Although most people are surprised by this fact, some mothers who learn that their daughter has reported being sexually molested by a family member choose to disbelieve their child and openly support the accused molester. Moreover, up to 1 in 5 children who report sexual molestation take it back or “recant”.
REDACTED STATEMENT: JANE DOE
OCTOBER 2008
AGGRAVATED SEXUAL ASSAULT
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II N T R O D U C T I O N abuse (CSA) are among the
most heartbreaking cases a
judge hears, for both emo-
tional and legal reasons.
How does the court evalu-
ate the testimony of the
young child who says it
never happened, the child
who discloses months
after the alleged event,
the girl who recants after
visitation with family mem-
bers, or the boy with an IQ of 51 who cannot
clearly articulate how the alleged abuse occurred?
Proving child sexual abuse in the absence of physi-
cal evidence or testimony of an eyewitness is difficult.
Children recant, child development issues intervene,
and cognitive limitations raise questions, while the testi-
mony of the adult perpetrator does not waiver. Indeed,
although errors in either direction can have devastating
consequences, finding the truth in CSA cases seems too
often impossible. Decision makers confront the twin
specters of leaving inarticulate children unprotected
from further traumatic sexual abuse on the one hand,
and subjecting innocent caregivers to criminal prosecu-
tion or the loss of parental
rights on the other.
Science can be a tre-
mendous asset to judges in
understanding and interpret-
ing the behavior of victims
of child sexual abuse, since
their behavior can often
seem counterintuitive. It is
essential that judges consider
children’s disclosure patterns
in light of current research in
order to have the greatest
chance to evaluate the facts
and find the truth. Children’s disclosure patterns are
crucial because physical findings are diagnostic of child
sexual abuse in 10% or fewer cases (Frasier & Makaroff,
this issue). Sexual abuse, especially when there is no
penetration, rarely results in physical trauma. Even when
there has been sexual penetration, the capacity for rapid
healing of the genital anatomy inhibits the detection of
evidence (The National Research Council, 1993, p. 72).
Therefore, children’s statements are central both to the
prosecution of the crime of child sexual abuse and the
protection of children from further abuse.
This review is intended to update criminal, juve-
nile, and domestic relations court judges who preside
The State of the Debate in Child Sexual Abuse Cases A B S T R A C T Erna Olafson, Ph.D., Psy.D., is Associate Professor of Clinical Psychiatry and Pediatrics at Cincinnati Children’s Hospital Medical Center and the C h i l d r e n ‘ s D i s c l o s u r e P a t t e r n s i n S e x u a l A b u s e C a s e s 28 J u v e n i l e a n d F a m i l y C o u r t J o u r n a l • W i n t e r 2 0 0 6
over CSA cases about current areas of agreement and
disagreement among scientific researchers about the
disclosure patterns of CSA victims. A major volume on
abuse disclosure patterns is scheduled for publication
in 2006 (Pipe, Lamb, Orbach, & Cederborg, in press).
It contains chapters by researchers from differing
perspectives that we have drawn upon for this article
(London, Bruck, Ceci, & Shuman, in press; Lyon, in press).
Unfortunately for those charged with making decisions
about children’s welfare, no single school of researchers
has the last word on these controversial issues.
Brief History patterns either begin with a discussion of Roland
Summit’s Child Sexual Abuse Accommodation Syndrome
(CSAAS) or structure their arguments around his model
of children’s behavior in these cases (London, Bruck,
Ceci, & Shuman, 2005; Lyon, 2002; Lyon, in press;
Summit, 1983). Summit argued that children often deny
being sexually abused, even when they are directly
asked, and that disclosing children often subsequently
recant their allegations. He based the accommodation
syndrome primarily on cases of intrafamilial child
sexual abuse (incest) rather than extrafamilial child
sexual abuse.
Although Summit’s “syndrome” has been litigated
with a variety of outcomes in many courts, it may have
become so controversial that it obscures rather than
clarifies the issues at hand. Judges should bear in mind
that for almost a century before Summit published his
influential paper, there was statistical evidence that
children often delay disclosure or remain completely
silent about sexual victimization. Indeed, this prior
literature was so extensive that a major psychological
journal rejected Summit’s accommodation syndrome
paper before it found publication elsewhere because,
the reviewers argued, it contributed nothing new
(Lyon, in press; Olafson, 2002). There have also been a
number of studies documenting children’s disclosure
patterns in otherwise corroborated child sexual abuse
cases since the 1983 publication of Summit’s paper
(Lyon, in press). Examining children’s disclosure pat-
terns one category at a time, without organizing them
around Summit’s now-controversial accommodation
syndrome, may clarify and simplify the issues.
The Issues among children known to have been sexually abused?
There are several issues:
■ Do most child victims delay reporting sexual abuse, ■ If directly asked, do most child victims disclose ■ If directly asked, do some CSA victims initially fail ■ How common is incremental abuse disclosure, from ■ Once children have disclosed sexual abuse, do a ■ Are there factors such as gender, developmental Sources of Information
The two most reliable sources of information about
disclosure patterns in CSA victims are:
■ Retrospective surveys of adults who report ■ Research about children’s statements during Both sources are imperfect. Cases that have indepen-
dent corroboration may be unrepresentative of sexual
abuse cases in general. Retrospective surveys depend on
human memory over time, so that under-reporting, over-
reporting, and inaccurate reporting may occur.
Nevertheless, cases with independent corrobora-
tion and retrospective surveys are superior to the
other sources sometimes used in literature reviews. For
example, studies that claim substantiation or conviction
rates as “independent” corroboration may significantly
inflate the percentages of actually abused children who
disclose their victimization during formal question-
ing. This is because substantiation, prosecution, and E r n a O l a f s o n a n d J u d g e C i n d y S . L e d e r m a n
29W i n t e r 2 0 0 6 • J u v e n i l e a n d F a m i l y C o u r t J o u r n a l
conviction depend so heavily at all decision stages on
children’s statements. To argue that substantiation rates
that depend upon children’s disclosures proves that
most children make disclosures when interviewed is to
argue in a circle (Lyon, in press).
The definitions of key terms also affect research out-
comes, but researchers do not always specify their oper-
ational definitions. “Child sexual abuse” can include a
wide variety of behaviors, from non-contact exposure to
genital fondling to violent genital, oral, and anal rape. In
this article, we focus primarily on contact child sexual
abuse. “Disclosure” also has a variety of meanings. We
define disclosure to mean a clear verbal statement that
at least one abusive act took place, although a disclosure
need not be a complete report of everything that hap-
pened. Our definition does not include suggestive doll
play and other fragmentary “partial disclosures” that,
when included in research studies, artificially inflate
children’s “disclosure” rates (e.g. Dubowitz, Black, &
Harrington, 1992).
“Non-disclosure” can also vary in meaning depend-
ing on whether it refers to a child’s non-disclosure dur-
ing a single or initial interview or a child’s non-disclo-
sure maintained over six or more interviews. Children
questioned only once show higher “non-disclosure”
rates than do children questioned several times, so that
studies such as that by Sorenson & Snow (1991) that
show very high initial non-disclosure rates have an even-
tual disclosure rate of over 90%.
Child Sexual Abuse Disclosures Delayed There appears to be a consensus among research-
ers that most child sexual abuse victims delay disclos-
ing, often until adulthood. A number of well-designed
retrospective surveys now show that the great majority
of victims delay disclosing contact child sexual abuse
during childhood (Finkelhor, Hotaling, Lewis, & Smith,
1990; Smith et al., 2000). These surveys also indicate
that even when adults recall having told someone
about the abuse, the majority of these cases were not
then reported to the authorities. In one survey, 28% of
respondents stated that they had disclosed to no one
before telling the telephone interviewer about the child
sexual abuse (Smith et al., 2000); another survey found
that 42% of men and 33% of women first told anyone
about having been sexually abused as children when
asked during the retrospective telephone interview
(Finkelhor et al., 1990).
London and colleagues (2005) summarize the ret-
rospective literature by noting that the results of 10
retrospective surveys indicate that only one-third of
adults who suffered child sexual abuse revealed the
abuse to anyone during childhood. The study concludes
that “approximately 60%-70% of adults do not recall
ever disclosing their abuse as children, and only a small
minority of participants (10%-18%) recalled that their
cases were reported to the authorities” (London et al.,
2005, p. 203). Although London and colleagues note the
research limitations inherent in adult retrospective liter-
ature, they also write, “Given the differences in method-
ology, definitions of abuse, and sample characteristics,
the general consistency of these findings across these
studies is noteworthy” (London et al., 2005, p. 201; but
see Poole & Dickinson, 2005).
Judges and other fact finders can only adjudicate
those cases that come to their attention, and a child’s
prior disclosure to a caregiver or friend constitutes
the most common means by which child sexual abuse
comes to the attention of the authorities and thus to the
courts (Lyon, in press). Therefore, because it appears
that most people delay disclosing until adulthood, chil-
dren who decide to tell someone about being sexually
abused and whose cases therefore come to court are
not representative of sexually abused children in gen-
eral. In other words, child protection authorities and
the judiciary are likely to see only a minority of those
children who are actually being sexually abused. There
are, of course, some sexual abuse cases that are report-
ed for reasons other than a child’s prior disclosure, such
as children’s sexualized behaviors, physical findings,
and other external evidence. This review article focuses
on the disclosure patterns and behaviors among both
groups of sexually abused children, those who had pre-
viously disclosed and a smaller number of those who
came into the system in some other way.
Child Sexual Abuse Disclosures Delayed There appears to be agreement among researchers
from diverse perspectives that “when children do dis-
close, it often takes them a long time to do so” (London C h i l d r e n ‘ s D i s c l o s u r e P a t t e r n s i n S e x u a l A b u s e C a s e s
30 J u v e n i l e a n d F a m i l y C o u r t J o u r n a l • W i n t e r 2 0 0 6
et al., 2005, p. 204). In a study of 399 children aged 8
to 15, Elliott and Briere (1994) find that of 248 subjects
assessed as having been sexually abused, 74.9% did not
disclose their abuse to anyone within the year that it first
occurred, and 17.8% had waited more than five years to
tell anyone. The courts are likely to see many such cases
in which children delayed reporting for months or even
years before telling someone about the abuse. It is also
not unusual for children to disclose the abuse long after
adjudication when they are in a safe environment and
the litigation is finished. Delays in telling anyone about
the abuse for several months, a year, or even longer
occur in a significant percentage of child sexual abuse
cases (Henry, 1997; Sas & Cunningham, 1995).
In weighing the evidence in child sexual Children’s Gradual Disclosures during Many prosecutors are familiar with the problem of
incremental disclosure, in which a child may disclose
only aspects of an abusive event, such as genital fon-
dling, during the initial interview. Shortly before trial
is scheduled to begin, the child, perhaps during court
preparation with the prosecutor, describes new details,
such as penetrating oral sex, that necessitate postpone-
ments, the filing of new criminal charges, and concerns
about the child’s credibility and competence. In one
such case, a young incest victim, when asked why she
had not mentioned crucial additional information dur-
ing her initial advocacy center interviews responded,
“I just didn’t think of it.” This pattern of partial disclo-
sure can be explained by Summit’s classic child sexual
abuse accommodation syndrome, but it may also simply
reflect the usual patterns of recall in the very young.
In an experimental study, Dr. Robyn Fivush asked non-
abused children aged 3-6 about a known event on
two subsequent occasions (Fivush, 1994). On the two
recall occasions, children reported different but still
accurate information about the events, with an overlap
of details between the two retellings of only 20%. This
research about children’s normal patterns of recollec-
tion and reporting could in itself justify recommending
that children be given more than a single interview to
tell the authorities about the events in their lives.
In a summary of 21 studies from 1965 to 1993 of
children diagnosed with gonorrhea, Lyon finds gradual
disclosure by children to be very common (Lyon, in
press). In 118 CSA cases studied by Elliott and Briere
(1994), there was external evidence for the abuse,
including, for example, medical evidence diagnostic of
child sexual abuse, perpetrator confession, a witness
to the abuse, or pornographic pictures of the child.
In a number of these 118 cases, victims disclosed par-
tially in the first interview by mentioning fondling, but
when investigators confronted them with the external
evidence for more severe abuse (penetration), the chil-
dren then made more complete disclosures.
Thus, when questioned during formal interviews,
children may only partially disclose during the initial
interview. Because evidentiary studies show that trau-
matic medical evidence (such as a ruptured hymen) is
lacking in a significant number of cases in which per-
petrators have confessed to penile penetration, judges
should not prematurely regard children’s statements
as complete after a single interview (Muram, Speck, &
Gold, 1991). As Elliott and Briere (1994) write, “Forensic
evaluations that consist of a single interview may result
in incomplete disclosure and less accurate determina-
tions, especially in cases where medical or other exter-
nal data are lacking or inconclusive” (p. 274).
This recommendation does not contradict the long-
held principle in the child protection fields to avoid
subjecting children to repeated interviews by multiple
investigators from social services, law enforcement, and
the court system. The National Children’s Advocacy
Center has developed and tested guidelines for extend-
ed forensic evaluations with reticent children. If several
interviews become necessary, it is recommended that a
single interviewer conduct them and that the question-
ing be sensitively structured to build rapport over time
and avoid repetitive questioning and suggestiveness
(Carnes, Wilson, & Nelson-Gardell, 1999; Carnes, Nelson-
Gardell, Wilson, & Orgassa, 2001). E r n a O l a f s o n a n d J u d g e C i n d y S . L e d e r m a n 31W i n t e r 2 0 0 6 • J u v e n i l e a n d F a m i l y C o u r t J o u r n a l
Because many sexually abused children in Non-Disclosure or Denial by Children When The most troubling cases for the courts are those in
which there are red flags indicating a strong possibility of
child sexual abuse: The case is reported, the child inter-
viewed, and the child discloses no sexual abuse. There are
two classes of children to consider here:
■ Children who previously disclosed partially or fully ■ Children who came into the system through other It is about children’s disclosure patterns once they
are in the system that the experts disagree, and these
cases are the most troubling to those responsible for
protecting children from abuse and protecting adults
from false allegations.
London et al. (2005) state that “the data clearly demon-
strate that most children who are interviewed about sexual
abuse do disclose and do not later recant…” (p. 217).
Lyon (in press) responds with a critique that reveals
problems with two kinds of case selection bias in many
of the samples upon which London and colleagues
based the above conclusion. Lyon argues that:
■ To avoid suspicion bias, one must examine cases ■ To avoid substantiation bias, one must examine To understand how both forms of selection bias
artificially inflate the actual rates of children’s sexual
abuse disclosures, consider the following extreme case.
If we suspect sexual abuse only when a child has previ-
ously disclosed, then 100% of children in a sample of
children suspected of being sexually abused will have
disclosed at some point. If we substantiate child sexual
abuse only if a child discloses, then 100% of children
in a sample of substantiated cases will have disclosed.
The reality is only somewhat less extreme. The great
majority of suspected CSA cases come to our attention
only because a child has previously disclosed. Child
sexual abuse substantiation also depends most heavily
on children’s disclosures, because external evidence of
child sexual abuse (such as physical findings or offender
confession) is rare and generally detected only after
sexual abuse has been suspected.
London et al. (2005) seem to agree with Lyon about
suspicion bias by writing, “Prior disclosure of abuse pre-
dicts disclosure during formal assessment” (p. 209), but
they do not then systematically deal with the problem of
suspicion bias. London and colleagues also acknowledge
but do not fully address the substantiation bias problem
by writing, “In many of the cited studies, classification of
abuse was often based in part on children’s disclosures;
consequently, the conclusion that abused children do
disclose abuse during formal interviews may be circular”
(p. 217). They then base their conclusion that “the evi-
dence fails to support the notion that denials, tentative
disclosures, and recantations characterize the disclosure
patterns of children with validated histories of sexual
abuse” (p. 194) on their review of research studies that
are in many cases flawed by both suspicion and substan-
tiation bias. What do studies that avoid both biases tell
us about this area of contention?
Studies of Disclosure Patterns in Cases without Nine boys and one girl were interviewed by police
after Swedish law enforcement discovered videotapes of
102 incidents of child sexual abuse, ranging from expo-
sure of the child’s genitals to oral/anal/vaginal intercourse
(Sjoberg & Lindblad, 2002). The perpetrator was either
related to the children or knew them through his work
at a day care center. Abuse severity was coded both from
the videotapes and from children’s statements. No child
had previously disclosed abuse nor had it been suspected.
Five children reported no abuse during police interviews,
for a disclosure rate of 50%. The child who had suffered C h i l d r e n ‘ s D i s c l o s u r e P a t t e r n s i n S e x u a l A b u s e C a s e s 32 J u v e n i l e a n d F a m i l y C o u r t J o u r n a l • W i n t e r 2 0 0 6
the greatest number (60 incidents) and most severe
sexual assaults according to the videotaped evidence did
not disclose during the police interview. Two of the five
children who did disclose did so only in response to lead-
ing questions. No child reported any sexual behavior not
documented on the videotape.
Cases with children not suspected to be sexual abuse
victims who are diagnosed with sexually transmitted dis-
eases, who are too old to have acquired the diseases con-
genitally and too young to have acquired them through
consensual sex with peers, also avoid both suspicion
and substantiation bias. Confining this review to STD
diagnosis deals with the problem raised by London et al.
(2005) that “medical evidence” is not always a “reliable
benchmark” because, for example, genital redness may be
caused by many things besides sexual abuse.
Lawson and Chaffin (1992) found that among 28 chil-
dren in which STDs were medically diagnosed without
prior suspicion of abuse, only 12 children (43%) made
an allegation of sexual abuse during the initial formal
interview, and 16 children did not. Almost half of these
children had shown no physical or behavioral symptoms
of sexual abuse, so that there were no “red flags” that
would have otherwise brought these children into the
system as possible CSA victims. Maternal attitude influ-
enced disclosure patterns greatly. Among those children
whose parents were supportive, 63% disclosed abuse
during these initial interviews, whereas when caregivers
expressed skepticism, only 17% disclosed.
Of the 16 false negatives in the original Lawson
and Chaffin study, five were subsequently located and
consented to be interviewed. Four of these five had a
supportive parent and one a non-supportive parent.
Researchers presented the study to parents and chil-
dren as an evaluation of responses to prior emergency
room visits, and they never mentioned child abuse.
Nevertheless, four of the five parents spontaneously
told the researchers that their children had disclosed
sexual abuse some time after the initial hospital inter-
view, a finding that supports the idea that CSA disclo-
sure is often an incremental process that may require
more than a single interview (Chaffin, Lawson, Selby,
& Wherry, 1997). Upon psychological testing, the four
non-disclosing children whose parents had been sup-
portive at the time of the initial interview tested three
times higher on dissociative symptoms than did the dis-
closing children and nine times higher on dissociative
symptoms than non-abused control children. Because of
the nature of this study and the very small numbers of
children involved, these results are far from conclusive,
but they do suggest a possible link between dissociative
symptoms and non-disclosure among CSA victims.
London et al. explain the Lawson and Chaffin
results by describing this sample as “unusual” and as
representing “the small hard core of children who do
not disclose abuse when directly asked” (2005, p. 215).
Lyon argues in response that the Lawson and Chaffin
sample avoids the problems of suspicion and substan-
tiation bias that characterize many other samples. Lyon
then raises a concern about the many cases that are
closed as unsubstantiated after a single interview during
which a possibly sexually abused child without medical
evidence fails to disclose when formally questioned.
A number of other samples document similarly
low rates of disclosure in STD cases. Lyon examined 21
studies published between 1965 and 1993 of children
diagnosed with gonorrhea. In nine of these papers, the
authors referred to a “history” of sexual contact or sexual
abuse for some of the children with gonorrhea, without
clarifying whether this history came from children’s dis-
closures or from other sources (Lyon, in press). In most
of the remaining studies, the authors used words such as
“admitted” or “denied” sexual contact or referred even
more directly to children’s statements. Even when all
the cases of “history” were counted as actual child dis-
closures, Lyon finds that the average rate of “disclosure”
among the 579 children in these studies was 43%, or 250
children. Given the broad definition of “disclosure” that
he applies here, Lyon argues that this may actually be an
overestimate of disclosure rates. Most of these studies
indicated that the medical professionals questioned the
children, but the precise nature of these questions is not
known. When Lyon omits studies with children younger
than three years of age to control for developmental
limitations on narrative skill, he finds that 185 of 437
children, or 42%, disclosed.
To summarize this sample of disclosure studies that
avoid both suspicion and substantiation bias, Sjoberg
and Lindblad find a disclosure rate of 50%, Lawson and
Chaffin find a disclosure rate of 43%, and in a review of
21 studies of children diagnosed with gonorrhea, Lyon
finds a disclosure rate of 43%. London et al. (2005) assert E r n a O l a f s o n a n d J u d g e C i n d y S . L e d e r m a n 33W i n t e r 2 0 0 6 • J u v e n i l e a n d F a m i l y C o u r t J o u r n a l
that when CSA victims are interviewed, a “majority” of
them disclose sexual abuse. These 23 studies contradict
that assertion by showing that only from 42% to 50%
of children known through external evidence to have
been sexually abused actually disclosed during their
formal interviews.
We agree with London and colleagues that “If the field
is to be guided by scientifically validated concepts then
this must be predicated on the literature that comes clos-
est to the standards of science” (2005, p. 220). Research
studies that avoid suspicion bias and substantiation bias
come closer to this scientific standard than do research
studies that suffer from one or both of these biases, and
these studies show far lower rates of children’s disclosure
of child sexual abuse than London et al. (2005) assert.
When children who have not previously Studies of Child Sexual Abuse Cases that Avoid Studies of previously disclosing children will gener-
ally show higher rates of disclosure than do studies in
which children had not previously disclosed, because
prior disclosure predicts children’s disclosure during for-
mal interviews. The majority of cases that judges are likely
to see will involve previously disclosing children, because
child sexual abuse is most often suspected when a child
says something to a caregiver or friend that brings the
case into the system. However, many research studies do
not fully document whether or not a child disclosed prior
to entering the system. Others state how many children
disclosed to another person prior to the formal interview.
Both categories are reviewed in this section.
Hershkowitz, Horowitz, & Lamb (2005) examined
all interviews with alleged victims of sexual abuse, aged
3 to 14, in Israel from 1998 to 2002 (10,988 interviews).
Most of the alleged victims were aged 7 to 14. During
one interview, 71.1% of these children made allega-
tions of child sexual abuse. Boys were less likely than
girls to allege sexual abuse. Children aged 3-6 were less
likely to make allegations than children aged 7-10, and
children aged 11-14 had the highest rates of allegation.
Children were much less likely to make allegations
when the suspect was a parent or parent-figure. This
very large study confirms patterns observed in smaller
U.S. samples. However, because of limitations in the data
set, the authors did not state which children had made
disclosures prior to the formal interviews, although it
is known that prior disclosure is the primary means
by which cases come into the system (Lyon, in press).
The authors were also unable to determine from the
data set which children had been interviewed more
than one time. Finally, it was not possible to analyze
separately those cases that had independent evidence
corroborating child sexual abuse, so that the validity
and non-validity of the children’s allegations could not
be determined.
Elliott and Briere (1994) find that 39 of 118 (33%)
children aged 8 to 15 for whom there was external evi-
dence of child sexual abuse made no disclosure about
having been sexually abused during formal interviews,
and some of the remaining 67% of children with exter-
nal evidence who did disclose required more than one
interview to do so. Twenty of these children had report-
edly disclosed to another person before the interview
but did not do so during the interview, and 19 disclosed
to no one either before or during the formal interview.
A higher percentage of the non-disclosing children had
mothers who were not supportive. There was a higher
percentage of African-American children among the
non-disclosing group. Victims were aged eight through
adolescence, and other research has shown that school-
aged children and adolescents are more likely to dis-
close sexual abuse when questioned than are young-
er children (DiPietro, Runyan, & Frederickson, 1997;
Hershkowitz et al., 2005; Keary & Fitzpatrick, 1994;
London et al., 2005; Lyon, in press; Sas & Cunningham,
1995). London et al. mistakenly calculate a disclosure
rate of 84% in the Elliott and Briere study, a percentage
that is inflated because of substantiation bias. London
and colleagues (in press) calculated the 39 non-dis-
closers against the 248 children classified as “abused,”
although the 248 substantiation figure includes over
100 children classified by the researchers as abused
because they made “consistent, detailed, contextually
embedded, developmentally age-appropriate accounts
of at least one abusive incident” (Elliott & Briere, 1994, p.
264). When substantiation bias is eliminated and the 39 C h i l d r e n ‘ s D i s c l o s u r e P a t t e r n s i n S e x u a l A b u s e C a s e s 34 J u v e n i l e a n d F a m i l y C o u r t J o u r n a l • W i n t e r 2 0 0 6
children who did not disclose during formal interviews
are measured against the 118 cases with corroborative
evidence independent of children’s disclosures, the
disclosure rate during formal interviews is 67% and the
non-disclosure rate of known victims is 33%.
In their forthcoming chapter, London et al. also
cite inflated 75% disclosure statistics from a study by
Dubowitz et al. (1992). There were 28 children in that
study who had medical examination findings indicative
of child sexual abuse, and of these, 13 fully disclosed, 7
did not disclose, and 8 “partially disclosed.” London et al.
(in press) must be including the 8 partial disclosers in
this high percentage, although these partial “disclosures”
are described by Dubowitz et al. (1992) as “suggestive
doll play or an inconclusive account of alleged abuse”
(p. 690). When only real disclosures are included, the
disclosure rate in the Dubowitz study is 46%.
Finally, because of methodological shortcomings
in two older studies, Sorenson and Snow (1991) and
Bradley and Wood (1996), they are reviewed only briefly
here. Sorenson and Snow report a 72% initial non-disclo-
sure rate by children, and Bradley and Wood report a 7%
total non-disclosure rate apparently over the course of
several interviews. The end results for both studies do
not differ greatly. Bradley and Wood write that 95% of
the children in cases that had external evidence of child
sexual abuse similar to that used by Sorenson and Snow
“made a partial or full disclosure of abuse during at least
one interview with DPRS or police” (p. 885). In their
evaluation and treatment sample, Sorenson and Snow
write that 96% of the children for which there was
external evidence eventually reached “active” disclosure,
often after weeks or months of treatment.
Prior disclosure predicts disclosure during Recantations
A 10-year-old girl who has told investigators that
she was repeatedly sodomized by her soccer coach
comes to the witness stand during criminal proceed-
ings, freezes, and mumbles to the jury that she “cannot
remember” what happened; as with many cases of anal
penetration, there is no medical evidence. An adoles-
cent boy who has told his school counselor that his
stepmother “messes with my dick” explains to the child
protection investigator the next day that he was “just
kidding.” A preschool girl who has reportedly told her
divorced mother that her daddy “tickles my coochie
and it hurts,” climbs under a table during the advocacy
center interview and denies ever visiting her father. Are
these children withdrawing their allegations because
they were never abused, or are they recanting true state-
ments about abusive events?
These are among the most challenging cases to
investigate and to litigate. There are far fewer studies on
recantation than on delay, non-disclosure, and disclosure,
and there is not yet definitive research about recanta-
tion rates in externally validated cases. Recantation
rates in various studies range from 4% (Bradley & Wood,
1996) to 22% (Sorenson & Snow, 1991). Most studies
of recantation rates contain serious methodological
flaws. Therefore, we cannot agree with the statement
by London et al. (2005) that “only a small percentage of
children in these studies recant” (p. 217). It is more accu-
rate to state that we simply do not yet know how often
and why children recant their statements about actually
having been sexually abused.
There is research currently under way. Malloy, Lyon,
Quas, and Forman (2005) recently presented results
from a random sample of 217 substantiated CSA cases
from the Los Angeles Dependency Court in 1999-2000
to discern disclosure patterns across all interviews.
Children were aged 2 to 17, and 90% were female. Most
of the children had from 3 to 9 interviews. The major-
ity (78%) had disclosed to someone prior to the police
or social services interview, so that the low initial non-
disclosure rate of 9% can be explained by this sample’s
suspicion bias. Twenty-three percent of the children
fully recanted their allegations at some point, and an
additional 11% minimized the severity of the abuse they
had initially reported by partially recanting, for a total of
34% full or partial recanters. Lack of maternal support
and abuse by a male caretaker were predictors for full
recantation. In cases that had medical evidence cor-
roborating the sexual abuse, 25% of the children either
fully or partially recanted the allegation, and 24.5% of E r n a O l a f s o n a n d J u d g e C i n d y S . L e d e r m a n 35W i n t e r 2 0 0 6 • J u v e n i l e a n d F a m i l y C o u r t J o u r n a l
children whose perpetrator confessed recanted at some
point during the evaluation. The authors conclude that
recantation is not rare in externally corroborated cases
and in substantiated cases, when all interviews in each
case are examined.
Recantations should not be interpreted to mean that
an allegation is necessarily false. Unfortunately, criminal
courts do not always agree. For example, in Florida, a
prior inconsistent statement from a recanting alleged
victim of child sexual abuse is not sufficient in and of
itself to sustain conviction, even if repeated on multiple
occasions (State v. Green 667 So.2d 756 Fla.,1995. West’s
F.S.A § 90.803(23)).
Researchers have not established whether Bizarre Disclosures
Many children’s cases never reach the courts
because they contain bizarre and impossible details.
These can include accounts of, for example, having
been abused aboard rocket ships, having been abused
by the Wizard of Oz, having been stabbed all over the
body (without medical evidence), having murdered
and dissected a baby, and other grotesque and extreme
statements. In a random sample of 104 child sexual
abuse and physical abuse “gold standard” cases with two
forms of external evidence selected from a child protec-
tion facility, the blind scoring of transcribed disclosure
statements shows that 15.38% of the most severe cases
with victims aged 4-9 contained such implausible details
(Dalenberg, 1996; Dalenberg, Hyland, & Cuevas, 2002).
These fantastic statements were from cases in which the
researchers could be certain that physical and/or sexual
abuse had actually taken place. The rate of bizarre state-
ments in the mild, externally verified cases from this
sample was less than 4%. Because both true and false
allegations can contain implausible details, their pres-
ence does not help investigators sort truth from fiction.
What this study does indicate is that implausible details
in an otherwise solid disclosure do not in themselves
prove that an allegation is false. Indeed, these fantastic
elements may indicate that the child experienced espe-
cially severe physical and/or sexual abuse.
Variables that Affect Disclosure Patterns
We agree with London and colleagues (in press) that
future research with a multivariate model is necessary to
find causal explanations for children’s disclosure patterns,
but there are some trends that seem to be emerging.
■ Maternal or parental support: Children who lack ■ Relationship to perpetrator: In some cases, the ■ Age: Retrospective surveys indicate that victims first ■ Gender: In both retrospective surveys and child C h i l d r e n ‘ s D i s c l o s u r e P a t t e r n s i n S e x u a l A b u s e C a s e s 36 J u v e n i l e a n d F a m i l y C o u r t J o u r n a l • W i n t e r 2 0 0 6
Tackett, Williams, & Finkelhor, 1993; Levesque, ■ Culture: Although more research needs to be done ■ Severity and duration of abuse: Research stud- ■ Batterers: The courts should be especially alert to ■ Dissociation and post-traumatic stress: Children ■ Modesty: Modesty or embarrassment should also a pediatric examination. It was only when the girls ■ Other reasons for non-disclosure: When non-dis- Conclusions is child sexual abuse, even in dependency cases where
the burden of proof is preponderance of the evidence
or clear and convincing evidence rather than proof
beyond a reasonable doubt. Few convictions carry the
same degree of stigma and legal ramifications for the
convicted and the potential for serious emotional and
psychological harm to the victim.
It is important to understand that the rules are
different in sexual abuse cases, and every judge must
understand the science. It is common in sexual abuse
cases for the victim not to disclose in a timely manner.
It is not unusual for the victim to disclose little by little
over a period of time. It can happen that the child victim
will recant. In any other prosecution for any other crime,
these actions would be considered indicia of unreliability E r n a O l a f s o n a n d J u d g e C i n d y S . L e d e r m a n 37W i n t e r 2 0 0 6 • J u v e n i l e a n d F a m i l y C o u r t J o u r n a l
or lack of truthfulness and would be legal and factual
impediments to conviction. Indeed, a denial of abuse by
the alleged victim would prevent prosecution.
In dependency cases, the court is bound to protect
the health and safety of the child while balancing the
rights of the parents. It is important that judges under-
stand the science so that they can do justice when the
defense lawyer argues, “It did not happen because the
child recanted”; “It did not happen because the child’s
disclosures were not made close to the event”; “It did
not happen because the child kept adding new infor-
mation.” As in domestic violence, the often frustrating
behavior of the victim needs to be explained to the
trier of fact from the victim’s perspective, by those
who have studied this behavior.
When justice is not done in a sexual abuse case, the
harm can be devastating. No jurist wants to take a child
from her home and break up a family when abuse has not
occurred. No jurist wants to leave a child unprotected in
an abusive family. The reality is that it is very often diffi-
cult for a judge presiding over a child sexual abuse case to
feel certain about his or her decision and interpretation
of the facts. Many judges spend sleepless nights worrying
about the ramifications of their decisions.
S U M M A R Y O F R E S E A R C H F I N D I N G S
1. Experts agree that a majority of child sexual abuse victims do not disclose their abuse 2. Experts agree that when children do disclose sexual abuse during childhood, it is often after long 3. Prior disclosure predicts disclosure during formal interviews. Children who have told someone about 4. Gradual or incremental disclosure of child sexual abuse occurs in many cases, so that more than one 5. Experts disagree about whether children disclose sexual abuse when they are interviewed. However, 6. School-age children who do disclose are most likely to first tell a caregiver about what has happened 7. Children first abused as adolescents are more likely to disclose than are younger children, and they are 8. When children are asked why they did not tell about the sexual abuse, the most common answer 9. Further research is needed about recantation rates, which range in various studies from 10. Lack of maternal or parental support is a strong predictor of children’s denial of abuse during formal 11. Many unanswered questions about children’s disclosure patterns remain, and further multivariate 38 J u v e n i l e a n d F a m i l y C o u r t J o u r n a l • W i n t e r 2 0 0 6
Sexual abuse cases are specialized cases that
require specialized knowledge, a tool judges must have
in order to do justice. Knowing the law alone is not
enough. By understanding the research in the sexual
abuse field (see page 37 for a summary of research
findings), judges can enhance their ability to make just
decisions by applying the law to the facts.
A U T H O R S ’ Erna Olafson, Ph.D., Psy.D. Department of Psychiatry, ML0539 Cincinnati, OH 45267
Judge Cindy S. Lederman Juvenile Justice Center, Room 201 Miami, FL 33142
C h i l d r e n ‘ s D i s c l o s u r e P a t t e r n s i n S e x u a l A b u s e C a s e s E r n a O l a f s o n a n d J u d g e C i n d y S . L e d e r m a n 39W i n t e r 2 0 0 6 • J u v e n i l e a n d F a m i l y C o u r t J o u r n a l
Bancroft, L., & Silverman, J. G. (2002). The batterer as parent: Bradley, A. R., & Wood, J. M. (1996). How do children tell? The Carnes, C. N., Nelson-Gardell, D., Wilson, C., & Orgassa, U. C. Carnes, C. N., Wilson, C., & Nelson-Gardell, D. (1999). Extended Chaffin, M., Lawson, L., Shelby, A., & Wherry, J. N. (1997). False Dalenberg, C. J. (1996). Fantastic elements in child disclosure Dalenberg, C. J., Hyland, K. Z., & Cuevas, C. A. (2002). Sources DiPietro, E. K., Runyan, D. K., & Fredrickson, D. D. (1997). Dubowitz, H., Black, M., & Harrington, D. (1992). The diagnosis Dunkerley, G. K., & Dalenberg, C. J. (1999). Secret-keeping Elliott, A. N., & Carnes, C. N. (2001). Reactions of nonoffending Elliott, D. M., & Briere, J. (1994). Forensic sexual abuse Finkelhor, D., Hotaling, G., Lewis, I., & Smith, C. (1990). Fivush, R. (1994). Young children’s event recall: Are memories Frasier, L. D., & Makoroff, K. L. (in press). Medical evidence and Ghetti, S., & Goodman, G. S. (2001). Resisting distortion? Goodman-Brown, T. B., Edelstein, R. S., Goodman, G. S., Jones, Henry, J. (1997). System intervention trauma to child sexual Hershkowitz, I., Horowitz, D., & Lamb, M. E. (2005). Trends in Jaffe, P., & Geffner, R. (1998). Child custody disputes and Keary, K., & Fitzpatrick, C. (1994). Children’s disclosure of Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Lamb, S., & Edgar-Smith, S. (1994). Aspects of disclosure: Lawson, L., & Chaffin, M. (1992). False negatives in sexual REFERENCES C h i l d r e n ‘ s D i s c l o s u r e P a t t e r n s i n S e x u a l A b u s e C a s e s 40 J u v e n i l e a n d F a m i l y C o u r t J o u r n a l • W i n t e r 2 0 0 6
Levesque, J. (1994). Sex differences in the experience of child London, K., Bruck, M., Ceci, S. J., & Shuman, D. W. (2005). London, K., Bruck, M., Ceci, S. J., & Shuman, D. W. (in Lyon, T. D. (2002). Scientific support for expert testimony on Lyon, T. D. (in press). False denials: Overcoming biases in Malloy, L. C., Lyon, T. D., Quas, J. A., & Forman, J. (2005). Muram, D., Speck, P. M., & Gold, S. S. (1991). Genital abnormalities The National Research Council (1993). Understanding Abuse Olafson, E. (2002). When paradigms collide: Roland Summit Pipe, M., Lamb, M., Orbach, Y., & Cederborg, A. (in press). Poole, D. A., & Dickinson, J. J. (2005). The future of the protocol Putnam, F. W. (1997). Dissociation in Children and Adolescents. Putnam, F. W. (in press). The impact of trauma on child Sas, L. D., & Cunningham, A. H. (1995). Tipping the balance Sauzier, M. (1989). Disclosure of child sexual abuse: For better Saywitz, K. J., Goodman, G. S., Nicholas, E., & Moan, S. F. (1991). Sjoberg, R., & Lindblad, F. (2002). Delayed disclosure and Smith, D. W., Letourneau, E. J., Saunders, B. E., Kilpatrick, D. Sorensen, T., & Snow, B. (1991). How children tell: The process Summit, R. C. (1983). The child sexual abuse accommodation Widom, C. S., & Morris, S. (1997). Accuracy of adult recollections REFERENCES 10/16/200 8
1
HOW CHILDREN HOW CHILDREN HOW CHILDREN HOW CHILDREN Dynamics of VictimizationDynamics of Victimization
DYNAMICS OFDYNAMICS OF Help us understand the Help us understand the coping strategiescoping strategies
Adapted from © CornerHouse 200 2
Child Sexual Abuse Child Sexual Abuse Roland Summit, MDRoland Summit, MD
S S — SecrecySecrecy E E — Entrapment and AccommodationEntrapment and Accommodation
D D — Delayed or Unconvincing DisclosureDelayed or Unconvincing Disclosure
R R — RetractionRetraction
© Finding Words New Jersey 10/16/2008
2 SecrecySecrecy 3
Terrifying reality of child Terrifying reality of child Child is alone with the offenderChild is alone with the offender Nondisclosure RatesNondisclosure Rates (Lyon, 2002)(Lyon, 2002) 86% of sexual assaults to 86% of sexual assaults to © Finding Words New Jersey
HelplessnessHelplessness Summit, 1983Summit, 1983
Children are subordinate to older Children are subordinate to older © Finding Words New Jersey Entrapment & AccommodationEntrapment & Accommodation Typically occurs repeatedly; child Typically occurs repeatedly; child © Finding Words New Jersey 10/16/2008 Entrapment & AccommodationEntrapment & Accommodation Summit, 1983Summit, 1983 FragmentingFragmenting Delayed or Unconvincing Delayed or Unconvincing Summit, 1983Summit, 1983 “Most on“Most on–going sexual abuse is going sexual abuse is nevernever © Finding Words New Jersey Triggers for disclosure:Triggers for disclosure: 10/16/2008 4
RetractionRetraction Chaotic Aftermath of DisclosureChaotic Aftermath of Disclosure RetractionRetraction Recantation rates across studies range from Recantation rates across studies range from Recantations most likely to occur in Recantations most likely to occur in © Finding Words New Jersey The Traumagenic ModelThe Traumagenic Model 5
1.1. BetrayalBetrayal
2.2. Traumatic Traumatic 3.3. PowerlessnessPowerlessness
4.4. StigmatizationStigmatization
Adapted from © CornerHouse 2002 10/16/2008 BetrayalBetrayal Finkelhor & Browne, 1985Finkelhor & Browne, 1985
Perpetrator in position of trust/authorityPerpetrator in position of trust/authority © Finding Words New Jersey Traumatic SexualizationTraumatic Sexualization Inappropriate conditioning of child’s Inappropriate conditioning of child’s © Finding Words New Jersey Traumatic Sexualization (cont’d..)Traumatic Sexualization (cont’d..) Examples:Examples: 10/16/2008 6
PowerlessnessPowerlessness Child cannot control noxious eventsChild cannot control noxious events Created powerless victim (deception and force)Created powerless victim (deception and force) © Finding Words New Jersey Powerlessness Powerlessness Finkelhor & Browne, 1985Finkelhor & Browne, 1985 Fear and anxiety symptoms: nightmares, Fear and anxiety symptoms: nightmares, l l StigmatizationStigmatization Child’s knows that the activity is deviant and taboo and Child’s knows that the activity is deviant and taboo and 2/3 revictimization rate2/3 revictimization rate © Finding Words New Jersey 10/16/2008 7
How Children Experience How Children Experience Interview ExamplesInterview ExamplesInterview ExamplesInterview Examples
Victim Responses to AbuseVictim Responses to Abuse
Twaite & RodriguezTwaite & Rodriguez–Srednicki, 2004Srednicki, 2004
Whiffen & MacIntosh, 2005Whiffen & MacIntosh, 2005 KendallKendall–Tackett, Meyer & Finkelhor, 1993Tackett, Meyer & Finkelhor, 1993
Swanstone, Tebbutt, O’Toole & Oates, 1997Swanstone, Tebbutt, O’Toole & Oates, 1997
DepressionDepression Victim Responses to AbuseVictim Responses to Abuse Ketring & Feinauer, 1999Ketring & Feinauer, 199 9
Victim Impact ContinuumVictim Impact Continuum
DurationDuration 10/16/2008 Victim Responses to AbuseVictim Responses to Abuse KendallKendall–Tackett, Meyer & Finkelhor, 1993Tackett, Meyer & Finkelhor, 1993 Other maltreatment (physical abuse)Other maltreatment (physical abuse)p yp y Support from partners and friends in adulthoodSupport from partners and friends in adulthood Coping/outlookCoping/outlook
Victim Responses to AbuseVictim Responses to Abuse Victim Impact ContinuumVictim Impact Continuum ?? AgeAge ?? GenderGender researchresearch
Victim Responses to AbuseVictim Responses to Abuse Ketring & Feinauer, 1999Ketring & Feinauer, 1999 Victim Impact ContinuumVictim Impact Continuum Vi timVi tim P p t t R l ti nship P p t t R l ti nship VictimVictim–Perpetrator Relationship Perpetrator Relationship 10/16/2008 VictimVictim–Perpetrator Perpetrator RelationshipRelationship
TargetTarget Victim Responses to AbuseVictim Responses to Abuse VictimVictim–Perpetrator RelationshipPerpetrator Relationship
FriendFriend Victim Responses to AbuseVictim Responses to Abuse SibliSibliSiblingSibling 10/16/2008 10
Victim Responses to AbuseVictim Responses to Abuse CaretakerCaretaker Victim Responses to AbuseVictim Responses to Abuse RelationshipRelationship LoverLover “What it was “What it was incest incest 10/16/2008 11
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Please do not talk about the facts of the case or anything you might think of as testimony The
judge and the prosecutor would like to know:
b. How your life is different because of the incident
c. What you think the defendant’s sentence should be
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Victim Witness Advocacy at
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Cases involving child sexual
About Children’s Disclosure Patterns
BY ERNA OLAFSON AND JUDGE CINDY S. LEDERMAN
In current research studies about the disclosure patterns of sexually
abused children, experts agree that most victims delay disclosure
for years, often until adulthood. Researchers disagree about dis-
closure rates and recantation rates among children during formal
interviews. Studies of children who had not previously disclosed but
are known through corroborative evidence to have been sexually
abused show lower rates of disclosure than do studies of children
who had disclosed prior to the formal interview. Gradual disclosures
among children are common, and more than a single interview may
be necessary in some cases. Prior disclosure, level of support by
non-offending parents, developmental level, and relationship to
perpetrator affect children’s rates of disclosure and their disclosure
patterns. More research is necessary to clarify children’s post-disclo-
sure recantation rates and predictors.
University of Cincinnati College of Medicine. She is Director of the Program on Child Abuse Forensic and Treatment Training at Cincinnati Children’s Hospital
Childhood Trust. Her presentations and publications focus on domestic violence, sexual assault, and child abuse.
Judge Cindy S. Lederman is the Presiding Judge of the Juvenile Court in Miami-Dade County, Florida. A member of the NCJFCJ’s Board of Trustees,
she was instrumental in creating the Dade County Domestic Violence Court and served as the court’s first Administrative Judge. In 1999, Judge Lederman was
awarded a Fellowship from Zero to Three: The National Center for Infants, Toddlers and Families in their Leaders of the 21st Century Initiative.
Many scholarly papers about children’s disclosure
What are the disclosure and non-disclosure patterns
sometimes until adulthood?
sexual abuse?
to disclose or deny being abused, so that more than
one formal interview becomes necessary?
partial and fragmentary accounts to full disclosure
over time?
high percentage of known victims subsequently
recant or retract their disclosures?
level, culture, degree of abuse severity, parental sup-
port, and relationship to perpetrator that influence
disclosure patterns among CSA victims?
having been sexually abused during childhood;
and
evaluation and treatment in cases with cor-
roborative evidence that is independent of
children’s statements, such as videotapes of the
actual abuse, physical findings, sexually trans-
mitted diseases, and offender confession.
Until Adulthood
within Childhood
abuse cases, judges and other fact finders
should be aware that, in a high percentage
of actual CSA cases, there will be delays of
months or even years between the onset
of the abuse and a child first disclosing to
another person.
Formal Interviews
externally corroborated cases are known to
disclose only gradually, more than a single
interview may become necessary to serve
children’s safety and justice. See the guide-
lines by the National Children’s Advocacy
Center (Carnes et al., 1999; 2001).
Interviewed about Child Sexual Abuse
to another person and thus precipitated entry into
the system; and
means, such as diagnosis of a sexually transmitted
disease during routine medical care, extreme sexual-
ized behaviors, or the discovery of videotapes docu-
menting the abuse.
that did not come to the attention of the authorities
because a child disclosed to someone prior to the
formal interview; and
cases in which substantiation was completely inde-
pendent of the child’s statements.
Selection Bias
disclosed are interviewed, and these chil-
dren are known to have been sexually
abused because of external corroborating
evidence, their rates of disclosure range
from 42% to 50%.
Only Substantiation Bias
formal interviews. However, in externally
corroborated cases in which children have
previously disclosed, a substantial percent-
age of children do not disclose during the
first formal interview. Many of these chil-
dren do disclose if given the opportunity in
subsequent interviews.
recantations are frequent or infrequent,
but they do occur in externally corrobo-
rated CSA cases, especially when abuse
was by a male caregiver and/or maternal
support was absent.
caregiver support are far less likely to disclose than
are children who have a supportive caregiver, when
“support” is defined as a willingness to believe that
the child sexual abuse could have happened (Elliott
& Briere, 1994; Lawson & Chaffin, 1992). Elliott &
Carnes (2001) find that a majority of mothers either
believe or support children in CSA cases. Those cases
that reach the courts may differ in crucial ways. Thus,
in dependency court, familial support is often absent,
hence the intervention of the state in the parent-
child relationship to protect the child. The victim
child, and often her siblings, are removed from their
home, and sometimes there is an arrest of a family
member who may be the breadwinner. In too many
cases, the child is blamed, feels responsible for break-
ing up the family, and eventually recants (Malloy et
al., 2005).
child is dissuaded from disclosing the abuse by fam-
ily members who do not believe the child and wish
to prevent shame and embarrassment to the family.
Most studies demonstrate lower rates of disclosure
or longer delays in doing so when abuse is by a
family member rather than by a non-family member
(Goodman-Brown, Edelstein, Goodman, Jones, &
Gordon, 2003; Hershkowitz et al., 2005; Sjoberg &
Lindblad, 2002; Smith et al., 2000; but see also Lamb
& Edgar-Smith, 1994; London et al., 2005).
abused during adolescence are more likely to dis-
close than are younger children, and they are more
likely to disclose first to another adolescent than to
a caregiver. Retrospective surveys also indicate that
school-aged children are more likely first to reveal
child sexual abuse to a parent than to another child
(London et al., 2005, p. 201).
samples, there are suggestions that boys may be
more reluctant to disclose than girls, although other
abuse-specific variables may influence gender differ-
ences (Ghetti & Goodman, 2001; Goodman-Brown
et al., 2003; Hershkowitz et al., 2005; Kendall-
1994; London et al., 2005; Sas & Cunningham,
1995; Sauzier, 1989; Widom & Morris, 1997).
in the area of culture and disclosure rates, there
are indications among child samples that children
from minority groups face culture-specific barriers
to disclosure that could contribute to delays or
denials (Dunkerley & Dalenberg, 1999; Elliott &
Briere, 1994; London et al., 2005, p. 205).
ies show inconsistent results. Future multivariate
analyses accounting for severity and duration of
abuse, age, gender, culture, and relationship to
perpetrator may clarify this issue.
the potential for child sexual abuse by batterers,
because research studies indicate that battering
father-figures are from four to nine times more
likely to perpetrate incest (primarily on girls) than
are non-batterers (Bancroft & Silverman, 2002).
Because of the atmosphere of terror that can per-
meate violent homes, both adult and child victims
are often justifiably reluctant to speak up when
formally questioned unless they can be convinced
that they will not be in danger for doing so (Jaffe
& Geffner, 1998).
subjected to prolonged, severe abuse may
face multiple obstacles to adequate disclosure.
Unwillingness to face the discomfort of post-trau-
matic flashbacks may cause traumatized children
to numb their feelings and cognitions and shut
down during interviews. Dissociative symptoms
may interfere (Chaffin et al., 1997; Putnam, 1997).
Cognitive disabilities caused by damage to the
central nervous system and brain are associated
in numerous studies with histories of severe child
maltreatment in early childhood, and these deficits
may interfere with children’s ability to recall and
describe their life experiences (Elliott & Briere,
1994; Putnam, this issue).
be considered as motives for silence. One labora-
tory study indicates that girls aged 5-7 are reluc-
tant to disclose even non-abusive genital touching
during interviews. Saywitz, Goodman, Nicholas,
and Moan (1991) found a 64% false negative dis-
closure rate in a subsequent interview among girls
who had been touched genitally and anally during
were directly asked with a yes-or-no question if
the doctor had touched them on the genital and
anal areas that these girls disclosed. This sugges-
tive question produced a false positive rate of 8%
(three girls) among those in the control group
who had not been genitally and anally touched,
and one of these girls provided contextual details.
Most experts in the field warn against interview
questions that name both act and perpetrator,
and many courts define such questions as leading.
Nevertheless, in this study, there were eight times
as many false denials when this suggestive ques-
tion was not asked than there were false allega-
tions when it was asked.
closing sexually abused children are questioned,
they cite fear as their primary motivation not to
tell. Older children who are familiar with depen-
dency procedures know that they and their sib-
lings may be removed from their home if they
tell. Children may fear being stigmatized as “sluts”
or “faggots” by their schoolmates if word gets
out (and it too often does) that they are sexual
abuse victims. Children may fear consequences to
themselves, to the perpetrator, or to other family
members (Goodman-Brown et al., 2003). Children
often otherwise love and trust sexual abuse perpe-
trators, and in some cases, they may not be fully
aware that what is happening to them is abusive,
criminal, and wrong.
The most difficult form of abuse to prove in court
during childhood.
delays.
the abuse prior to the formal interview are more likely to disclose during that interview than children
who have not. Children who have not previously disclosed and who have come to the attention of
the authorities because of medical evidence, videotapes, and other external evidence, are less likely to
disclose during medical or investigative interviews than are previously disclosing children.
interview may become necessary.
when both suspicion bias and substantiation bias are factored out of studies, studies with external
corroborating evidence of child sexual abuse show that 42% to 50% of children do not disclose sexual
abuse when asked during formal interviews.
to them.
more likely to confide first in another adolescent than to a caregiver.
is fear.
4% to 22%.
questioning. Abuse by a family member may inhibit disclosure. Dissociative and post-traumatic symp-
toms may contribute to non-disclosure. Modesty, embarrassment, and stigmatization may contribute to
non-disclosure. Gender, race, and ethnicity affect children’s disclosure patterns.
research is warranted.
A D D R E S S E S :
The Childhood Trust
University of Cincinnati Medical School
11th Judicial Circuit Court
3300 N.W. 27th Avenue
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EXPERIENCE ABUSEEXPERIENCE ABUSE
CHILD SEXUAL ABUSECHILD SEXUAL ABUSE
child’s perspective and child’s perspective and child s perspective and child s perspective and
Accommodation SyndromeAccommodation Syndrome
HH H lpl ssn ssH lpl ssn ssH H — HelplessnessHelplessness
Summit, 1983Summit, 198
sexual abuse: sexual abuse:
Threats/promises to keep secretThreats/promises to keep secret
Sh m nd iltSh m nd iltShame and guiltShame and guilt
Women: 33Women: 33–92%92%
Men: 42Men: 42–85% 85%
adolescents unreportedadolescents unreported (NIJ, 2003)(NIJ, 2003)
70% of sample told to keep 70% of sample told to keep
abuse secretabuse secret (Berliner & Conte, 1990)(Berliner & Conte, 1990)
people, especially those in people, especially those in
authority authority
Perpetrators groom children in Perpetrators groom children in
nonnon–sexual ways firstsexual ways firstyy
Typical response of small Typical response of small
creatures to terror is to freezecreatures to terror is to freeze
Child’s guilt about not protesting Child’s guilt about not protesting
leads to more silenceleads to more silence
Victims report saying “no” would Victims report saying “no” would
have only resulted in continued have only resulted in continued
abuse and perhaps further harm abuse and perhaps further harm
(Berliner & Conte, 1990)(Berliner & Conte, 1990)
Summit, 1983Summit, 1983
must survivemust survive
Child must accommodate to Child must accommodate to
increasing sexual demands increasing sexual demands increasing sexual demands increasing sexual demands
Child must accommodate to Child must accommodate to
increasing awareness of betrayal by increasing awareness of betrayal by
caretakerscaretakers–problems in relationship problems in relationship
with nonwith non–offending parentoffending parent
Feel responsible for the wellFeel responsible for the well–being being
of the entire familyof the entire family
Special problems of male victimsSpecial problems of male victims
3
(cont’d…)(cont’d…)
Behavioral Strategies: sexualized Behavioral Strategies: sexualized
behavior, lying, difficulty concentrating, behavior, lying, difficulty concentrating,
substance abuse, running awaysubstance abuse, running away
Psychological Strategies:Psychological Strategies:y g gy g g
DissociationDissociation
Dissociative Identity DisorderDissociative Identity Disorder
DisclosureDisclosure
disclosed outside the family.”disclosed outside the family.”
Disclosure in bits and piecesDisclosure in bits and piecespp
Disclosed almost incidentally in state Disclosed almost incidentally in state
of turmoilof turmoil
Disclosed without evident feelingDisclosed without evident feeling
In a sample of sexually abused In a sample of sexually abused
children (N=248), 75% did not children (N=248), 75% did not
disclose within a year of onset (Elliot disclose within a year of onset (Elliot
& Briere, 1994).& Briere, 1994).
Delayed or Unconvincing Delayed or Unconvincing
DisclosureDisclosure
Family conflictFamily conflict
Incidental discovery by 3Incidental discovery by 3rdrd partypartyIncidental discovery by 3Incidental discovery by 3 partyparty
Outreach educationOutreach education
Protection of younger childrenProtection of younger children
Medical problemsMedical problems
Close friendshipClose friendship
Family stress and disbeliefFamily stress and disbelief
Potential family disintegration and guiltPotential family disintegration and guilt
After disclosure child discovers the threats After disclosure child discovers the threats After disclosure, child discovers the threats After disclosure, child discovers the threats
underlying the secrecy are trueunderlying the secrecy are true
Unsupportive interactions with larger Unsupportive interactions with larger
systems.systems.
Summit, 1983Summit, 1983
44–50% 50% (Lyon, 2002)(Lyon, 2002)
Recantation rates from 4Recantation rates from 4–27% 27% (London, Bruck, (London, Bruck,
Ceci & Shuman, 2005)Ceci & Shuman, 2005)
intrafamilial abuse cases where significant intrafamilial abuse cases where significant
family members are disbelieving, nonfamily members are disbelieving, non–
supportive, blaming, and stressed.supportive, blaming, and stressed.
Finkelhor & Browne, 1985Finkelhor & Browne, 198
SexualizationSexualization
5
Child discovers that someone he/she Child discovers that someone he/she
depended upon caused harmdepended upon caused harmp pp p
Grief reactions and depression over the Grief reactions and depression over the
loss of a trusted figureloss of a trusted figure
Higher levels of posttraumatic and Higher levels of posttraumatic and
dissociative symptoms dissociative symptoms (Leahy, Pretty, & (Leahy, Pretty, &
Tenenbaum, 2004)Tenenbaum, 2004)
Can lead to avoidance of close Can lead to avoidance of close
relationships or to indiscriminate choicesrelationships or to indiscriminate choices
Finkelhor & Browne, 1985Finkelhor & Browne, 1985
sexual responsivenesssexual responsiveness
Problematic beliefs and feelings Problematic beliefs and feelings
associated with sexuality as well as associated with sexuality as well as
dysfunctional arousal patterns can dysfunctional arousal patterns can
developdevelop
Finkelhor & Browne, 1985Finkelhor & Browne, 1985
Sexual preoccupations and repetitive sexual behavior Sexual preoccupations and repetitive sexual behavior
of young child victims, such as masturbation or of young child victims, such as masturbation or
compulsive sex play.compulsive sex play.
Display of sexual knowledge and interests that are Display of sexual knowledge and interests that are p y gp y g
inappropriate to their age.inappropriate to their age.
Confusion of sexuality with nurturance or power.Confusion of sexuality with nurturance or power.
Promiscuity in adolescence, aversion to sex, Promiscuity in adolescence, aversion to sex,
flashbacks to the molestation experience, difficulty flashbacks to the molestation experience, difficulty
with arousal and orgasm, with arousal and orgasm, vaginismusvaginismus, negative , negative
attitudes toward their sexuality and their bodies.attitudes toward their sexuality and their bodies.
Finkehlor & Browne, 1985Finkehlor & Browne, 1985
Child’s attempts to halt the abuse are Child’s attempts to halt the abuse are
frustrated; e.g., when they unsuccessfully frustrated; e.g., when they unsuccessfully
attempt to report abuseattempt to report abusep pp p
Force & threat are not necessary to instill Force & threat are not necessary to instill
powerlessnesspowerlessness
Narratives of victims analyzed for themes of Narratives of victims analyzed for themes of
perpetrator methods perpetrator methods (Leahy, Pretty, & Tenenbaum, 2004)(Leahy, Pretty, & Tenenbaum, 2004)
Created omnipotent perpetrator (reality Created omnipotent perpetrator (reality
definition/control & manipulation)definition/control & manipulation)
(cont’d…)(cont’d…)
phobias, hypervigilance, clinging behavior, and phobias, hypervigilance, clinging behavior, and
p yp g g gp yp g g g
somatic complaintssomatic complaints
Sense of impotence: despair, depression, Sense of impotence: despair, depression,
suicidal behavior, learning problems, inability to suicidal behavior, learning problems, inability to
cope with environments that continues on into cope with environments that continues on into
adolescence and adulthood, revictimizationadolescence and adulthood, revictimization
Compensating for powerlessness: needs to Compensating for powerlessness: needs to
control and dominatecontrol and dominate
Finkelhor & Browne, 1985Finkelhor & Browne, 1985
abuser may convey negative statementsabuser may convey negative statements
Negative connotations (badness, shame, & guilt) are Negative connotations (badness, shame, & guilt) are
communicated to the child, especially after disclosurecommunicated to the child, especially after disclosure–
b i t d i t th hild’ lfb i t d i t th hild’ lf i C lt l i C lt l become incorporated into the child’s selfbecome incorporated into the child’s self–image. Cultural image. Cultural
meaning plays a big role.meaning plays a big role.
Risk of revictimization Risk of revictimization (Classen, Palesh & Aggarwal, 2005)(Classen, Palesh & Aggarwal, 2005)
Predictors: childhood sexual abuse & severityPredictors: childhood sexual abuse & severity
Associated with multiple difficulties including selfAssociated with multiple difficulties including self–blame and blame and
shameshame
AbuseAbuse
Anxiety DisordersAnxiety Disorders
Di i ti /di i ti di dDi i ti /di i ti di dDissociation/dissociative disordersDissociation/dissociative disorders
Post traumatic stress symptomsPost traumatic stress symptoms
Attachment issuesAttachment issues
Fears and somatic complaintsFears and somatic complaints
Sexual behavior problemsSexual behavior problems
Generalized behavior problemsGeneralized behavior problems
SelfSelf–esteem issuesesteem issues
KendallKendall–Tackett, Meyer & Finkelhor, 1993Tackett, Meyer & Finkelhor, 1993
FrequencyFrequency
ForceForce
Invasiveness of abuseInvasiveness of abuse
8
Jonzon & Lindblad, 2005 Jonzon & Lindblad, 2005
Victim Impact ContinuumVictim Impact Continuum
SupportSupport
Maternal support in childhoodMaternal support in childhood
KKendallendall–Tackett, Meyer & Finkelhor, 1993Tackett, Meyer & Finkelhor, 1993
•• Age at time of assessment Age at time of assessment appearsappears relatedrelatedAge at time of assessment Age at time of assessment appearsappears relatedrelated
•• Difficult to assess due to intervening variablesDifficult to assess due to intervening variables
•• Studies inconsistent; recommended for further Studies inconsistent; recommended for further
KendallKendall–Tackett, Meyer & Finkelhor, 1993Tackett, Meyer & Finkelhor, 1993
Leahy, Pretty & Tenenbaum, 2004Leahy, Pretty & Tenenbaum, 2004
Range: Father figure..other Range: Father figure..other
family/acquaintance..strangerfamily/acquaintance..stranger
“Closeness” of relationship“Closeness” of relationship
High levels of authority/trust associated with High levels of authority/trust associated with
emotional manipulation and increased symptomsemotional manipulation and increased symptoms
9
Victim Responses to AbuseVictim Responses to Abuse
Sees self as victimSees self as victim
“Why me?”“Why me?”
May be more frightened May be more frightened
but less guilt riddentbut less guilt riddent
Begins as one of companionshipBegins as one of companionship
May fill a parental gapMay fill a parental gap
Possibility of protectiveness by victim Possibility of protectiveness by victim
toward perpetratortoward perpetrator
VictimVictim–Perpetrator Perpetrator
RelationshipRelationship
Enmeshed system in Enmeshed system in
familyfamily
Age or power difference Age or power difference
may not be perceived by may not be perceived by
victimvictim
VictimVictim–Perpetrator RelationshipPerpetrator Relationship
Vigilant of perpetrator’s needsVigilant of perpetrator’s needs
Protective of perpetratorProtective of perpetrator
May also be concerned about impact on May also be concerned about impact on
rest of familyrest of family
VictimVictim–Perpetrator Perpetrator
A d A d Age and power Age and power
difference not difference not
perceived by victimperceived by victim
Feelings of specialnessFeelings of specialness
Protective of Protective of
perpetratorperpetrator
like to be an like to be an
victim”victim”
will exist a well
informed, well
considered and yet
fervent public
conviction that theconviction, that the
most deadly of all
possible sins is the
mutilation of a child’s
spirit.
© CornerHouse 2002
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