Understanding Children's Medium for Disclosing Sexual Abuse: A Tool for Overcoming Potential Misconceptions in the Courtroom

Complainants in child sexual assault trials are often questioned by the defence about disclosure of the alleged abuse. The defence will often ask the child how they disclosed the alleged sexual abuse, including to whom the initial disclosure was made. Such questions are legitimate and directed towards testing the complainant's allegations. Sometimes, such questions are used to impeach the complainant's credibility. It is not uncommon in such instances for the defence to suggest that certain modes of disclosure are more consistent with having been sexually victimized and that a complainant who has disclosed otherwise is more likely to have fabricated the allegations of abuse. This article reviews the findings of empirical research on whom victims of child sexual abuse most commonly disclose their abuse to and by what means such disclosure is commonly made. This understanding is important to challenge misconceived views about how victims disclose child sexual abuse.     

False allegations of sexual abuse by children and adolescents

The frequency of false allegations of sexual abuse by children and adolescents is of significant legal and clinical importance. The rate of false allegations of sexual abuse is examined in a large sample of Child Protective Services (CPS) cases. The criteria used by CPS workers in judging the validity of allegations are considered, and the relationship between substantiation rates and attitudes about the trustworthiness of child reports of abuse is explored. Many professionals in the field of child sexual abuse are more skeptical of child and adolescent claims of sexual abuse than available research suggests is warranted.     

Professional Issues Related to Allegations and Assessment of Child Sexual Abuse in the Context of Family Court Litigation

This article focuses on the challenge of dealing with allegations of child sexual abuse in the context of the Family Court of Australia. Of all cases that come before the Court, those involving such allegations are relatively uncommon. they tend to be the most difficult cases, however, and are more likely to require a trial and the involvement of qualified practitioners. The review establishes that parental separation is a special circumstance in which sexual abuse may be more likely to occur, and many allegations of sexual abuse are found to be true. There is evidence, however, that a proportion of allegations made by people other than the child concerned may be false. Whether these false allegations are well intentioned and genuinely believed, or maliciously motivated has been a contentious issue. Issues considered include the mishandling of cases, the failure by professionals to consider equally plausible alternative hypotheses than the sexual abuse of a child, confirmation bias, and the profound repercussions of allegations for all members of the family. It is concluded that all allegations of child sexual abuse must be evaluated in a thorough and sensitive manner to separate the few false allegations from the many that are true.     

Allegations of child sexual abuse in child custody disputes: a therapeutic assessment model

Guidelines are set forth for judges and others who must make decisions in custody disputes that include allegations of child sexual abuse. The focus is on the protection of the child and the model highlights the role of mental health professionals, prescribing separate therapists for child and parent where possible. Allegations of sexual abuse are seen as an indicator of emotional risk for the child, even in cases where the allegations are untrue.     

Assessing Alleged Child Sexual Abusers in Noncriminal Contexts: Proposed Guidelines for Practice

Assessing child sexual abuse allegations is a challenging task for any child protection or mental health professional given that the secretive nature of sexual abuse is often associated with limited medical evidence and a lack of independent corroborative information. In addition to the scant evidence available to help decide the case, there are controversies surrounding the legal standard of proof and immense pressure to act quickly to ensure the safety of the children who are allegedly abused. Unfortunately, there is currently a lack of literature pertaining to the assessment of alleged child sexual abusers. This article examines the standard of proof and legal conundrum pertaining to alleged child sexual abuse cases. More importantly, it proposes guidelines for mental health professionals conducting an assessment of such persons. Assessments, if conducted effectively, can assist the court and child protection services in managing the risk of future inappropriate sexual behaviors.     

Sexual abuse in children and adolescents with intellectual disability

The present authors conducted a study of the occurrence of victimization and the perpetration of sexual abuse among 43 in‐patients with intellectual disability aged between 9 and 21 years who were admitted to a child and adolescent psychiatric in‐patient department over a period of 5 years. A retrospective case‐note review was employed that explored the nature and severity of abuse in relation to the age, gender and level of disability. The prevalence of abuse or abusive behaviour, i.e. 14% of 300 admissions, did not change over time. In 13 out of the 43 cases, the issue of sexual abuse was identified after admission. Victimization alone occurred in 21 cases, perpetration alone in six cases, and both victimization and perpetration in 16 cases. Fifty per cent of the victims had been abused by a member of their close or extended family. Most cases (62%) were adolescents. There was only one instance of a victim being abused by a female. However, there were five girls who were perpetrators, all of whom had previously been victims. By contrast, 11 out of the 17 male perpetrators had been victims. Despite difficulties of disclosure, it was possible to establish that severely disabled patients had suffered sexual abuse. The present data support theories which (1) recognize gender differences in sexual abuse patterns and (2) have a developmental perspective, incorporating the influence of adolescence.     

Possible explanations for child sexual abuse allegations in divorce

Based on a clinical sample of 136 cases, four classes of child sexual abuse cases in divorce are proposed: divorce precipitated by discovery of sexual abuse; long-standing sexual victimization revealed after marital breakup; sexual abuse precipitated by marital dissolution; and false allegations made during or after divorce. Implications for clinical practice are discussed.     

Disclosure of child sexual abuse. For better or for worse

The data presented here offer a longitudinal perspective on sexually abused children. Disclosure data are postulated to be important variables in the short-term and long-term victim-to-patient process. Fifty-five per cent of the 156 children seen purposefully disclosed their sexual abuse, most frequently to their mothers. Children who never told, but were seen after accidental disclosures, showed less distress, whether hiding minor or major forms of sexual abuse. This finding support the clinical impression that disclosure adds extra stress on children and cannot be expected of every victim. A history of past mental health intervention did not seem to enhance the child's ability to tell. Education of all professionals is critical. Approximately 18 months after the end of the crisis intervention offered at intake, 115 of the 156 cases were re-evaluated. Overall, most children showed improvements on standardized tests, but 24 per cent got worse. Specific symptoms were found to cluster in four groups: acute anxiety, characterologic, family dynamics, and specific symptoms related to sexual abuse (sexual maladjustment, prostitution, revictimization, sexually assaultive behavior). Although the data seem to support the notion that crisis intervention by trained clinicians is helpful, it is too early to tell if the ominous findings described in adult survivors can really be decreased. The impact of disclosing child sexual abuse on entire families should not be underestimated, even in cases of extrafamilial abuse. The poor ratings parents gave law enforcement, judicial, and Child Protective Service professionals may be linked to the reluctance of victims to disclose their abuse and underscores the need to review current procedures and practices. Overall, a great majority of parents did see the sexual abuse as harmful to the child and to the family, but they were evenly divided about whether the disclosure was harmful or helpful to the child and family. A final word of caution comes from the 19 per cent of adolescents who regretted their disclosures. For clinicians and for researchers, the data presented here lead to further questions. A longer follow-up period is needed to assess whether these victims will be similar to the adults described in the literature or will become survivors with less pathology and less pain.     

Clarifying erroneous child sexual abuse allegations

A review of several hundred court cases involving child sexual abuse allegations has shown that both children and adults make false reports. Various kinds of false reports are defined, described, and grouped according to type: misunderstandings, misreporting, distortion through illness, distortion by design, professional error, misrepresentation, and a grouping of less common instances.     

Psychopathology of sexual abuse in young people with intellectual disability

The present study addressed two issues using a sample of child and adolescent victims and perpetrators of sexual abuse: (1) the extent of post‐traumatic stress disorder (PTSD) in the sample; and (2) the possible distinction between perpetrators whose motivations were sexually impulsive, and those who were controlling and abuse‐reactive. Retrospective case material from 43 cases (21 victims only, and 22 perpetrators, of whom 16 were also victims) provided the data. Post‐traumatic symptomatology was not common. Only one case of PTSD was found. Perpetrators could be distinguished by whether they had suffered sexual abuse alone, sexual and physical abuse, or neither. The proposed distinction between perpetrators received support. Sexual abuse directed at younger victims was associated with earlier experience of multiple forms of abuse. The present data does not support the view that post‐traumatic symptoms following victimization are a mediator of sexual abuse perpetration. It is argued that an elaboration of the Williams & New developmental model of perpetration better fits the data.     

Therapeutic management of sexual abuse allegations in custody and visitation disputes

Our experience is that in many cases, trying to assess the "truthfulness" or "falseness" of sexual abuse allegations that occur in the midst of custody and access disputes may not be possible. Instead therapeutic management of such cases is advocated. A case is presented in which sexual abuse was suspected because the recanting child displayed sexualized symptoms. Following a thorough assessment, which indicated that the child was abused, but could not confirm who the offender was, both the child and the mother were seen in psychotherapy on a regular basis. The father used counselling to achieve rights for visitations. The building of a therapeutic relationship allowed us to experiment with the situation to where we felt we could identify the potential offender who had to be kept away from the child. In addition, the therapeutic relationship enables this family to come to us to resolve their disputes rather than use the judicial system.     

Mental disorders and DSM-IV paedophilia in 185 subjects convicted of sexual child abuse

The objective of this study was to explore how sexual child abusers who meet the DSM-IV criteria for paedophilia differ from those who do not. We studied DSM-IV disorders and paedophilic interests in all cases of sexual child abuse referred to forensic psychiatric investigation in Sweden between 1993 and 1997 (n=185). Frequency and severity of other mental disorders did not differ between subjects with and without DSM-IV paedophilia. However, men with paedophilia had more previous paedophilia convictions, same-sex and younger victims and less often intoxicated status when committing the act. The concept of paedophilia as a mental disorder is not supported by the DSM-IV diagnosis, which primarily describes the acting out of attraction.     

Mental disorders and DSM-IV paedophilia in 185 subjects convicted of sexual child abuse

The objective of this study was to explore how sexual child abusers who meet the DSM-IV criteria for paedophilia differ from those who do not. We studied DSM-IV disorders and paedophilic interests in all cases of sexual child abuse referred to forensic psychiatric investigation in Sweden between 1993 and 1997 (n=185). Frequency and severity of other mental disorders did not differ between subjects with and without DSM-IV paedophilia. However, men with paedophilia had more previous paedophilia convictions, same-sex and younger victims and less often intoxicated status when committing the act. The concept of paedophilia as a mental disorder is not supported by the DSM-IV diagnosis, which primarily describes the acting out of attraction.     

Specificity and sensitivity of sexually anatomically correct dolls in substantiating abuse: a pilot study

Sexually anatomically correct dolls are often used to verify or refute allegations of sexual abuse in young children. As a test of their effectiveness in facilitating decisions about the abuse status of young children, the authors conducted blind interviews with six abused subjects, five nonclinic controls and four psychiatric controls. The child psychiatrist interviewer followed a standardized protocol and was able to correctly categorize 33% of the abused and 67% of the nonabused children. Proper classification was 53% for the sample using this protocol. The authors' preliminary conclusion is that, without other information available to the interviewer, sexually anatomically correct dolls are a poor source of information to decide the abuse status of a young child. The authors recommend that professionals should be cautious when basing decisions on a single instrument, such as sexually anatomically correct dolls. Mental health professionals are encouraged to maintain quality standards in evaluation of children by conducting a comprehensive examination in child sexual abuse cases.     

On describing the psychological struggle of child sexual abuse victims through Kierkegaard's concept of self

The aim of this paper is to use Soren Kierkegaard's concept of self to demonstrate some psychological phenomena of child sexual abuse victims. Their self is to a large extent determined by extreme outer circumstances i.e. the abuse and the abusers. In order to cope with the consequent psychological pain, such children employ powerful defense mechanisms which consequently, however, means that they remain longer in the abuse. Psychotherapies are attempts to help them to create their own self and gradually come out of their abuse. However, such creation of oneself is only carried out within their concretely traumatized self.     

The assessment of custody and access disputes in cases of sexual abuse allegations

Sexual abuse allegations directed at one parent can arise in the context of custody and access disputes. The role of the clinician, when such allegations occur, is to provide an assessment of the total situation, taking the allegations into account. To assess the probability that sexual abuse has occurred involves a thorough assessment of the accuser, the accused, the accusation, the child, and different family subsystems. Particular attention should be paid to interviewing the young child with detailed focus on the interviewing process, how the interviews are reported and what conclusions may be drawn from them. Following a thorough assessment, the clinician may reach one of three conclusions: that the sexual abuse has probably occurred, has probably not occurred, or is unsure. A strong caution is given against becoming entangled in an endless process of trying to find out whether the allegations are true or false. Whatever conclusions are reached are but one factor in the recommendation regarding custody and/or access. Ultimately the recommendation will be made according to the best interests of the child, taking into account the child's relationships and attachments, as well as the sexual abuse allegations.     

A conceptual model for judging the truthfulness of a young child's allegation of sexual abuse

Because of the increased number of allegations of sexual abuse made by young children and the often severe legal penalties given to adult perpetrators, there is reason for concern about false or mistaken accusations. This paper develops a conceptual model for judging the truthfulness of such allegations by a young child.     

Prediction of Jury Verdicts in Child Sexual Assault Trials

Child sexual abuse allegations are typically resolved by jury trial. The presence of a number of variables, known before a trial commences, may play a significant part in trial outcomes beyond jurors’ assessment of witness credibility. New Zealand Crown Prosecutors completed survey questionnaires for 137 trials related to charges of sexual offending against children. Nine trial variables were recorded along with other trial data. The hypothesis was confirmed that the presence of any three or more of the nine evidential variables was significantly predictive of conviction on at least one sexual offence per trial. The results were similar for the total sample and the two subgroups of historical cases and the child cases with complainants aged younger than 17 years at the time of trial. The three variables most strongly associated with conviction were similar fact evidence, evidence from a witness to the offending, and positive medical evidence or DNA evidence.     

Knowledge of Eyewitness Identification Issues: Survey of Public Defenders in New South Wales

This article explores the legal and clinical processes underpinning gender differences in Australian Family Court statistics which show that mental illness is the primary reason for limiting mothers’ contact with their children. Analysis of a sample of published judgments from 2009 to 2011 featuring mental illness and outcomes of limited child contact identified that allegations of child sex abuse were a common feature of cases in which mothers’ child contact was limited. Four illustrative cases are presented with a focus on the processes used in the identification of mental illness. The data indicate that there are different patterns of response to cases where a party has a previously diagnosed mental illness and cases where mental illness is invoked as a possible explanation for child sex abuse allegations. These identified patterns of differentiated response provide a possible explanation for the gender disparity in Family Court reasons for limiting child contact on the grounds of mental illness.