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Abused: Can You Tell?
Testimony on Sex Abuse Victims Challenged
Volume 2, Issue 7 -- Published: Sunday, May 31, 1998 -- Last Updated: Monday, Mar 11, 2002

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Featuring Expert Commentary by:

Ann Burgess, D.N.Sc.
The Forensic Panel
Susan Crump, Esq.
Texas A & M Universi
William Foote, Ph.D.
The Forensic Panel

Jump to expert commentary below.

Courts continue to demonstrate uncertainty about exactly what the behavioral sciences can contribute to sorting out allegations of child sexual abuse. Two recent cases provided more direction and guidance for the admissibility of expert input. But both State v. Stowers and Irving v. State force us to ask, can we tell when a child is sexually abused? In State v. Stowers, the defendant was charged with raping four of his children. Each of them testified at trial. Two of the children recanted, while one of the children who originally denied the abuse testified that the rape had in fact occurred. The fourth child's testimony was inconclusive. Enter the expert witness, an experienced clinical psychologist named Dr. Robin Tener.
The trial court allowed Dr. Tener to testify that the behavior of the children who changed their stories was consistent with the behavior of other children who had been sexually abused. Stowers was convicted of raping all four of his children.
The court of appeals, which affirmed Stowers conviction certified a conflict of decisions to the Ohio Supreme Court for review. At issue: Did the expert's opinion that the behavior of a child is consistent with the behavior of other sexually abused children, impermissibly convey to the jury the expert's belief that a child was actually abused?
Wordsworth Irving's case presented a slightly different quandary—and a different outcome. He was convicted of sexual battery and lewd assault of a child under age 12. This after attempting to suppress any expert testimony that tended to demonstrate that his victim's behavior was consistent with that of a child who had been sexually abused. Mr. Irving sought to have such testimony evaluated in accordance with Frye v. United States, 293 F. 1013 (D.C. Cir. 1923) for the purpose of determining its admissibility.
Both prongs of Irving's motion were denied. Dr. James Hord, a clinical psychologist, later testified that the alleged victim exhibited symptoms that were consistent with a child who had been sexually abused. Dr. Hord explained how he had utilized specific psychological tests, the kinetic family drawing test and projective story-telling cards to reach his conclusions. The psychologist spoke of how he found these tests especially reliable, and used them with 95 to 98 percent of the children he sees.

Fyre Hearings:

Generally required where a party seeks to admit new or novel scientific evidence. In such cases the proponent must demonstrate that the evidence is generally accepted within the relevant scientific field.


Irving was convicted. He appealed the decision.
Holdings: In State v. Stowers, the Ohio Supreme Court held that an expert witness' testimony that a child's behavior is consistent with behavior observed in sexually abused children was admissible. Basing its decision on several sections of the Ohio Rules of Evidence (Evid R. 702 & 704), the court stated an expert could convey his opinion that the child in question was actually abused—despite the fact that this testimony embraces an ultimate issue of fact. The court also allowed expert opinion based upon the observed behavior of a child rather than upon the expert's belief in the truth of the child's statement.
Even though a child sexual abuse syndrome is not yet recognized by the behavioral sciences, reversal was not warranted, wrote Justice Cook. Dr. Tener's testimony, distinguished as based on experience and education as opposed to scientific testing, was admissible. Mr. Stowers' conviction was affirmed.
However, in Irving v. State, the appellate court held that the admission of the State's expert's testimony was harmful error and remanded that case for a new trial. Judge Mickle's opinion drew heavily from Hadden v. State, 690 So. 2d. 573 (1997), which distinguished pure opinion testimony, based solely on the expert's experience and training, is not subject to the Frye standard. The court concluded that Dr. Hord's use of projective tests in this case introduced diagnostic standards which went beyond "pure opinion." This "scientific-expert testimony" rather than "pure opinion testimony" thus required the trial court to conduct a Frye hearing. The ruling in Hadden that child sexual abuse accommodation syndrome (CSAAS) had not been proven to be generally accepted by a majority of psychological experts also doomed the testimony of Dr. Hord. The court in Irving, noting the expert's testimony was based upon the inadmissible CSAAS, ruled that admission of this testimony constituted reversible error.
Susan Crump, Esq.
Professor of Law
Texas A & M Universi
Professor Crump comments: The role of a scientific expert witness in Frye has been to assist the trial judge in identifying the relevant scientific community and to report what the majority of scientists in that community think about the conclusions of the scientific test and principles at issue. In other words, courts do not independently assess the scientific reliability of Frye evidence-they simply take a scientific head count.
Although this sounds straightforward enough, courts across the country have come to different conclusions when they have attempted to apply. Frye outside the areas of the purported "soft' sciences, such as psychiatry, sociology, economics, or even engineering. These sciences are called soft only because their results are not always susceptible to verification by the so-called scientific method, at least in the view of some courts. Courts currently disagree not only as to what constitutes scientific, technical or specialized knowledge in this area but also to which these categories Frye should apply.
This nationwide judicial murkiness is reflected in Irving and Stowers. Of the two, only Irving involves the admissibility of what is loosely called profile evidence.
When profile evidence is offered, it usually involves an expert testifying that a person-such as the victim in the case-exhibits behavioral characteristics consistent with individuals who have suffered the same trauma. From such testimony, the prosecution then argues that the victim was indeed telling the truth when she said she was sexually assaulted. The problem with profile evidence is that the behavioral characteristics exhibited by abused children are also exhibited by non-abused children. Courts under Frye are therefore reluctant to admit such testimony unless there is general acceptance among psychologists as to whether the symptoms point uniquely to abuse. In the case of child sexual abuse, there is no such generally accepted psychological test-at least according to the court.
Unlike in Irving, the Stowers expert testimony does not conclude that the child was abused because she exhibits symptoms of abuse. It simply assists the jury in evaluating whether their normal tendency to view such behavior as indicative of a falsehood is appropriate. The Stowers court, therefore, holds that such testimony need not be based upon what the court categorizes as the psychologist's observation and experience, a much lower standard of admissibility.
Irving and Stowers, illustrate how courts are in a muddle when it comes to determining the admissibility of scientific evidence in cases involving psychological testimony. There seems to be no overarching explanation in either case as to which part of psychologists testimony is scientific as opposed to technical or based upon specialized knowledge, and how a court makes those distinctions. Furthermore, why should Frye not apply to all psychological testimony? Neither case gives attorneys nor expert witnesses much guidance. The cases do, however, illustrate how admissibility of psychological testimony depends to a large extent how the offer is made, for what purpose, and in what jurisdiction. This means lawyers must know how courts in their jurisdiction view admissibility of psychological evidence and be willing to lay the proper predicate. Experts must be prepared to educate the lawyer and the court as to the underlying reasons-scientific or otherwise-his testimony is reliable. And no one should be surprised by inconsistent and unpredictable rulings.
William Foote, Ph.D.
Forensic Psychologist
The Forensic Panel
Dr. Foote comments: When a child is abused by an adult, only two people are usually present: the perpetrator and the victim. Unless the perpetrator videotapes the abuse or confesses, the only one who can tell us about what happened is the child. Officials therefore have little choice but to rely upon the child's statements to successfully prosecute the offender and properly treat the victim.
However, those working in the area have experienced growing unease with blind acceptance of children's testimony, in part because of high profile cases (such as the McMartin preschool case in which false child testimony helped convict innocent people), as well as research findings.
The last 10 years have seen an explosion in research concerning the impact of a host of events upon children's testimony. Much of this data is summarized in the excellent book by Katherine Kuehnle (Kuehnle, K., (1996) ASSESSING ALLEGATIONS OF CHILD SEXUAL ABUSE. Sarasota, Florida: Professional Psychology Press). Her survey indicates that the accuracy of children's recollections is dependent upon age. Older children are generally more reliable witnesses than younger kids. However, Kuehnle adds that preschool-age children's memories are generally accurate if not influenced by pre- and post-event inaccurate suggestions.

RISKY TECHNIQUES in Interviewing Possible Child Victims
  • Direct questions for yes/no response
  • Leading questions
  • Repeated questions
  • Blatant reward or punishment for answers
  • Consequences for not cooperating
  • Providing statements from other witnesses
  • Anatomically Correct dolls


Validating Qualities of the Child Account
  • Logical structure in recollections
  • Richer detail to the account
  • Details are embedded in the appropriate context
  • Greater amount of speech reproduced in account
  • Unusual or superfluous details to the story

Unfortunately, it is a rare case that does not include a number of post-event interactions with adults. Parents, social workers, police or psychotherapists interact with children alleging sexual abuse and have their own agendas. Each interaction with the child has the potential to color not only the child's testimony, but also the child's recollection of life events. A recent paper by Stephen Ceci and his colleagues (Bruck, M., Ceci, S. et al. (1998) American Psychologist Vol. 53(2) 136-151) addresses influences on the child's testimony.
Because of existing agendas, the child may be subjected to a biased interview. This bias takes a number of forms, many of which may be present in the same interview. For example, if the interviewer abandons open-ended questions and resorts to direct (especially yes/no) questions, the questioning takes on a more demanding quality. Leading questions, in which the answers are suggested, are a leading source of error. For the child, repeated questions suggest that the child's initial answer was somehow wrong. Some interviewers subtly or blatantly reward or punish the child's account. In some cases, the actions of the interviewer become coercive by threatening the child with dire consequences if she does not cooperate.
Interviewers with police training may use the standard interrogation technique of providing statements from other witnesses as a means of getting the witness to conform with her peers. When interviewers using this technique incorporate false statements, it becomes a powerful method for producing erroneous reports. Finally, the use of anatomically correct dolls is controversial because some research indicates such methods may cause children to do sexual things with the dolls simply because the sexual parts are there. The Bruck group's disturbing conclusion is that the use of more than one of these techniques in combination may cause the child to convincingly render false reports to professionals and the court.

Psychological Profile:

An idiosyncratic description of interval dynamics, interpersonal exchanges, and contextual requirements for certain behaviors to be observed.


So, what's a psychiatrist or psychologist to do? As the Stowers and Irving cases suggest, the route of validating the child's report on the basis of the presence or absence of traumatic symptoms is indeed a perilous one. Not only is the court's acceptance of such testimony in question, but the scientific validity of such techniques leaves a lot to be desired. Post-Traumatic Stress Disorder may bear the marks of the original trauma in the form of specific fears, many symptoms could signal chronic depressive or anxiety disorders. Additionally, those symptoms could arise from other events which are often seen in the context of child-sex abuse cases. These include parental alcoholism, physical abuse, and neglect. The presence of these symptoms may be diagnostic only of the child's chaotic history. The fact that one event precedes another does not mean one event causes the other.
This leaves the mental health professional with only a few techniques for assessing the accuracy of the child's report. Most promising of these techniques is Criteria Based Content Analysis (CBCA) (Horowitz, S.W.et al (1997) Legal & Criminological Psychology, 2 (1) pp 11-21). This structured means of reviewing a child's recorded and transcribed statement relies upon some 19 elements of that narrative to differentiate genuine from fabricated accounts. In general, the more the child has a logical structure in her recollections, the richer the account is in detail, the larger extent to which those details are embedded in appropriate context the greater amount of speech reproduced in the account and the more unusual or superfluous details provided by the child, the more likely the child's recollection is to be based upon real events. This technique has been validated in a number of studies.
While new methods are an improvement over the "sounds like abuse to me" analysis heretofore employed, clinicians are still a long way from having a means of determining the whole truth of a child's account. It's a good thing that this is not our job, but the court's.
Ann Burgess, D.N.Sc.
Psychiatric Nurse
The Forensic Panel
Professor Burgess comments: Is there a profile of a sexually abused child? Yes, there is a process to profile children who report they have been sexually abused. Clinicians consider many factors: the child's statement of abuse and subsequent behavior, the context in which the behavior occurs, the relationship of the child to the defendant, and the physical and mental health of the child. Next, they review their findings in light of any additional information they have regarding the abuse, and third, they compare their findings with diagnostic criteria derived from clinical research and the cases they have seen in their clinical practice.
Profiling is a process from which a profile is derived. However, profile does not mean one set picture. Rather, it is meant to be a dynamic description that explains the behavior, operations, thinking of an individual that leads to types of behavior. The notion that there is one set profile of a sexually abused child is a misuse of the term because it implies a fixed description.
A second well argued term is syndrome. A syndrome is a cluster of clinical observations of symptoms often made early in the study of a disorder. In the late 1800's, a heart attack was diagnosed by a cluster or syndrome of four symptoms which remain classic to this day even though laboratory science has advanced. A symptom, standing alone, not in a cluster, and without laboratory assistance provides an incomplete picture.
The range and intensity of symptoms noted in verified child sexual abuse cases have confirmed consistency. There have been epidemiological and longitudinal studies of the incidence and prevalence of child sexual abuse and the symptoms associated with it.
In child sexual abuse cases, observations are made on the intensity of the child's anxiety the disruption of key regulatory processes such as sleep, appetite, mood, aggression, impulsivity, sexual interests, the content of dreams and nightmares, plus physical findings including sexually transmitted infections. Forensic science has significantly advanced precision in child sexual abuse cases. For example, the use of a colposcope can detect pelvic or genital injury not seen by visual examination. It is a combination of clinical findings following thorough assessment that enables a determination that a child has been sexually abused.

Building a Profile of an Abused Child:
  • Intensity of a child's distress
  • Disruption of sleep, appetite, mood, sexual interests
  • Sexual impulsivity
  • The content of dreams and nightmares
  • Physical Exam findings:
  • Lab findings, including sexually transmitted diseases
  • Use of a colposcope can detect pelvic or genital injury not seen by visual examination


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