Supportive or suggestive: Do human figure drawings help 5- to 7-year-old children to report touch?

Vil Du?! incorporation of a serious game in therapy for sexually abused children and adolescents

BACKGROUND

Talking about experiences of sexual abuse in therapy is difficult for children and adolescents, amongst others due to a lack of vocabulary to describe the situation, avoidance, or feelings of shame, fear, and self-blame. The serious game Vil Du?! was developed to help children open up about sexual experiences. Vil Du?! is a non-verbal communication game, which resembles a dress-up game, in which children can show the therapist what happened to them. The current study examined how and for which therapy components Vil Du?! was used by therapists.

METHODS

We used a mixed-methods triangulation design. Therapists filled out online surveys about the use of Vil Du?! with 23 clients (M_age = 11.38 years, SD = 3.96; 61 % female). We also conducted semi-structured interviews with 10 therapists. The data were analyzed in SPSS (quantitative) and Nvivo (qualitative) following the stepwise guidelines of Zhang and Wildemuth.

RESULTS

Merged qualitative and quantitative data revealed that therapists acknowledged the usefulness of Vil Du?! mostly for the therapy components trauma narration and processing, and psycho-education about sexuality. In addition, Vil Du?! might be most useful for clients who have difficulty with disclosing sexual abuse experiences, due to limited verbal abilities or feelings of guilt, shame, avoidance, and tension.

CONCLUSIONS

Recommendations from this study were incorporated in a user manual as a first step toward more systematic and broad implementation of Vil Du?! in the treatment of young sexual abuse victims. A next step is to test whether implementing Vil Du?! in therapy is effective in reducing the negative mental health consequences of sexual abuse for children and adolescents.

Beliefs About Children's Memory and Child Investigative Interviewing Practices: A Survey in Dutch Child Protection Professionals from 'Safe Home'

Knowledge of children’s memory and forensic interviewing skills are crucial in child abuse investigations. Safe Home is the Dutch hotline where both professionals and citizens can report concerns about child abuse or domestic violence. Professionals at Safe Home often serve as first responders to determine the need for a child abuse investigation, protective measures and/or further police investigation. In this study, child protection professionals (N = 158) employed at Safe Home (i.e., behavioral scientists, medical doctors, and social workers) completed an online survey on beliefs about memory functioning and forensic interviewing. In line with earlier studies, we expected to find a lack of knowledge about memory functioning among Safe Home workers. Furthermore, we expected limited use of forensic interviewing methods that have received empirical support. Indeed, we found many professionals endorsed beliefs not in line with current memory research, especially beliefs about repressed and recovered memories. Still, high percentages of professionals also reported memory beliefs related to false memory formation and suggestion that were in line with scientific evidence. Some professionals reported using interviewing methods for which there is no empirical validation. Because child protection professionals are often the first to interview children about allegations of abuse, the current findings identify a need for training in child forensic interviewing, including knowledge of human memory.

Searching for Truth: The Forensic Interviewer's Use of an Assessment Approach While Conducting Child Sexual Abuse Interviews

This study examined the assessment approach interviewers use while conducting interviews to assess truth as narratives are gathered in children's disclosure statements by examining 100 forensic interviews completed at a Children's Advocacy Center. A descriptive review was used to examine the steps engaged by interviewers as they followed a protocol and content analysis was used to identify interviewers' questioning strategies as they assessed children's disclosure narratives during interviews. Findings indicate that interviewers apply a protocol in order to support advancing to a phase of eliciting details in children's narratives. Questioning strategies included using a variety of question types to progress from general to specific, incorporating interview aids sparingly as necessary, and integrating multidisciplinary team feedback. Findings suggest that an assessment approach is inherent to the process of actively conducting a forensic interview. Rather than assessment beginning strictly upon completion of children's narratives, this paper describes how interviewers incorporate an assessment framework throughout interviewing.

Young children's ability to use two-dimensional and three-dimensional symbols to show placements of body touches and hidden objects

In two experiments, we investigated 3- to 5-year-old children's ability to use dolls and human figure drawings as symbols to map body touches. In Experiment 1, stickers were placed on different locations of children's bodies, and the children were asked to indicate the locations of the stickers using three different symbols: a doll, a human figure drawing, and the adult researcher. Performance on the tasks increased with age, but many 5-year-olds did not attain perfect performance. Surprisingly, younger children made more errors on the two-dimensional (2D) human figure drawing task compared with the three-dimensional (3D) doll and adult tasks. In Experiment 2, we compared children's ability to use 3D and 2D symbols to indicate body touch as well as to guide their search for a hidden object. We replicated the findings of Experiment 1 for the body touch task; for younger children, 3D symbols were easier to use than 2D symbols. However, the reverse pattern was found for the object locations task, with children showing superior performance using 2D drawings over 3D models. Although children showed developmental improvements in using dolls and drawings to show where they were touched, less than two thirds of the 5-year-olds performed perfectly on the touch tasks. Both developmental and forensic implications of these results are discussed.

Eliciting accounts of alleged child sexual abuse: how do children report touch?

Investigative interviewers frequently question alleged victims of child sexual abuse about any touching or bodily contact that might have occurred. In the present study of forensic interviews with 192 alleged sexual abuse victims, between 4 and 13 years of age, we examined the frequency with which alleged victims reported bodily contact as "touch" and the types of prompts associated with "touch" reports. Even young alleged victims of sexual abuse reported bodily contact as "touch," and they used the word "touch" more frequently in response to recall than recognition prompts. Regardless of age, children typically referred to "touch" before interviewers used this term, suggesting that even young children are able to report "touch" without being cued by interviewers.

Body maps do not facilitate older children's report of touch

In a single experiment, we assessed the effect of body maps on reports of touch by 5- and 6-year-olds, 9- and 10-year-olds, and adults. Children and adults participated in a staged event in which they were touched four times. Immediately following the event, children and adults were asked to either show using a body map or show using their own body where they had been touched. Consistent with prior research, body maps were ineffective with 5- and 6-year-olds. Furthermore, although older children and adults reported more touches and were more accurate than younger children, body maps did not enhance the quality of their reports. We conclude that the provision of a body map does not facilitate reports of touch by any age group, raising serious questions about their use in forensic contexts.

Divining Testimony? The Impact of Interviewing Props on Children's Reports of Touching

There is a long-held assumption that objects help bridge the gap between what children know and what they can (or are willing to) explain. In this review, we present research on the extent to which two types of objects used as props in investigative interviews of children, anatomical dolls and body (human figure) diagrams, actually help children report accurate information about autobiographical events. We explain why available research does not instill confidence that props are the best solution to interviewing challenges, and we consider practitioners' and policy-makers responses to this evidence. Finally, we discuss the types of developmental research that are necessary to advance the field of evidence-based interviewing of children.

Evidence supporting restrictions on uses of body diagrams in forensic interviews

OBJECTIVE

This study compared two methods for questioning children about suspected abuse: standard interviewing and body-diagram-focused (BDF) interviewing, a style of interviewing in which interviewers draw on a flip board and introduce the topic of touching with a body diagram.

METHODS

Children (N=261) 4-9 years of age individually participated in science demonstrations during which half the children were touched two times. Months later, parents read stories to their children that described accurate and inaccurate information about the demonstrations. The stories for untouched children also contained inaccurate descriptions of touching. The children completed standard or BDF interviews, followed by source-monitoring questions.

RESULTS

Interview format did not significantly influence (a) children's performance during early interview phases, (b) the amount of contextual information children provided about the science experience, or (c) memory source monitoring. The BDF protocol had beneficial and detrimental effects on touch reports: More children in the BDF condition reported experienced touching, but at the expense of an increased number of suggested and spontaneous false reports.

CONCLUSIONS

The two props that are characteristic of BDF interviewing have different effects on testimonial accuracy. Recording answers on a flip board during presubstantive phases does not influence the quality of information that children provide. Body diagrams, however, suggest answers to children and elicit a concerning number of false reports.

PRACTICE IMPLICATIONS

Until research identifies procedures and/or case characteristics associated with accurate reports of touching during diagram-assisted questioning, interviewers should initiate discussions about touching with open-ended questions delivered without a body diagram.

Exploring the effects of age and delay on children's person identifications: verbal descriptions, lineup performance, and the influence of wildcards

We explored the effects of age and retention interval on several measures of children's person identification ability: verbal descriptions, lineup performance, and the success of a 'wildcard'--a photo of a silhouetted figure with a large question mark superimposed--in reducing children's tendency to choose from target-absent lineups. Children aged 5-7 years (N= 101) and 8-11 years (N= 109) were briefly exposed to an experimental confederate during a staged event. Either 1-2 days or 2 weeks later, children described the confederate and were then presented with either a target-present or -absent lineup. Within each group, approximately half of the children were presented with a wildcard and half were not. Target-present lineup performance improved as age increased. Compared to control children, children in the wildcard condition were more likely to correctly reject the target-absent lineup, and less likely to identify the innocent suspect. The wildcard did not influence children's target-present lineup accuracy, nor did delay exert an influence on any of our measures of lineup performance. These findings extend our knowledge of children's person identifications, as well as providing further support for the use of wildcards in photographic lineups.

Forensic Interviewing Aids: Do Props Help Children Answer Questions About Touching?

The belief that props help children report abuse has fostered the widespread use of anatomical dolls and body diagrams in forensic interviews. Yet studies involving alleged abuse victims, children who have experienced medical examinations, and children who have participated in staged events have failed to find consistent evidence that props improve young children's ability to report key information related to bodily contact. Because props elevate the risk of erroneous touch reports, interviewers need to reconsider the belief that props are developmentally appropriate in forensic interviews, and researchers need to explore new approaches for eliciting disclosures of inappropriate touching.

Human figure drawings and children's recall of touching

In 2 studies, children ages 3 to 7 years were asked to recall a series of touches that occurred during a previous staged event. The recall interview took place 1 week after the event in Study 1 and immediately after the event in Study 2. Each recall interview had 2 sections: In 1 section, children were given human figure drawings (HFDs) and were asked to show where the touching took place; in the other section, the same questions were asked without the HFDs (verbal condition). Children were randomly assigned to 2 different conditions: HFD 1st/verbal 2nd or verbal 1st/HFD 2nd. There were 2 major findings. First, HFDs elicited more errors than the verbal condition when used to probe for information that the child had already been asked. Second, regardless of interview method, children had poor recall of the touches even when these occurred minutes before the interview. It is suggested that cognitive mechanisms involving memory and semantics underlie children's poor recall of touching in both verbal and HFD conditions.

Do human figure diagrams help alleged victims of sexual abuse provide elaborate and clear accounts of physical contact with alleged perpetrators?

The present study examined whether the use of human figure diagrams within a well-structured interview was associated with more elaborate and clearer accounts about physical contact that had occurred in the course of an alleged abuse. The sample included investigative interviews of 88 children ranging from 4 to 13 years of age. Children were interviewed using the NICHD Investigative Interview Protocol, and were then asked a series of questions in association with unclothed gender-neutral outline diagrams of a human body. A new coding scheme was developed to examine the types and clarity of touch-related information. Use of the HFDs was associated with reports of new touches not mentioned before and elaborations regarding the body parts reportedly touched. The HFDs especially helped clarify reports by the oldest rather than the youngest children. The clarity of children's accounts of touch was also greater when details were sought using recall prompts.

Children's eyewitness memory: a comparison of two interviewing strategies as realized by forensic professionals

A critical issue for developmental psychology is how to obtain accurate and complete eyewitness memory reports from preschoolers without offering suggestions that might result in false allegations. We examined effects of two interviewing strategies (police/verbal interviews and clinician/prop-assisted interviews) on young children's reports about a medical examination. A total of 58 4-year-olds participated in the study, which conformed to a 2 (Interview Type)x2 (Number of Interviews) factorial design. Analyses revealed that interviewers spent less time off topic and asked more free recall questions in the police/verbal interviews than in the clinician/prop-assisted interviews. Compared with police/verbal interviews, clinician/prop-assisted interviews resulted in significantly more correct rejections and commission errors in children's memory reports. However, on a final free recall test, error rates were comparable across conditions. Higher child verbal intelligence predicted memory accuracy in police/verbal interviews, and greater parental attachment anxiety predicted children being asked a higher number of misleading questions. The study provides new insights into interview techniques that promote preschoolers' accurate eyewitness reports.

Adults usually believe young children: the influence of eliciting questions and suggestibility presentations on perceptions of children's disclosures

Do people realize the danger of asking misinformed children yes-no questions? Study 1 confirmed that disclosures children made during free recall in an earlier suggestibility study were more accurate than disclosures following "yes" responses to yes-no questions, which in turn were more accurate than disclosures following "no" responses. In Studies 2 and 3, college students watched interviews of children and judged the veracity of these three disclosure patterns. Participants generally believed false reports representing the first two patterns, although watching expert testimony that included a videotaped example of a false report reduced trust in prompted disclosures. Results document the need to inform forensic decision-makers about the circumstances associated with erroneous responses to yes-no questions.

Narrative exposure therapy for the treatment of traumatized children and adolescents (KidNET): from neurocognitive theory to field intervention

Many children in war-affected and refugee populations have experienced multiple traumatic experiences, and high rates of psychologic disorders, especially posttraumatic stress disorder (PTSD), are found. Intervention strategies require pragmatic and effective approaches to treatment. This article describes the rationale for and the use of narrative exposure therapy in children (KidNET). KidNET is a short-term treatment for PTSD based on a neurocognitive theory of traumatic memory. Early treatment trials, including randomized controlled studies, show promising results for the treatment of children and adolescents who have PTSD living in war-affected countries and refugee communities.