterproductive, but the evaluator has continuing concerns about the possibility of abuse, the child may be referred for an extended evaluation or therapy that is less directive, but diagnostically focused.

Recommendations regarding conditions necessary to insure the child's protection from possible abuse should be made. When possible, interviewing the primary caregiver and reviewing other collateral data first to gather background information may facilitate the evaluation process. Discussion of possible abuse with the child in the presence of the caregiver during evaluation interviews should be avoided except when necessary to elicit information from the child. In such cases, the interview setting should be structured to reduce the possibility of improper influence by the caregiver on the child's behavior or statements.

In some cases, joint sessions with the child and the non-accused caregiver or accused or suspected individual might be helpful to obtain information regarding the overall quality of the relationships. Such joint sessions should not be conducted for the purpose of determining whether abuse occurred based on the child's reactions to the participating adult.

Joint sessions should not be conducted if they will cause significant distress for the child. Joint sessions with a child and an accused or suspected individual should only be considered when the individual is a parent or primary caregiver. In making a decision about conducting a joint session with a child and the accused or suspected parent, the evaluator should carefully weigh the possibility of gaining valuable information against the significant potential for negative consequences for an abused child and for the evaluation process.

A child should never be asked to discuss the possible abuse in front of an accused or suspected parent. The evaluator should create an atmosphere that enables the child to talk freely, including providing physical surroundings and a climate that facilitates the child's comfort and communication. The evaluator should convey to all parties that no assumptions have been made about whether abuse has occurred.

Language and interviewing approach should be developmentally and culturally appropriate. The evaluator should take the time necessary to perform a complete evaluation and should avoid any coercive quality to the interview. Interview procedures may be modified in cases involving very young, minimally verbal children or children with special problems e.

The difference between the evaluation phase and a treatment phase should be articulated. Under certain circumstances e. It may be helpful to preface questioning with specific statements designed to reduce misunderstandings during the interview s , and promote accuracy and completeness. It may be helpful to begin the interview with open-ended questions about neutral topics e. Initial substantive questioning should be open-ended and as non-directive as possible to elicit free recall responses. More focused or specific questioning should follow.

Once information is provided in response to a specific question, open-ended prompts should again be used. The child should be questioned directly about possible sexual abuse at some point in the evaluation if less directive approaches have not yielded adequate information to answer the referral question. The evaluator may use the form of questions deemed necessary and justified to elicit information on which to base an opinion. Highly specific questioning should only be used when other methods of questioning have failed, when previous information warrants substantial concern, or when the child's developmental level precludes more non-directive approaches.

However, responses to these questions should be carefully evaluated and weighed accordingly. Coercive or intimidating questioning is never justified. A variety of non-verbal tools may be used to assist young children in communication, including drawings, toys, dollhouses, dolls, puppets, etc. Since such materials have the potential to be distracting or misleading they should be used with care. They are discretionary for older children. Anatomical dolls are accepted interview aids.

Evaluators using anatomical dolls should be knowledgeable about the functions they may serve and should conform to accepted practice. Anatomical dolls should not be used as a diagnostic test for sexual abuse. Definitive conclusions about a history of sexual abuse should not be based solely on interpretation of behavior with the dolls. Unusual behavior with the dolls may suggest further lines of inquiry that should be pursued.

The unusual behavior and the responses to further questioning should be noted in the evaluation report. Story books, coloring books or videos that contain explicit descriptions of abuse situations are potentially suggestive and are primarily teaching tools. They are typically not appropriate for evaluation purposes. Formal psychological testing of the child is not necessary for the purpose of proving or disproving a history of sexual abuse.

Psychological testing may be useful when the clinician has questions about the child's intellectual or developmental level. Psychological tests can also provide helpful information regarding a child's emotional status and general functioning. Psychological testing of parents is not a routine component of child evaluations. An evaluation that includes assessment of parents may involve psychological tests. The evaluator may state an opinion that abuse did or did not occur, an opinion about the likelihood of the occurrence of abuse or simply provide a description and analysis of the gathered information.

Opinions should include supporting information e. Possible alternative explanations should have been considered. The evaluator should not suggest that mental health professionals have any special ability to detect whether an individual is telling the truth.

The evaluation may be inconclusive. If so, the evaluator should cite the information that causes continuing concern but does not enable confirmation or disconfirmation of abuse. If inconclusiveness is due to such problems [Page ] as missing information or an untimely or poorly-conducted investigation, these obstacles should be clearly noted in tike report.

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