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Addressing Challenges and

Controversies in Child Sexual
Abuse Interviewing
Connie Nicholas Carnes, Debra Nelson-Gardell &
Charles Wilson
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FORENSIC ISSUES

Addressing Challenges and Controversies

in Child Sexual Abuse Interviewing:
The Forensic Evaluation Protocol
and Research Project
Connie Nicholas Carnes
Debra Nelson-Gardell
Charles Wilson

SUMMARY. This article describes a forensic evaluation protocol, de-

signed at the National Childrens Advocacy Center (NCAC). The
means by which the NCAC forensic evaluation protocol addresses the
challenges and controversies inherent in the field of sexual abuse al-

Address correspondence to: Connie Nicholas Carnes, National Childrens Advo-

cacy Center, 106 Lincoln Street, Huntsville, AL 35801 (e-mail: ncac@hiwaay.net);
Debra Nelson-Gardell, The University of Alabama, School of Social Work, Box
870314, Tuscaloosa, AL 35487; Charles Wilson, National Childrens Advocacy
Center, 200 Westside Square, Suite 700, Huntsville, AL 35801.
[Haworth co-indexing entry note]: Addressing Challenges and Controversies in Child Sexual Abuse
Interviewing: The Forensic Evaluation Protocol and Research Project. Carnes, Connie Nicholas, Debra
Nelson-Gardell, and Charles Wilson. Co-published simultaneously in Journal of Aggression, Maltreat-
ment & Trauma (The Haworth Maltreatment & Trauma Press, an imprint of The Haworth Press, Inc.) Vol. 2,
No. 2 (#4), 1999, pp. 83-103; and: Maltreatment in Early Childhood: Tools for Research-Based Intervention
(ed: Kathleen Coulborn Faller) The Haworth Maltreatment & Trauma Press, an imprint of The Haworth
Press, Inc., 1999, pp. 83-103. Single or multiple copies of this article are available for a fee from The
Haworth Document Delivery Service [1-800-342-9678, 9:00 a.m. - 5:00 p.m. (EST). E-mail address:
getinfo@haworthpressinc.com].

E 1999 by The Haworth Press, Inc. All rights reserved. 83

 84 Maltreatment in Early Childhood: Tools for Research-Based Intervention
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legation assessment are discussed. Results of a two-year study are

reported, in which efficacy of the protocol is demonstrated in three
areas: (1) in gathering facts to validate true abuse, thus assisting the
child protective and legal systems in case decision making, (2) in deter-
mining when initial concerning statements of children are actually not
due to sexual abuse, but to other events or circumstances, and (3) in
uncovering false allegations and vindicating the falsely accused. A
multi-site research project currently underway that involves more than
40 Childrens Advocacy Centers across the United States, which will
further test the efficacy of the model and further refine practice, is
described. The multi-site project will also include data on the evalua-
tors own abuse history and whether or not this affects evaluation
outcomes. [Article copies available for a fee from The Haworth Document
Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com
<Website: http://www.haworthpressinc.com>]

KEYWORDS. Assessment, extended assessment, clinical evaluation,

forensic evaluation, interviewing, psychosocial assessment, abuse in-
vestigation, assessing abuse allegations

When sexual abuse is suspected, evaluations of children pose many

challenges, and moreover, the field of child interviewing is fraught
with controversy regarding management of those challenges. For ex-
ample, frightened children, a complex protective and legal system,
caregivers who are frequently less than supportive, equivocal medical
findings and little or no physical evidence all make interviewing and
determining the likelihood of abuse difficult. Compounding these
challenges are a set of controversies and debates over childrens
memory and suggestibility, how to decide whether children have been
sexually abused, and variability in interview structure and practice.
In response to the above noted challenges and controversies, a
forensic evaluation protocol was designed at the National Childrens
Advocacy Center (NCAC) in 1995. The protocol design was based on
research and current standards of practice (APSAC, 1991; Elliott &
Briere, 1994; Faller, 1996; Lawson & Chaffin, 1992; Pence & Wilson,
1994; Saywitz et al., 1991; Saywitz et al., 1992; Walker, 1994). Evalu-
ators implemented the protocol for two years and documented the
results. Based upon the analyses of these data (in effect a pilot proj-
ect), the authors designed a cross site research project involving more
than 40 Childrens Advocacy Centers across the United States to test
the efficacy of the model and to further refine practice. The overall
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goal of implementing the standard forensic protocol is consistent with

the scientist-practitioner model: to base practice upon research and use
research to enhance practice. This article: (1) describes the NCAC
forensic evaluation protocol; (2) discusses how the protocol addresses
the challenges and controversies inherent in the field of sexual abuse
allegation assessment; and (3) presents the results of the pilot project.

THE NCAC FORENSIC EVALUATION PROTOCOL

The Madison County Multidisciplinary Team is the heart of the
NCAC, that originated in 1985 in Huntsville, Alabama. The team
reviews and manages cases involving child sexual abuse and severe
physical abuse. Evidence is collected through medical examinations
by physicians, investigative interviews by law enforcement and CPS,
and related investigative work by all members of the team. In most
cases, these efforts yield adequate information for decision making
regarding prosecution and child protective issues. In 26% of the cases,
however, additional information is needed by the team. In cases where
the child was unable or unwilling to freely disclose abuse during the
investigative interview, an extended forensic evaluation of the child
was employed. In these cases the child is referred to the NCAC Inter-
vention Services program.
More specifically, children are referred to the NCAC Intervention
Program for Forensic Evaluation when: (1) the child does not disclose
abuse to investigators, but exhibits behaviors or other indicators
strongly suggesting victimization, (2) the child does not disclose the
full extent or nature of abuse during the initial investigative interview
by law enforcement or child welfare agency personnel, or (3) the
information gathered in the initial investigative work needs further
clarification. Thus, forensic evaluation is conducted with a specific
subset of children in which initial investigative results are unclear.
Elliott and Briere (1994) also identified this unique subset of children.
In a study examining the outcomes using their forensic evaluation
model, they placed children into categories described as abused, non-
abused and unclear abuse history. Their evaluation consisted of at
least one child interview, a medical examination, an interview with the
nonoffending caregiver, and an assessment of the childs distress using
the Briere Trauma Symptom Checklist for Children. Elliott and Briere
recommend a more extended series of interviews in the absence of
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external evidence and caution that cursory interviews with children

may increase the likelihood of false negatives by truncating a poten-
tially more complete and valid disclosure. Other research also sup-
ports a more comprehensive evaluation. Faller (1996) notes that a
more comprehensive model is not subject to the criticism, especially
in court, of the simpler models, and that it allows the evaluator to
access multiple sources of data for better decision making.
The current NCAC protocol involves eight sessions. An evaluator
conducts the first session with the primary non-offending caregiver
and gathers an extensive history of the family and child. The caregiver
then completes the Child Behavioral Checklist (Achenbach, 1988) and
the Child Sexual Behavior Inventory (Friedrich, 1990). The second
session is devoted to developmental assessment and rapport building
with the child. Session three focuses on psychosocial assessment to
explore the childs self-understanding, self-esteem and perceptions
regarding their support system or lack of it. During the fourth session,
the evaluator introduces educational materials about good, bad and
secret touching, and conducts a body parts inventory. During sessions
five, six and seven, the evaluator employs abuse-focused, but non-
leading questioning techniques and procedures. This is done to gather
information regarding such topics as family violence, substance abuse,
care routines (i.e., bathing, eating), environment, people, sexual abuse
and discipline. The cognitive interview technique (Saywitz et al.,
1992) and narrative elaboration procedure (Saywitz et al., 1996) are
used with school age children when a partial disclosure has been
obtained. At the eighth session, the evaluator changes the focus to
body safety and prevention education and provides closure for the
child. The Trauma Symptom Checklist (Briere, 1996 ) is completed by
age-appropriate children at the final session.
The NCAC Forensic Evaluation protocol was initially designed as a
12-session model. Two purposes guided its design. First, children need
a sense of safety and a pace without pressure to provide information
that adults can use to protect the child and prosecute the offender.
Second, evaluators must obtain the information in a forensically sound
manner. After implementation of the model for one year with 24
children, disclosure patterns were examined. For the purposes of that
analysis, a disclosure was defined as any piece of new sexual abuse
information which significantly contributed to the evaluators ability
to assist the team to confirm or disconfirm the suspicion of abuse. The
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pattern of disclosures obtained from the first 24 children supported the

Sorenson and Snow (1991) finding that some children tend to disclose
over time. However, it was also determined that in 100% of the cases,
new disclosures which were obtained, occurred during the first eight
sessions. Those disclosures, obtained from the ninth to the twelfth
session, were enhanced reports of detail, rather than new reports of
information. Due to these findings, the number of sessions of the
model was decreased from 12 sessions to its present eight-session
format. In the pending larger cross-site research project, we will vary
length of evaluations between eight and four sessions to assess the
effects of the pace on eliciting useful information.

ADDRESSING THE CONTROVERSIES:

THE EMPIRICAL BASIS
OF THE FORENSIC EVALUATION PROTOCOL

Faller (1996) divided the primary controversies in child sexual

abuse interviews into four categories: (a) the ability of the interview-
er to conduct a competent interview, (b) the competence of the child to
describe actual events, (c) interview structure and process and (d) deci-
sion-making about the likelihood of sexual abuse (p. 86). Each of
these controversies will be reviewed here to explicate the empirical
basis of the strategies chosen for the NCAC Forensic Evaluation Pro-
tocol. How the chosen strategies, including the initiation of a larger
scale project to test the efficacy of the model, address the controver-
sies will be examined.

The Ability of the Interviewer to Conduct a Competent Interview

Some detractors suggest that interviewers foster false allegations

and use leading and suggestive practices (e.g., Ceci, Huffman, Smith, &
Loftus, 1994). Others claim child interviewers are poorly trained and
educated and have questionable motives for working in the field (e.g.,
Gardner, 1991). Although actual motives of individuals are virtually
impossible to validate scientifically, Gardner (1992) provided a criti-
cism suggesting that interviewers may be abuse survivors working out
their own issues. A paucity of scientific data exists related to inter-
viewers previous abuse history. In a survey (Jackson & Nuttall, 1993)
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of 656 social workers, pediatricians, psychiatrists, and psychologists,

17% of the respondents reported a history of sexual abuse. Kelly
(1990) surveyed 228 police officers, child protective workers, and
nurses who attended an educational program on child abuse, and
found a 13% incidence of child sexual abuse history. In another study,
Howe, Herzberger, and Tennen (1988) surveyed mental health service
providers at the masters and doctoral levels. Eight percent of their 101
respondents reported childhood sexual abuse. Taken together, the re-
sults of the three survey studies suggest that sexual abuse survivors are
not overrepresented in the identified professions. In fact, the percent-
ages are generally below the statistical estimates of sexual abuse prev-
alence in the general population. Finkelhor (1994) has reported as a
result of summarizing 19 prevalence studies that a solid, albeit possi-
bly conservative, estimate based upon the available research of preva-
lence among sexual abuse histories is 20% for U.S. females and
5-10% for U.S. males. Comparisons of abuse prevalence in the survey
research with Finkelhors estimates suggest that sexual abuse survi-
vors may actually avoid working in the child protection field.
All three studies (Howe et al., 1988; Jackson & Nuttall, 1993;
Kelly, 1990) also looked at clinicians responses using an analog
methodology. They used vignettes and asked subjects to make judg-
ments about them. Jackson and Nuttall found that clinicians who
reported childhood abuse history were more likely to believe abuse
allegations than were colleagues who did not have an abuse history.
Kelly found that subjects who reported childhood sexual abuse attrib-
uted more responsibility to the offender than did the non-victims.
Howe et al. found that those reporting childhood abuse histories
viewed physically abusive parental acts depicted in the vignettes as
more severe and more likely to be harmful than those with no reported
history of abuse. None of these outcomes suggest that professionals
are working out their own abuse issues, but they do suggest abuse
survivors may have increased empathy for the child and a firmer belief
that abusers are in the wrong, orientations that are not inappropriate
for those working in the field of child maltreatment.
The pending larger scale study will take the issue into the real
world of interviewing, and directly test whether or not abuse history
affects the decision-making process in suspected cases of sexual
abuse. Interviewers participating in the pending research project will
answer a confidential 70-item questionnaire that assesses the inter-
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viewers history of neglect, physical, sexual, and emotional abuse

(Bernstein & Fink, 1993). The data will be analyzed to determine
whether any correlation exists between evaluator abuse history and the
outcome of childrens abuse disclosures during Forensic Evaluation.
The study will not be able to speak to the reasons for any correlations,
if they are found. It will, however, provide empirical observations
related to whether any such correlations actually exist for the study
sample.
The criticism that evaluators use leading and suggestive practices
was directly addressed in the creation of the Forensic Evaluation pro-
tocol. All practices used within the protocol are research based, and
designed to obtain accurate information that can either support or not
support allegations of sexual abuse. The tools and techniques are
specifically designed to be non-leading and to be used in a develop-
mentally appropriate fashion. A Forensic Evaluation is considered
successful when it yields sufficient quality and quantity of information
to be able to help in validating or invalidating suspicions of abuse.
According to Reed (1996), [t]he primary purpose of investigations of
suspected child maltreatment should be to arrive at valid conclusions
about the truth of the matter (p. 104). This is an important orientation
stressed to those evaluators trained on use of the model. This orientation
encourages critical evaluation of childrens statements and counters the
claims by some critics that abuse investigators are looking for abuse
under every rock.

The Competence of the Child to Describe Actual Events

The controversy over childrens competence breaks down into four

categories: childrens reluctance to disclose, childrens memory prob-
lems, childrens suggestibility and improbable or unusual material
elicited from children during interviews.

Reluctance

Reluctance is commonplace and difficult to overcome in suspected

child sexual abuse cases. In a laboratory study (Saywitz, Goodman,
Nicholas, & Moan, 1991) children exhibited reluctance to acknowl-
edge even socially sanctioned genital touching by a doctor. Although
childrens reluctance and embarrassment in discussing sexual material
pose a challenge to interviewers, these factors also create a deterrent
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against false allegations. Lyons (1995) points out that those pressures
which discourage true abuse reports, also operate to discourage false
reports. In fact, research has shown children are far more likely to
deny or fail to report abuse that has occurred (Lawson & Chaffin,
1992; Faller, 1988).
As discussed above, the NCAC Forensic Evaluation protocol was
designed to be conducted over time to give children the needed safety
and non-pressured pace, in accordance with data showing that some
children tend to disclose over time (Sorenson & Snow, 1991). The
model was specifically designed to help reluctant children overcome
their reluctance, fear, embarrassment, and avoidance coping. Thus, it
begins with sessions of rapport building, developmental evaluation
and psychosocial assessment before directly addressing the more
threatening topics pertaining to abuse.
Memory Issues
The complex issues of memory acquisition, storage and retrieval
have been widely studied in the laboratory. One salient finding in the
research literature is that preschoolers need different cues for retrieval
than do school-age children (Fivush, 1993). Preschool children do not
do well on free-recall tasks, and require specific external cues to direct
their attention to specific interview topics. The Forensic Evaluation
Protocol employs abuse specific, non-leading questioning procedures
to inquire about such topics as care routines, substance abuse, domes-
tic violence and physical and sexual abuse. The focused questioning
techniques are based upon the work of Walker (1994) and others, to be
developmentally appropriate and non-suggestive. Abuse is approached
obliquely, without direct leading. While detractors would describe
almost any focused question as leading, for the purposes of practice
and research using the Forensic Evaluation protocol, a leading ques-
tion means a question in which the answer is suggested, for example,
He touched your privates, didnt he? or Didnt he make you touch
his pee-pee?
School-aged children can respond to more open-ended techniques
for memory retrieval, therefore, the Cognitive Interview (Saywitz,
Geiselman, & Bornstein, 1992), and Narrative Elaboration (Saywitz,
Snyder, & Lamphear, 1996) procedures are employed in the model
when questioning older children given there has been an acknowledg-
ment by the child of an abuse incident. In laboratory studies, these
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techniques increase accuracy and quantity of detail by providing

memory retrieval cues without being leading or suggestive. Evaluators
in the pending cross-site NCAC project were trained on use of these
techniques during the on-site training, and Dr. Karen Saywitz devel-
oped a training tape for use in this project that is being provided to all
trainees further to assure consistent practice using these techniques.
Suggestibility
Suggestibility has been defined as the degree to which ones
memory and/or recounting of an event is influenced by suggested
information or misinformation (Reed, 1996, p. 106). Suggestibility
concerns take three forms: (1) coaching or shaping by caregiver to
make false allegations, (2) coaching or shaping to cause the child to
keep the secret or interpret abuse as something innocuous and (3) inad-
vertent interviewer or parental influence. Lyons (1997) described a
recent series of laboratory research as the new wave of suggestibili-
ty research (e.g., Leichtman & Ceci, 1995; Ceci & Bruck, 1993). This
research applies in different ways to the three forms of suggestibility.
Coaching to report false abuse. Ceci stated during a television
broadcast of Nightline that his research was designed to be used in
understanding false allegations coached by adults, which he believes
are a small percentage of cases (Hayes & Hill, 1996). In his studies,
children are exposed to misleading, suggestive interviewing practices,
and sometimes (although not the majority of the time) preschoolers
say they have seen or experienced something they have not. In the
Sam Stone study (Leichtman & Ceci, 1995), a stereotype induction
is used, and then children are purposely misled with embedded
suggestions. The researchers hypotheses that some children can be
coerced or manipulated into false allegations, and that preschoolers
are more suggestible than older children are supported by their find-
ings. An extremely high degree of purposeful misleading over long
periods of time occurs in these studies. Ceci commented that they had
to work very hard at leading children to get their reported effects
(Hayes & Hill, 1996). This type of paradigm is ecologically valid
when one looks at the dynamics of the small percentage of cases in
which caregivers coach false allegations. These caregivers have time
and access to offer repeated suggestions, and they have the power over
the child to coerce false statements. Individuals trained in the use of
the Forensic Evaluation protocol are taught to be alert for symptoms of
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coaching and shaping to report false abuse, particularly in young

children, and to specifically assess for these potential factors during an
evaluation.
Coaching to avoid reporting true abuse. Coaching and shaping are
more frequently used to keep children from reporting true abuse or to
cause recantation. Abuse perpetrators and colluding caregivers have
motivation to purposely shape a childs perceptions and statements by
repeatedly exposing a child to suggestions that abuse did not occur.
They also have access, time, and a relationship with which to impose
coercive influence on the child to remain silent or to retract true
statements of abuse. These pressures on the child may be exerted over
months or sometimes years. In these cases, the Ceci paradigm of
coercive misleading over long periods of time is also applicable.
Clarke-Stewart et al. (Goodman & Clark-Stewart, 1991) showed that
children could be persuaded to claim something didnt happen. In their
paradigm, children observed a janitor who was supposed to be
cleaning, but played with some toys. Later, an interrogator made pro-
gressive and strong suggestions that the janitor was only cleaning the
toys and not playing with them. Some children were influenced to
accept the interpretation that the janitor was cleaning and not playing
with the toys. Children can be mislead by caregivers to keep silent or
to make up elaborate explanations to keep their caregivers out of
trouble. Even with an extended evaluation model, overcoming this
interviewing challenge is difficult.
Inadvertent interviewer influence. The Ceci research is less ecologi-
cally valid when applied to an interview setting in which the inter-
viewer has very little time, access and relationship with the child. In
fact, the studies were designed not for use in attacks on legitimate
interviewers, but to learn about cases in which false reports are
coached by caregivers. According to Ceci, the majority of interviews
done with kids by front line workers are well done (Hayes & Hill,
1996). Ethical standards would clearly prohibit legitimate interviewers
from purposely and overtly misleading children. Professional inter-
viewing training invariably focuses on techniques to avoid coercion
and suggestibility effects. In the NCAC Forensic Evaluation protocol,
the risk of suggestibility is minimized by limiting direct non-leading
questioning of preschoolers to two or three sessions during the Foren-
sic Evaluation protocol. Interviewers in this study are trained to be
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alert for signs that a child may be trying to please, and to be proactive
in avoidance of coercion.
The suggestibility studies do illustrate the obvious need to avoid
bribes, coercion and stereotype inductions with children. A balanced,
reasoned response is needed. Fortunately, in actual practice, available
interviewing techniques range from open-ended to focused and non-
leading, and can be tailored to the developmental level and situational
factors of the child. Strong support exists in the literature that children
can give accurate accounts when not asked leading questions. There is
little support for the contention that an interviewer could inadvertently
alter a childs memory or ability to recount events within two to three
interviews using non-leading techniques accurately.
Ceci and his colleagues (Toglia, Ross, Ceci, & Hembrook, 1992)
showed that the suggestibility effect was drastically reduced when an
interviewer was perceived by the child as less knowledgeable about
facts. Error rates decreased from 33% to 18% when the interviewer
presented him/herself as less knowledgeable. Evaluators using the
Forensic Evaluation model are trained to impart to the child the im-
pression they are ignorant of case facts. To reinforce this further,
evaluators are taught to establish early in the evaluation, and reiterate
as necessary the following set of rules designed to empower the child
(Saywitz, Geiselman, & Bornstein, 1992):
1. If you dont know the answer, dont guess, just say you dont
know.
2. If you dont want to answer, its OK to say so.
3. If you dont understand something, let me know, and I will say it
a different way.
4. If a question is asked more than once, you dont have to change
your answer, just tell me what you remember, the best you can.

Understanding Unusual or Improbable Information

Some childrens statements contain unusual or improbable informa-

tion that defies a common sense of reality. Everson (1997) proposed
explanations for these elements in childrens abuse accounts includ-
ing: deliberate attempts by the perpetrator to confuse the child, threat
incorporation, traumagenic memory distortion, the childs coping
mechanisms, developmental limitations, interviewer errors, leading
techniques, errors due to misused media and deceptive processes on
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the part of the child. Dahlenberg (1996) studied cases in which fantas-
tic elements were present. She notes: fantastic elements occurred
most frequently in the accounts of children known to have been
abused, and indeed were most common among children known to have
suffered severe abuse. These findings directly counter the hypothesis
that fantastic elements in childrens accounts of abuse give reason to
discredit the entire account (p. 8). Dahlenberg suggests that the bias
that can be produced by hearing fantastic elements should be coun-
tered by investigating the source and meaning of the elements.
The NCAC Disclosure Credibility Desk Guide (discussed in detail
later), which was designed to assist the decision-making process dur-
ing a Forensic Evaluation, encourages the user to explore on several
levels for the meaning of unusual or improbable elements in childrens
statements. Embedded in the guide is a systematic process of evaluat-
ing the disclosure in terms of several categories described by Everson,
including developmental and emotional factors, motivational factors
and alternative explanations. Everson suggests that interviewers may
overly dismiss disclosures due to these unusual elements and/or are
too defensive when encountering the elements during interviewing or
court. An evaluator need not be as defensive in the presence of such
elements if he or she conducts a careful analysis of them in the context
of other aspects of the disclosure and of the childs functioning. This
multi-level analysis should lead to increased accuracy in the decision
whether or not to dismiss the disclosure due to the unusual elements,
and increase precision in communicating with other professionals and
juries about the childs statements.
Interview Structure and Practice
How Many Interviews?
There are negatives associated with both too many and too few
interviews. If decisions are made with too few interviews, the system
may miss identifying abuse and place or leave a child at continued
risk. If too many interviews are conducted, the associated risk is the
potential of influencing the child. Excessive numbers of interviews
also can be costly, reducing the number of children who can reap the
benefits of an extended evaluation. The Forensic Evaluation protocol
is being refined based on practice and research. As mentioned above,
it was begun as a 12-session model and reduced to eight based on
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results of a year of practice. The pending larger project seeks further

understanding of the most effective length of an extended evaluation.
Using a system of random assignment of eligible research participants,
children will be evaluated using either four sessions or eight sessions.
The effect on decision-making about the allegations will be examined.

How to Use Media

A variety of tools are used during Forensic Evaluation. Anatomical

dolls, standardized and free-hand anatomical drawings, free-style
drawing, regular dolls and puppets, as well as other tools are incorpo-
rated into practice to help children in communication. Information
obtained using tools and props is not interpreted by the evaluator, but
is simply used to facilitate the childs communication of his or her
experience. The props are simply used as a means to an endhelping
the child to communicate clearly. APSAC guidelines for use of ana-
tomically detailed dolls (APSAC, 1995) are followed. In the pending
project, outcome data will be analyzed in an attempt to determine the
effects of various tools in eliciting useful information during an evalu-
ation. Following each interview, the evaluator will document which
techniques were used during the session and what the effect use of the
tool had on eliciting information.

Decision-Making About the Likelihood of Sexual Abuse

Much has been written about how to assess interview and other data
(Faller, 1988; Pence & Wilson, 1994; Raskin & Yuille, 1989; Yuille,
1988). Some factors consistently examined are interview findings,
external factors such as medical evidence, and linguistic production of
the childs account. The final step of the Forensic Evaluation protocol
is to examine the credibility of the results using the NCAC Disclosure
Credibility Desk Guide. The guide is not an empirically normed scale,
although the larger research project will enable evaluation of its char-
acteristics. It is a desk guide, designed to help the evaluator in analyz-
ing the results of a Forensic Evaluation. It is intended to be used as a
tool during decision-making regarding the disclosure. The elements in
the guide are drawn in part from the literature on statement validity
analysis. The elements are provided as a framework for analysis of the
evaluation outcome, and they fall into eight categories: (1) confirming
qualities of statements, (2) specific details obtained, (3) developmen-
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tal factors, (4) emotional content, (5) behavioral checklist results

(Friedrich, 1990; Achenbach, 1988; Briere, 1996), (6) corroborative
information/confirmatory factors, (7) motivational factors, and (8) al-
ternative explanations. The presence or absence of any one or more of
the factors does not dictate the results. The primary usefulness of a
guide such as this is the discipline for critical analysis of childrens
disclosure developed by the user. Evaluators who become accustomed
to this type of analysis carry the awareness into the interviewing
setting and incorporate the thought processes into practice. Such
thinking is inconsistent with a witch hunt mentality.
Evaluators use the NCAC Disclosure Credibility Desk Guide in
decision-making about evaluation results. Results fall into four pos-
sible categories, conceptualized as the cells of Figure 1.

Cell 1: Credible Disclosure

The child made disclosure(s) which meet credibility criteria. The

evaluators final impression (which includes the childs disclosure,
corroborative information, Child Behavior Checklist [Achenbach,
1988], Child Sexual Behavior Inventory [Friedrich, 1990] and Trauma
Symptom Checklist [Briere, 1996] results, and defined confirmatory
factors) is that the disclosure is credible.

Cell 2: Credible Non-Disclosure

The child made no disclosure of sexual abuse. The evaluator is

confident to conclude that no abuse occurred. Some other explanations
may have been found for the initial suspicion that abuse may have

FIGURE 1.

Disclosure Non-Disclosure or
Problematic Disclosure

Credible Cell 1: Credible Disclosure Cell 2: Credible Non-Disclosure

Suspicion of abuse supported No or low index of suspicion remains

Non-Credible Cell 3: Non-Credible Disclosure Cell 4: Unclear

Evidence of coaching or other High index of suspicion remains, but

factors decrease or remove no disclosure or problematic
suspicion of abuse disclosure exists
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occurred. For example, a childs initial description of an adult touch-

ing his or her genitals is found to be associated with an innocuous
event such as application of medication or bathing.
Cell 3: Non-Credible Disclosure
The child made disclosure(s). Based upon the examination of the
childs disclosure against credibility criteria, the evaluator is confident
the disclosure is inaccurate and the abuse probably did not occur. For
example, the disclosure may have been due to coaching, shaping or
other factors.
Cell 4: Unclear
The child made no disclosure, but confirmatory factors, behavioral
indicators or other factors continue to raise a high index of suspicion.
Or, the child made a partial disclosure(s), but the disclosure(s) were
too vague or problematic to validate suspicions of abuse and a high
index of suspicion remains.
The purpose of the Forensic Evaluation is accomplished when re-
sults are obtained which can be categorized as falling within the first
three cells. In cell 1, abused children are identified and the information
from the Forensic Evaluation can be used by the system to justify
protective measures and to support prosecution and civil court actions.
In cell 2, the children identified as non-abused typically have environ-
mental or mental health concerns, and are directed to appropriate care
based upon the evaluation findings. In cell 3, the wrongfully accused
may be vindicated.
The Forensic Evaluation Protocol was implemented on a pilot basis
over two years. Evaluation results were classified as described in
Figure 1: credible disclosure, credible non-disclosure, non-credible
disclosure, and unclear. Outcomes in the legal and child protective
systems were tabulated for those children in the credible disclosure
category.

RESULTS OF THE NCAC FORENSIC EVALUATION

PROTOCOL PILOT
Sample
The Forensic Evaluation model was used to evaluate 51 children at
the NCAC in Huntsville, Alabama, from March 1995 to February
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1997. Referral criteria were detailed earlier in this paper. The mean
age of the children was approximately 7.5 years, with a range of 2.5 to
16 years of age. Thirty-two or 63% of the sample were female and 19
or 37% of the sample were male. Thirty-four or 67% of the sample
were white and 17 or 33% of the sample were African-American.
Outcomes of Disclosure Credibility Assessment
After disclosure credibility assessment by the evaluator, the out-
comes were categorized in the manner described earlier (see Table 1).
Out of the 51 evaluations done according to the protocol, 24 (47%) of
them resulted in credible disclosures supporting the validity of the
sexual abuse allegations. Confirmatory factors associated with these
disclosures are illustrated in Table 2. In 71% of the cases with credible
disclosures, legal action was successfully pursued. A number of con-
fessions were obtained by confronting alleged offenders with specific
details of childrens statements obtained during Forensic Evaluations.
In all familial offender cases, protection measures were initiated by
child protective services. Confirmatory factors existed in 83% of the
cases. Recalling that children placed in Forensic Evaluation are placed
there when results of initial investigative efforts are unclear, the sys-
tem may not have had this rate of legal and protective success had
there not been a means for children to disclose in a non-pressured
setting.
Nine (18%) were categorized as credible non-disclosures. As de-
scribed above, the conclusion of the evaluation was that abuse was
unlikely to have occurred. In each case, an alternative explanation was
found for the initial suspicion. In two cases, the childs initial descrip-
tion of an innocuous event such as bathing or medication application
was misinterpreted. In three cases, non-aggressive sexual acting out
with peers was identified with no known adult involvement, and ap-
propriate referrals and interventions were made. In two cases, the
children were assessed as having general impulse control problems,
and the sexual acting out initially identified appeared to depend on the
impulse control rather than sexual abuse. These children were referred
for mental health services.
Six cases were categorized as non-credible disclosures. Recall that
these cases were referred from a larger group of over 200 reviewed by
the team. Three of these six children were siblings, and the evaluation
results strongly suggested coaching by an adult caregiver to make
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TABLE 1. Outcomes Using the Forensic Evaluation Model

Disclosure Non-Disclosure or
Problematic Disclosure

Credible Cell 1: Credible Disclosure Cell 2: Credible Non-Disclosure

n = 24 (47%) n = 9 (18%)

Non-Credible Cell 3: Non-Credible Disclosure Cell 4: Unclear

n = 6 (12%) n =12 (23%)

false allegations. In two cases, which involved older children (a broth-

er and sister who had extensive previous involvement with the child
protective system due to abuse by caregivers), the initial allegations
were recanted and the children admitted they made the allegations to
try to alter their placement with a relative. In one case, the child
recanted the initial allegations, and appears to have serious mental
health problems that led to the allegations.
Twelve (23%) were categorized as unclear. In three of these cases,
highly suspicious medical evidence (i.e., gonorrhea, severely atten-
tuated hymen) was present, but the children did not disclose informa-
tion about sexual abuse. In one case, a teenager had no memory of
abuse, but pornographic pictures of him during latency age existed and
the alleged offender confessed. Three of the preschool children in this
group were exhibiting highly sexualized behaviors that brought them
to the attention of the system, but their developmental limitations in
communication significantly affected the ability of the evaluator to
confirm or disconfirm likelihood of abuse.

THE NCAC MULTI-SITE RESEARCH PROJECT

The NCAC has initiated a multi-site research project that will be

conducted in the field setting. Evaluators from at least 30 sites (the
majority of which are Childrens Advocacy Centers) have agreed to
implement the NCAC Forensic Evaluation Protocol, and agreed to
collect data associated with the process and outcome of the imple-
mentation. All evaluators attended two-day intensive training in Hunts-
ville, Alabama at their own expense. The training addressed the con-
ceptual and practical aspects of the model, and the implications and
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TABLE 2. Confirmatory Factors Associated with Credible Disclosures

Subject Witness Medical Confession Alleged Alleged Indictment Conviction Family Child
Evidence Offender Offender Court- Welfare
Declined Failed Intervention Safety
Polygraph Polygraph Plan

1 x x x x

2 x x x

3 x x x x x

4 x x x x x

5 x x x x x

6 x x x x x

7 x x

8 x x x

9 x x

10 x x x

11 x x pending x

12 x x

13 x pending x

14 x x pending x x

15 x x pending x x

16 x pending na

17 pending na

18 x x x

19 x

20 x x x x

21 x pending na

22 x x x x

23 x x prosecution x
agreement

24 na

requirements for participating in research of this nature. All partici-

pants were provided with a 224-page manual containing copies of
relevant research articles on practices employed in the model for their
ongoing use and reference. Another group of sites has agreed to serve
as a control group for this project. They will collect data during the
same time on children with characteristics similar to those referred for
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Forensic Evaluation, and conduct single investigative interviews so

that effectiveness of single interviews may be compared with effec-
tiveness of extended evaluation. A total of 25 states will be repre-
sented in the study. Data collection is scheduled to continue for
approximately one year with an anticipated sample of 200-500 sub-
jects. The existing research in the field is heavily dominated by analog
studies with few studies on actual practice. This study will examine
the real world of child abuse investigation and quantify the findings.
The purpose of the research is to identify, for a specific population of
high-risk children, effective strategies for eliciting useful information
about the presence or absence of childrens sexually abusive experi-
ences given varying evaluation process lengths, childrens and inter-
viewers unique characteristics and circumstances, and interviewers
techniques and tools.

CONCLUSION
The creation and implementation of the NCAC Forensic Evaluation
Protocol and the initiation of a larger scale research project as dis-
cussed here are in response to the assertion of many leaders in child
protection that field research on child interviewing and evaluation is
needed. There is no question that field generated research potentially
has massive methodological confounds. The internal validity of such
research is often problematic. However, the gain in external validity is
what is currently needed. It is a matter of starting somewhere. The
Forensic Evaluation model was designed with careful attention to
current research knowledge and now scores of dedicated professionals
and researchers have joined together. They have committed them-
selves to adoption of the model and to the expensive and painstaking
task of collecting data to refine practices further, and perhaps more
importantly, to advance knowledge.

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