PRINCIPLES AND PRACTICE OFChild and AdolescentForensic lvi.docx

PRINCIPLES AND PRACTICE OF
Child and Adolescent
Forensic lvi ntal Health
Edited by
Elissa R Benedek, M.D.
Peter Ash, M.D.
Charles L. Scott, M.D.
Washington, DC
London, England
Chapter ] 6
Reliability and Suggestibility
of Children's Statements
From Science to Practice
Sarah Kulkofsky, Ph.D.
Kamala London, Ph.D.
n spring 1985, a 4-year-old student at the Wee Cale
Nursery School was having his temperature taken
with a rectal thermometm when he commented,
"That's what my teacher does to me at nap time at
school." The child's comment led to an mvestlgation
of Kelly Michaels, a young teacher at the nursery

school All children at the nursery school wele lepeat-
edly questioned about potential abuse by their parents
(who were informed about sexual abuse suspmlons in
the school), by investigators, and in individual and
gtoup therapy sessions. The chfldlen eventually made
a number of horrendous and sometimes bizalre alle-
gations, including that they were raped with spoons,
knives, and Lego blocks; that Kelly Michaels fmced
them to lick peanut butter off her naked body; that she
forced them to eat feces and drink urine; and that she
forced them to play games in the nude. Despite the
fact that there was no physmal evidence m the case
and that Kelly Michaels passed a polygraph test, she
was indicted on 299 charges and, after an 11-month
trial, was sentenced to 47 years m prison. She served 5
years m prison before her case was overturned on ap-
peal, largely as a result of the unreliability of the chil-
dren's testimony, which was elicited in a highly sug-
gestive manner.
In the United States, more than 4 million cases of
child maltreatment ale investigated each year (Pipe et
al. 2007) Histormally, children rarely provided uncor-
roborated testimony in legal settings. However, be-
cause of society's greater recognition of the prevalence
and problems associated with child maltreatment,
partmulmly with child sexual abuse (CSA), several ju-
dicial leforms were enacted starting in the 1970s and
1980s that brought more children at younger ages into
the courts. It is estimated that more than 100,000
childlen m the United States testify annually m crim-
inal and civil proceedings (Cecl and Bruck 1993).
As children began flooding the legal system, con-
cerns were raised about their ability to provide com-

plete and accmate accounts about past events. Many
of these concmns were raised in lesponse to some
high-profile sexual abuse cases, such as those revolv-
ing Kelly Michaels, as well as similar cases involving
Gerald and Cheryl Amlrault and the McMartm Pre-
school. These cases were characterized by bizarre alle-
gations of abuse made by multiple children as well as
by aggressive and overzealous interviewing tech-
niques. When many of these cases started to come to
light, very little research existed regarding the reliabil-
ity of children's statements or appropriate interview-
217
21 8 Principles and Practice of Child and Adolescent
Forensic Mental Health
ing techniques. In the years since, a vast literature has
amassed outlining chlldreffs abilities to provide re-
ports of past experiences as well as Interviewer behav-
iors that can compromise the integrity of chlldlen's
statements.
In this chapter, we provide an overview of the liter-
ature on the factors that can affect the accuracy of chil-
dren's statements. In the first malor section, we pro-
vide a review of the llteratule on children's accuracy
when leporting past events In the second major sec-
tion, we address disclosure patterns among sexually
abused children, as beliefs about how and when chil-
dren disclose abuse often influence lntervlewels' deci-

sions to pursue more aggiesslve questioning strate-
gies Finally, we end the chapter with an overview of
recommendations for ptactitionels.
Children's Accuracy When
Reporting Past Events
Memory Development
First and foremost, understanding children's abihty to
provide complete and accurate reports of past events in
fmensic contexts requires knowledge of the develop-
ment of memory about personally experienced events.
Research has shown that by around age 2 years, chil-
dren begin to talk about past events (Nelson and Flvush
2004). At this young age, however, children's reports
often require a great deal of adult prompting; their re-
sponses to open-ended questions such as 'q-hll me what
happened" tend to include very little detail (Fivush
1993). Because many of the studies of children's per-
sonal memory focus on naturally occurring events, ac-
curacy is difficult to assess because the researcheIs do
not kmow what actually happened. However, maternal
reports tend to confirm children's statements (e.g, F1-
vush et al. 1987), and work involving staged events for
which statements can be venfied also has shown high
rates of accuracy (e.g., Leichtman et al. 2000). As such,
young cfuldren's spontaneous lecall of past events is of-
ten chaiacterized as accurate but Incomplete.
The conclusion that children's spontaneous re-
ports are largely accurate has led some clinicians to
conclude that if a child makes a spontaneous state-

ment, it can be assumed to be true {Cecl et al. 2007a).
However, it is certainly not the case that all spontane-
ous statements are accurate. In particular, if the child
is interviewed about confusing events or events that
run counter to his or her knowledge, accuracy may be
compromised. This is particularly important because
in many forensic contexts, such as CSA, children are
indeed asked to report about confusing events.
For example, Ornstein et al. (1998) had children
experience a mock medical examination In which
some common features (such as listening to the
child's healt) were omitted and atypmal features (such
as wiping the child's belly button with alcohol) were
added. When children were interviewed about the
event after a 12-week delay, 42% of the 4-year-olds and
74% of the 6-year-olds spontaneously repolted that at
least one of the missing common features had been a
pint of the examination. In a similar study, Kulkofslc/
and colleagues (2008) had preschool-age children en-
gage in a pizza-baking activity that included several
unusual elements (e.g., the pizza was cut with chop-
stinks). When interviewed 1 week later, on average,
24% of the childlen's bee-recall statements were clas-
sified as incorrect. Furthermore, it is impmtant to
note that these errors were not inconsequential In na-
ture. For example, more than a quarter of all children
recalled a nonpresent knife in response to an open-
ended question, and many children added further de-
tail and embellishment. To illustrate, one child re-
called, 'ÿ very sharp knife.., it cuts us... I telled Aaron
'Don't use that sharp lÿife!'"

In actual forensic intmviews, the interviewer
would not lÿow which statements made by a child
were inaccurate. Thus, children may be generally ac-
curate about previously expeiienced events, but the in-
clusion of key inaccurate details may lead interviewers
down a dangerous road. As we outline in the next sec-
tion, erroneous beliefs on the part of an interviewer
about what might have happened can negatively influ-
ence the accuracy of children's statements.
FurthermoIe, although children are able to report
memories of childhood experiences and may report
memories from younger ages than adults are able to
recall (Fivush and Schwarzmueller 1999), there does
appeai to be a limit to how early in childhood children
can lemember. Specifically, children show difficulty
remembering events that occurred prior to the onset of
language. For example, Petelson and Ridehout (1998)
interviewed young children about a wslt to an emer-
gency department that occurred when children were
between 13 and 34 months old Only children who
were 25 months and older at the time of the injury
were able to recall verbally any details of the event at
later intelvlews. In a related study, Simcock and
Hayne (2002) exposed 2- to 3-year-old children to a
novel event and then tested their memories 6 months
and 1 year late1. At both the inmal exposure and the
Reliability and Suggestibility of Children's Statements: From
Science to Practice 219
memory mtervmws, parents reported children's vocab-
ulary, mchidmgwords that were pertinent to the novel

event. At both time points, no child used words to de-
scribe the event that had not been palt of the child's
vocabulary at the time of the original event. Taken to-
gether, these results indicate that later verbal recall of
an event is, in part, dependent on childlen's language
abihty at the time of encoding.
To summarize, the research on memory develop-
ment in young children suggests that, m general,
young children's spontaneous reports of personally ex-
permnced past events are largely accurate but can be
qmte sparse. However, accuracy is impaired when chil-
dren are asked to recall confusing or ambiguous events,
and their enors are not necessarily limited to inconse-
quentlal or peripheral details. In addition, throe is a
limit to how eally in childhood children can remember,
and thus, the veracity of memories lecalled before the
onset of language should be considered suspect.
e e e8u ,gestlbd ty
Cecl and Bruck (1993) defined suggestibihty as "the
degree to which children's encoding, storage, letrieval,
and reporting of events can be influenced by a range of
social and psychologmal factors" (p. 404). This broad
deflmtion of suggestibility allows for mformatmn that
is presented both before and after an event to tarot
childlen's recall and further allows for the possibility
that children's reports may be inaccurate even without
any underlying memory impairment.
Although children's spontaneous repmts are gen-
erally accurate, reports that emerge as a lesult of sug-
gestive interviewing techniques tend to be qmte error-
prone. In the classic sense, suggesttve interviewing in-

volves aslÿng leading questions. Studms of actual in-
vestigative interwews indicate that interviewers fre-
quently ask children leading questmns (Gecl et al.
2007bJ. Moreover, training programs designed to
teach best practmes for interviewing young wÿtnesses
do not appear to be effective in reducing the number of
leading questmns interviewers ask (Sternberg et al.
2001 b). In general, childlen are less accurate when an-
swering direct questions compared with open-ended
questions (Ornstem et al. 1998; Peterson et al. 1999),
and young children ale less hkely than older chlldlen
and adults to respond to leading questmns with "I
don't kmow" (Hughes and Grieve 1980). Leading ques-
tmns are particularly problematic because the rater-
viewer presupposes that certain events occurred (e.g.,
"He took your clothes off, didn't he?'); however, with-
out knowing exactly what happened, whmh is ahnost
always the case m forensic mtervlews,'an inter-
viewer's leading question may actually be misleading.
The suggestiveness of an intervmw goes beyond
simply indexing the number of leading questions.
Rather, one must consider how interviewer bias plays
out in the intervmw. Interwewer bias characterizes
those mtercieweÿs who hold a priori behefs about what
has occuned and mold the interview to maximize dis-
closures that are consistent with those beliefs. As such,
intervmwer bias has a negative effect on the accuracy of
child witnesses' statements. Experimental resealch
has shown that when mtervmwers are misinformed
themselves about what has occmred, children's reports
me less accurate and tend to incorporate the mismfor-
matron given to interviewers (Goodman et al. 1995;

White et al. 1997). Table 16-1 provides categorms and
examples of suggestive interwewing techniques.
Interviewer bias may be commumcated through
other suggestive techmques in addition to asldng lead-
ing questmns. These include providing pomtive rein-
forcement and negative feedback, using peer or paren-
tal pressure, creating a negative or an accusatory
emotional tone, inducing stereotypes about the ac-
cused, and repeating questions or interviews until the
child provides the desired answer. Resealch indicates
that, compared with using a single suggestive tech-
nique, combining suggestive techmques tends to re-
sult in heightened levels of suggestlbihty For example,
Graven et al. (1998, 2000) examined how the tech-
niques that were used by investigators in the McMar-
tin Preschool case tainted children's testimony beyond
that of misleading questions alone. In one study (Gar-
yen et al. 2000), the researchers asked kindergarten
children to recall details from when a visitor named
Paco came to their classroom. Half of the children
were given interviews that included misleading ques-
tions about plausible events (e.g., "Did Paco break a
toy?'J and bizarre events (e.g., "Did Paco take you to a
farm m a hehcopter?'). In this group, children as-
sented to 13% of the plausible questions and 5% of the
fantastic questions. A second group of children were
given negative feedback to theil "no" responses and
positive feedback to their "yes" responses. This latter
group falsely assented to the plausible items 35% of
the time and the bizarre 1terns 52% of the time. Fur-
thermore, these group differences remained when
chfldlen were interviewed neutrally 2 weeks later.
These data indicate that interviewer bias m earlier in-
terviews can'tamt children's later reports even if these
later interviews are conducted in an unbmsed manner.

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220 Principles and Practice of Child and Adolescent
TABLE 16-1. Examples of suggestive interviewing techniques
Suggestive technique Example
Leading questions
Repeating questions
Positive reinforcement
Negative feedback
Peer or parental pressure

Intervmwel: He took your clothes off, didn't he?
Interviewer: Where did he touch you?
Child. He didn't.
Interviewer: Tell me where he touched you
Interviewer: Did he touch you on your bottom?
Child: Yes
Intervmwer: That's right. You're doing a really good lob.
Interviewer: Did he lrass you?
Child: No
Interviewer: You're not doing very well.
Interviewer: The other kids told me he did these things. I just
need you to
tell me.
Creating a negative or accusatory
emotional tone
Inviting children to pretend or
speculate
Interviewer These are bad guys. We're going to put these bad
guys in jail.
Interviewer' What do you think it would have been hke? What
could have
happened?
To illustrate how leading questions may be com-
bined with other techniques {such as question repeti-
tion), consider the following interview examples from
the Bernard Baran sexual abuse investigation.

Child A
Morn' No. Did he give you a box of donuts?
Child: WhaU
Morn: Did he give you a box of donutsÿ
Child No
Morn: No Did he give you anything or say any-
tlnng?
Child: He gave us a birthday.
Interviewer. Did you play, did you play a game called
"The Touching Game" at ECDCÿ
Child, No
Intermewer. Yeah So I was remembering, I lmow a
game that I used to play called "The Touching
Game." I wonder if you ever played that at
school.
Child. I didn't
Intervmwer. You don't remember that game?
Child: We didn't do it
Interviewel: You didn't?
Child: No.
Child B
Mom: You can't remember anything he said to you?
Did he say, "wake up," or he didn't say any-
thing at all?
Clfild" No
Morn: He just went and did wheat?
Child: Nothing

Mom: And after he pulled, after he pulled on your
pee pee, did he tell you anything then? Did he
give you anythingÿ
Child: No.
The defendant In this particular case was convicted
of eight courÿts of CSA and was sentenced to thiee con-
current life terms in prison, based almost exclusively
on the testimony of the young children in this case.
Although a combination of highly suggestive tech-
niques is more likely to introduce false memory, such
highly suggestive techniques are not necessary to taint
children's reports. Children can incorporate mislead-
lng infolmation into their accounts even after a single
suggestive interview (Ceci et al. 2007b). Furthermore,
other milder forms of suggestmns have been shown to
influence the accuracy of children's reports. For exam-
pie, m a recent set of studies, Prinmpe et al. (2006,
2008) showed that rumors spread among peers can
lead to false repoits. Principe and colleagues found
that many children not only reported false details as a
result of rumor transmission but also maintained that
they had actually seen the false events themselves.
In most typical suggestibility studies, there are re-
liable age differences, with younger children being
mine suggestible than older children and adults (Cecl
and Bruck 1993). In fact, age appears to be the single
best predictor of suggestibility (Geddie et al. 2000).

i'
However, this is not to say that only young children are
suggestible. A great deal of evidence indicates that
older children and adults can fall prey to suggestive
techniques (Finnila et al. 2003). Furthermore, in some
situations, older childien actually may be more sug-
gestible than younger children. In particular, in some
cases, older children's more advanced cognitive capa-
blhties actually led to increased incorporation of false
information {Cecl et al 2007b; Pnncipe et alo 2008).
One argument that is often made against much of
the research on suggestibility is that children are only
suggestible about inconsequential, peripheral details of
events. However, just as is the case with children's
spontaneous eIiors, tile effects of suggesuve questmn-
ing are not limited to irrelevant and penpheral details of
unemotional events. Studies showing the ddeterlous ef-
fects of suggestive techmques have included central de-
tails to negative and painful events, such as doctor's of-
flee and emergency department visits (Bruck et al. 2000;
Burgwyn-Bales et al. 2001) and other forms of bodily
touching (Poole and Lindsay 1995; White et al. 1997}.
Finally, it is important to note that childten's false
reports that emerge through suggestive techniques
may be indlstmguishable from true statements. Both
Cecl et al (1994} and Leichtman and Cecl (1995} had
legal and psychological experts watch videotapes of
children's true and false reports that emeiged as a re-
sult of suggestive techniques. In both cases, tile profes-
sionals were no better than chance at distinguishing

true from false memories. Furthermoie, Bruck et al
(2002} systematically compared childien's true and
false narratives and found that false narratives con-
tained mote spontaneous details, more temporal
markers, more elaboiations, and more aggressive de-
tails than did true nairatives (see also Powell et al.
2003). Even when experts attempt to apply mole sys-
tematic me%ods to distinguish true from false leports
elicited through suggestive questions, then decisions
are not reliable. For instance, criterion-based content
analysis has been touted as one way to d,stinguish true
from false repoIts in forensic contexts (Vril 2005) In
criterion-based content analysis, experts code the wit-
ness's statement for the presence of specific contents
that are expected to occur more frequently in true re-
ports. Although some limited evidence indicates that
criterion-based content analysis can sometimes distln-
guish truthful statements from intentional lies, it can-
not reliably distinguish true statements ftom false
statements that were developed as a result of sugges-
tive questioning techniques (Kulkofslo7 2008).
Taken together, the hterature shows that childIen
are vulnmable to leading questions and other sugges-
tive techniques, including some very mild forms of
suggestion Although young children appear to be the
most suggestible, older children are also susceptible to
suggestive techniques. Furthermore, children may be
suggestible about central details of events and events
that involve pain or bodily touch. Finally, children's re-
ports that emerge through suggestive questioning of-

ten appear quite credible.
If suggestive techniques are so dangerous, why do
interviewers use them? Seveial possible leasons for
their use exist. First and fmemost, children come Into
contact with an interviewer only if there is some rea-
son to suspect that thy have been abused This suspi-
cion obviously colors the entiIe interview and may
lead to intervmwm bias. Given that young childIen, in
particular, often give very scarce leports, forensic in-
terviewers may be tempted to resort to moIe sugges-
tive techmques in an attempt to verify their suspicions
of abuse. Commonly held beliefs about how children
disclose abuse duiing interviews also may influence an
interviewer's decision of how to question them. Some
intervIewms believe that the use of suggestive tech-
niques is necessary because children may be reticent
to disclose sexual abuse and may disclose abuse only
in a lengthy process, if at all. Belief in this pattmn may
lead interviewers to aggressively pursue children who
they suspect to be victims of sexual abuse. We now
turn to the Issue of whethm this belief in these disclo-
sure patteins is actually warranted.
Disclosure Patterns Among
Sexually Abused Children
Child Sexual Abuse
Accommodation Syndrome
In 1983, Summit wrote "The Child Sexual Abuse Ac-
commodation SyndIome," a theoretical view based on
his clinical experiences with his adult psychiatric pa-
tmnts. He postulated that children who have experi-

enced intrafamihal sexual abuse may be reluctant to
disclose abuse because of motivational reasons such as
being ashamed, scared, or embanassed. As a result, he
argued that abused children may delay abuse disclosure,
deny abuse when asked, make pmtlal disdosures, and
retract abuse disclosures. He latel extended the theory
to include children who have expeiienced extlafamihal
sexual abuse (Summit 1992}. Summit's theory (Sum-
mit 1988, 1992) has exerted a tIemendous influence on
il
222 Principles and Practice of Child and Adolescent
forensic interview pracUces with children and contin-
ues to be taught internationally In many contemporary
tlaining seminars for child abuse professionals.
Although Summit {1992) later cautioned practitio-
ners that GSAAS is a clinical opinion, not a scientific
or diagnostic instrument, some investigators have
latched onto the idea that sexually abused children
deny abuse or even that denial is diagnostic of abuse.
In many instances of alleged satanic ritualistic abuse
cases from the late 1980s, themes emerged whereby
the investigators reported refusing to believe children
despite their repeated denials of abuse (London et al.
2005) Many clinicians and forensic interviewers con-
tinue to intelpret abuse denials or inconsistencies in
children's statements as consistent with the children
passing through the stages postulated by CSAAS

The tenets postulated by CSAAS have undergone
little scientific scrutiny to date. This is perhaps be-
cause Summit's theory was seen as consistent with fo-
renslc interview practices and general beliefs about
abuse disclosure (Summit 1992). However, in several
recent publications, London and colleagues (2005,
2007, 2008) reviewed the literature on disclosure pat-
terns among sexually abused children The goal of
these reviews was to examine the contemporary em-
pmcal findings legardIng the nature and timing of
children's sexual abuse disclosmes. Two main sources
of data exist: 1) adults' retrospective accounts of CSA
and whether they disclosed the abuse to anyone and 2)
case records horn children undergomg contemporane-
ous forensic evaluation. We briefly review the major
findings below.
perienced CSA indicated that the abuse was brought to
the attention of authorities, with 4 of the 7 studies re-
porting rates ftom 10% to 13%. Although the retrospec-
tive accounts are subject to problems inherent in any
retrospecUve account, London et al. (2008) concluded
that extant data suppolt Summit's notion of secrecy
among sexually abused chIldien' only about one-third
to one-half of clfildren ever tell anyone, and even fewer
cases come to the attention of authorities.
Many of the retIospective studies repolted very long
delays between the abusive episodes and children's dis-
closures, sometimes of several years Although data are
limited at present, the trend seems to be that some
children disclose lelatively close in time to the abuse
(e.g., within the filst 6 months), whereas others walt

manyyeals or never tell anyone during childhood (Lon-
don et al. 2008).
Research on Abuse Denials
During Formal Interviews
Research on Secrecy and
Delayed Disclosure
Data from the retrospective accounts indicate that
many adults reported that they never told anyone din-
mg childhood about the CSA they experienced. Even
fewer repoRed that the abuse came to the attention of
authorities Across 13 retrospective abuse disclosure
studies levlewed, 21%-87% of the participants reported
that they disclosed the sexual abuse during childhood
(for studies and citations, see London et al. 2008). Of
the 13 studies reviewed, 11 found that between 34%
and 54% of their adult sample who experienced GSA
reported that they ever told anyone about the abuse
during childhood. Fewer studies reported data on
adults' retrospective lepolts of whether the abuse dis-
closure involved authorities such as police or social
workers. Across 7 studies to plovIde data on disclosure
to authorities, 5%-18% of the adults who reportedly ex-
Although victims may not readily report sexual abuse,
this does not mean that they will deny abuse ff asked
directly about it. Studies of children undergoing as-
sessment for suspected CSA provide the second source
of data on disclosure pattelns of abused children.
These studies generally examined archival records
from children who weie seen by police, social workers,
physicians, or assessment teams. Use of samples un-
dergoing forensic assessment allows an exploration of
the extent to which childlen make denials and recan-

tations during forensic assessment.
Unlike the letrospective studies reviewed earlier,
London and colleagues (2005, 2007, 2008) reported a
wide range of disclosure rates actoss 21 different studies
to examine abuse disclosure during forensic or medical
interviews. Disclosure rates ranged from a low of 23%
(Sorensen and Snow 1991) to a high of 96% (Bradley
and Wood 1996). Methodological features, paiticularly
sample choices and intelview methods, appear to play a
plimary lole In accounting for these discrepant rates.
Because of its impoltance, we focus on this issue.
To calculate uue rates of disclosures and denials
during forensic interviews, mfolmation is needed that
accurately classifies childlen as abused or nonabused
regardless of whether they make an allegation during
the intelariew. At the same time, the chosen sample
should be representative of all children to come before
forensic interviewers. For example, sampling methods
that ehminate childlen horn their sample who readily
disclose to forensic interviewers would not provide ac-
curate estimates of the overall rates of disclosure. At
T I
the same time, because abuse substantlation is often
reliant on the child's dlsclosme, samples that include
only highly probable or prosecuted cases may exclude
possible true cases in which the child demes abuse
during interviews

London et al. (2005) argued that disclosure rates
during forensic mtervmws vary systematmally accord-
ing to the certainty with whmh children in the study
samples were abused. They divided the hterature into
four major groupings:
Group i--cases of dubious vahdity
Group 2--select subsamples
Group 3--all childlen to come before fmensm m-
terviewel s
Group 4--cases that come before fmenslc inter-
viewers that are rated as founded or highlyprobable
The lowest disclosure rates came from studms in
Group 1, with very dubious or overtmned cases and
documented poor interview techniques (Gonzalez et al.
1993; Sorensen and Snow 1991). In these studies, the
abuse denials may have been true denials rather than
evidence of reluctant disclosure. Many of the children
from Gonzales et al.'s sample wele from the McMamn
Preschool case. Children in the Sorensen and Snow
(1991) study wele from a rash of neighborhood ritual-
lstic satanic abuse cases, most of which either were not
prosecuted or were later thrown out of court. Because of
the documented highly suggestive techniques used in
these studms (Schleiber et al. 2006), we argue that
these studies do not provide any information about dis-
closure patterns among abused children.
The second major group of studies repmted disclo-
sure rates among select subsamples of chlldlen who
come before authorities. These studies provide the
second tier of disclosure rates--between 43% and 61%
of children disclosed abuse when interviewed (for the

study cltatmns, see London et al. 2008). Two types of
cases are included in this grouping" 1 ) children under-
going extended evaluauon for nondisclosure with high
suspicion of abuse and 2) children coming to the at-
tention of authorities because of strong evidence of
abuse (e.g., wdeotaped abuse evidence m sexually
transmitted …
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© National Children’s Advocacy Center, 2015. Page 1 of 3
Position Paper on the Use of Human Figure Drawings in
Forensic Interviews September 2015
Position Paper on the
Use of Human Figure Drawings in Forensic Interviews
The use of human figure drawings (HFDs) during a forensic
interview has historically been and
continues to be widely discussed and disputed. Decisions are
often made based on unspoken value
judgments and routine practices, rather than a thorough review
of the literature. Proponents of

HFD support their stance with statements such as “this is the
way that we have always done it” or
“it is part of my training or protocol.”
Over the years, forensic interview protocols have varied with
respect to the use of HFDs with some
protocols advocating for the routine use of HFDs and others
excluding their use (NICHD, Lyon’s
10-Step). For many years the CornerHouse and Finding
Words/Child First interview protocols
recommended the introduction of the anatomically detailed
drawings of both sexes to be followed
by the identification of body parts including private parts, and
questions about appropriate touches
as the standard method of transitioning to allegations of sexual
abuse. The acronym RATAC
(rapport / anatomy identification / touch inquiry / abuse
scenario / closure) reflected the stages of
the protocols. In 2012 CornerHouse revised their protocol,
adopting a more narrative and open
approach and, consequently, CornerHouse no longer references
the RATAC acronym.
The National Children’s Advocacy Center (NCAC) has always
promoted an inclusive and flexible

approach, acknowledging that many of the decisions about
practice are made at the local level.
The NCAC does not prohibit the use of HFDs, but also does not
recommend their use as common
practice. The majority of children who disclose during a
forensic interview about sexual or
physical abuse are able to do so in response to the question
“What are you here to talk about
today?” and are able to provide adequate detail and clarification
without the introduction of more
suggestive questions or props. A large body of research has
demonstrated the benefits of obtaining
information from children through the use of recall-based
questions (open-ended and ‘wh’) which
are shown to improve both the quantity and quality of
information elicited from child witnesses.
The same research documents the dangers of reliance on
recognition-based (multiple choice,
yes/no, and leading) questions, including when seeking
clarification of previous statements. In

keeping with these principles, the NCAC discourages the use of
HFDs as they are concrete
recognition-based prompts.
A bibliography of research on the use of HFDs (clothed and
unclothed and with or without
anatomical details) may be viewed in the Child Abuse Library
Online (CALiO™) Professional
Bibliographies section. Research includes both field studies
(reviews of actual forensic interviews)
and laboratory studies (staged events or routine medical
procedures). Attention to the entire body
of this research informed NCAC’s current position.
Some of the main points from the research are as follows:
e to elicit additional details from children
following a narrative description
of abuse. However, there is a greater error rate in the
information produced, which is
similar to the greater error rate when interviewers use
recognition-based questions.
a risk of influencing the

direction of the conversations with the children.
has been shown to lead to
(1) true disclosures about body touches, (2) false disclosures
about body touches, and (3)
false denials about body touches.
-reliance on HFDs for forensic
interviewers when the use of a
HFD is routine, either because of habit or lack of training and
consideration of other
approaches.
verbal abilities are at the greatest
risk of being influenced by the use of recognition-based
prompts (questions and tools).
ng HFDs is magnified when combined with
option-posing, yes/no, or
leading questions.
In conclusion, it is the NCAC’s position that, based on current
research, HFDs should not be used
as a matter of standard practice. However, when interviewing
children with communication

challenges, media, including HFDs and free drawings, may be
necessary additional tools. For
these cases, HFDs should be introduced only if the child has
made a verbal disclosure of
maltreatment and other clarification options and approaches
have been exhausted.
http://calio.org/resources/bibliographies
http://calio.org/resources/bibliographies
Preferred citation: National Children’s Advocacy Center (2015).
Position Paper on the Use of
Human Figure Drawings in Forensic Interviews. Huntsville, AL:
Author.

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