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Last month, CLP featured an article on interviewing children with disabilities in child abuse cases. This follow-up piece provides best practices and guidance when interviewing children with specific disabilities.
No document can address every situation that you will face in the field as you interview children in suspected cases of sexual abuse. Some situations may require emergency attention, and the steps recommended here may be impossible. However, to the extent that you can control the speed of the investigation, this document sets forth the best practices learned through our experience working with children with disabilities.
Investigation Start
In most cases, the only way to learn whether a child has a disability is to ask. Ask the person who reported the suspected abuse (usually a teacher or family member) and get all the details. Disabilities are often imperceptible to the outsider, so it is important to ask the person who made the report in every case. Never assume that just because a child appears “normal,” that the child has no disabilities.
Take these steps at the start of an investigation:
1. In all cases, even where you do not suspect a disability, ask the reporter/teacher/relative whether the child has any disabilities or has an IEP or 504 plan.
2. If the child has any disabilities, try to obtain: (1) the IEP or 504 plan, and (2) the most recent assessment, BEFORE you conduct the interview. The IEP/504 plan will tell you what kind of accommodations the child needs in the classroom; the assessments will help you understand the nature of the disability. You will need to obtain a release from a parent or guardian to get these school records. If the child is already in state custody, the Department of Children and Families should have these records in the child’s file, and can provide them to you without a release.
3. Discuss any issues or questions you have about the disability with the parent or custodian. If the parent cannot explain the disability and how it might impact your interview, get a release to speak to the child’s teacher or case manager.
4. Determine whether the child can read and write. Many children with disabilities may not be able to speak their answers, but will be able to write them. Make sure you bring pen and paper for the child to the interview.
5. Find out from the parent what time of day is best to conduct the interview. Is the child exhausted after a day of school, so the morning is better? Or is this a child who is working very hard at school and will try to end the interview as soon as possible to get back to school? These are the kinds of questions to ask before you set the time.
Disability-Specific Approaches
Attention Deficit Disorder/Attention-deficit Hyperactivity Disorder
1. Find out whether the child is on medication, and whether the parent can make sure the child is appropriately medicated for the interview.
2. Review the IEP/504 plan to see if the school is using any techniques to keep the child focused. For example, if the child gets breaks every half hour at school, consider whether you should do the same.
3. Many children who delay disclosure get diagnosed with ADD a few months after the first assault. An ADD diagnosis can be powerful evidence of post-traumatic stress disorder and help to prove the assaults actually occurred. Find out when the diagnosis was made. If the ADD diagnosis post-dated the assaults, get the following:
a. School records to show when the child first started having problems focusing.
b. Medical records showing when the difficulty with focusing was first reported to the doctor and any other significant changes.
c. Any school records that show other changes in behavior.
Autism Spectrum Disorders & Asperger’s Syndrome
Autism spectrum disorders result in the child having a constellation of disabilities. Not every child on the spectrum will have every one of the issues below, but keep these in mind.
1. Literal Language Disability
Assume that every child on the spectrum has a literal language deficit. Literal language deficits can destroy your interview if you do not understand them.
A child with this disability has no ability to understand expressions, sarcasm, or jokes. Everything you say will be interpreted literally. If you say that you “want to talk for a few minutes,” that means three minutes. If your interview continues past three minutes, you are a liar and not to be trusted.
Expressions like, “sit tight, I’ll be right back,” cause confusion and distress as the child tries to understand why you are asking him/her to sit in a weird way and what kind of position she needs to get into to be sitting “tight.” You cannot say things like, “hold that thought and we’ll come back to it,” because the child will spend the rest of the interview trying to figure out how to hold a thought in her hands like you hold an object. Be careful with what you say. Avoid expressions, jokes and sarcasm.
Think, too, about what it is like for a child who regularly misinterprets language like this. These children regularly rely on people to interpret a world they cannot understand. Are there parts of the child’s story that don’t make sense? A child who has this disability may adopt the offender’s excuses and report them as true. If something does not make sense, think of the literal language disability and how the confusion might be explained, and ask the child for more details.
2. Verbal Disabilities
Many children on the spectrum have verbal communication disabilities. Some may not speak at all and may use devices to help them communicate, like a letter-board or a computer. Learn as much as you can about how the child communicates before the interview. Autistic children with verbal communication disabilities may not be able to give a narrative answer and my not be able to answer open-ended questions.
If you feel like the interview is going nowhere because the child cannot communicate verbally, offer the opportunity to write the answers. If that fails, ask questions that give the child choices.
So, if the simple question “Where did this happen?” does not get a response, try a question with choices: “Did this happen in the car, the bedroom, the kitchen, or where?” Children with this disability can often speak the answer if it is offered as a choice.
Try, of course, to avoid leading questions. Sometimes, however, an autistic child may require a leading question in order to respond. If that is the case, ask some leading questions you know are wrong. This establishes that the child disagrees with you when the leading question is wrong. For example, if you know a child was assaulted at home, you might ask, “Did this happen at school?” If the child answers positively, then your interview is not reliable. But if the child disagrees with you and says no, it will help later to show the child gave reliable answers in response to leading questions.
3. Sensory Overload
Children on the autism spectrum need to be interviewed in quiet rooms.
Many children on the spectrum have severe sensory issues. One or more of their senses may be extremely sensitive, and outside stimuli can quickly become overwhelming. Frequently, their hearing becomes an area of distress as they hear noises other people cannot hear, and regular volume noises can be extremely loud and uncomfortable. Extraneous noises might be so disturbing that they cause the child to startle. Even the buzz of fluorescent lights can drive an autistic child to distraction. Be aware that noises that you cannot hear may be overwhelming the child you are interviewing.
Ask the parent before the interview if there is a problem with sensory issues. Ask the child if the room is quiet enough and if the child is comfortable before you begin.
Know that some autistic children cannot bear to be touched, and that a simple pat on the back will be unwelcome and could cause distress if the child has sensory issues.
4. Repetitive Movements
Many children on the autism spectrum make repetitive movements, like hand flapping, knee-knocking, or other movements that you might find distracting or disturbing. Talk to a caregiver or teacher before the interview to learn whether this is an issue for the child.
If a child starts making repetitive movements in the interview, ignore them. Do not ever ask the child to stop, as these movements help calm the child when the child is feeling anxious. But do notice them; if the movements are increasing, you are talking about an issue that causes the child distress. Videos of these interviews, when viewed by an expert or the child’s therapist, can be very helpful to show that the child started showing distress when he/she began talking about the assault.
Many children on the spectrum need to spin objects when they are anxious. The child might pick up a random object and try to make it spin, or use a coin. Try to continue the interview while letting the child spin. Again, the spinning helps calm the child.
Some children may need to spin themselves in circles. Ask a caregiver or teacher before the interview about what you might do if this happens. Have a plan for how you are going to conduct an interview if the child needs to be turning in circles while he/she answers questions.
Selective Mutism/Other Verbal Disabilities
Selective mutism is common for children on the autism spectrum, but it can happen with anyone. A child with this disability will be capable of speaking perfectly well at times, but unable to speak at all when anxious. You may have a child who is perfectly chatty in the introductions, but becomes mute when you get to the substance. Or, a child with this disability may simply deny that anything happened because that is easier than becoming mute if she/he has to think about painful things.
When dealing with a child with a verbal disability like selective mutism, it is important to address it upfront with the child. Explain to the child that you understand that it can sometimes be hard to talk, and that that is totally fine. Hand the child pen and paper, and make clear that writing down answers is always okay and that the child should feel free to do whatever is easier.
If the child writes responses, make sure to maintain the record if you are recording the interview. Read the written response out loud, number the response on the paper, and, then say that you are marking that response as “number x.”
Some children need adaptive technologies to communicate. Work with a parent or special educator for the child to find out how that works. If it is too complex for you to learn, arrange for someone who understands it to assist the child in the interview. The child’s aide or special educator may be the best person if you cannot find someone who does not know the child. Make that person take an oath at the start of the interview about exactly what the person will be doing in the interview, and that the child’s words will not be edited or modified in any way.
Some children may have speech impediments that make their speech incomprehensible to anyone other than their family or special education teachers. Use the special educator to interpret for you in the interview. Have the person take an oath at the start of the interview that he/she will interpret both accurately and literally to the best of his/her ability.
Low Functioning
Review all IEPs to determine the child’s functioning level. A 15 year old who looks fine and speaks well may be functioning at the level of a six year old in school. Respect the child’s biological age, but conduct the interview at an appropriate level for every child’s intellectual ability.
Children with low IQs often have trouble with years, months, seasons, days of the week, and time. Often, they only understand the past, the present, and the future—all other defining terms are meaningless.
If a child with disabilities says something happened last week when you know it was two years ago, or in the winter when the report you have says it was the summer, follow up with the child’s teachers and special educators to find out if the child struggles with those issues in school. Often, it will be right in the child’s IEP that the school is working to teach time concepts to the child, and the teachers will be strong witnesses about the child’s disability in reporting when something happened.
Deaf Children
Try to learn about the nature of the child’s communication abilities. Many deaf children are proficient lip readers. Some can speak well, even though they cannot hear what they say. Most, nonetheless, will prefer to rely on an interpreter for something this important rather than their lip-reading skills, but you should inquire about the child’s preference. Some may prefer to write their responses.
Deaf children will require two interpreters for your interview. You will need a Certified Deaf Interpreter for the child (CDI), and an American Sign Language interpreter for you (ASL). The CDI is a deaf adult certified in interpreting deaf communication, including, but not limited to, ASL. Young deaf children may not even know ASL. An additional benefit of a CDI is that deaf children are more comfortable communicating to someone who is deaf.
The CDI will interpret the deaf child’s statements into ASL. The ASL interpreter will in turn interpret ASL into spoken words for you. Note that ASL is American Sign Language. If your deaf child is from a home where American English is not the primary language, you will need a sign language interpreter who is fluent in that sign language.
It can be difficult to find certified interpreters, especially in rural areas. There are several companies that advertise their services on the Internet, and there may be one in your area. You might also check with a local school that serves deaf children, or with your state child services agency.
All interpreters must take an oath that they will accurately interpret the literal translation to the best of their ability, and that they have the training, experience, and qualifications to do so. Plan on this interview taking three times longer than you would expect. Do not let a relative serve as an
interpreter.
Reactive Attachment Disorder
Reactive Attachment Disorder is common among children in foster care, children who have had multiple changes of primary caregiver, and sometimes with adopted children. It is an emotional disturbance that causes the child to respond to social situations in a developmentally inappropriate way.
These children require a special kind of patience. They might do things that seem designed to purposefully anger you, such as criticizing your clothing or your weight, or accusing you of bad things. They might get up and walk around, or get up and leave. Some may throw objects in the interview room.
Stay calm; keep your cool; and recognize that these responses are beyond the child’s control. Rather than argue with the child, try to calmly redirect the conversation.
Children at Risk of Self Harm
Many children who have been sexually abused engage in self-harming behaviors. This is common when the child has been abused frequently, or has been abused by multiple offenders.
These children may be suicidal. Some may harbor suicidal thoughts; others may have prior attempts and periods of hospitalization. They may also engage in “cutting,” and you may notice the telltale signs of scars and cuts in various stages of healing on their arms and legs. Cutting is not an unusual response to repeated sexual abuse.
The most important thing for these children is for you to have a safety plan for after the interview. Your interview will be a traumatic event for this child, and you want to make sure that the child will be safe when it is over.
Usually, the person who reports the suspected abuse for a child who is at risk of self harm will also advise you that this is a child at risk. Talk to that person at length about a safety plan for after the interview. See if you can arrange for the child to go directly to the child’s therapist after the interview to help the child process the trauma of the interview, and evaluate the child for safety concerns.
If you have no warning that the child you are interviewing is at risk of self harm, but you notice the telltale cuts and scars during the interview, make a safety plan when you are done with the interview. Again, it is ideal for the child to go directly to the child’s therapist.
If the child does not have a therapist, work with the caregiver to develop a safety plan. Try to arrange for the child to start seeing a therapist as soon as possible. If the child does not seem stable at the end of the interview, a trip to the emergency room may be warranted.
Post-Traumatic Stress Disorder
Many children who are sexually abused develop post-traumatic stress disorder (PTSD), usually within a few months after the first assault. The symptoms of PTSD may include several of the following: inability to focus (often misdiagnosed in these children as ADD); sleep disturbances (nightmares); irritability or angry outbursts; hypervigilance (constantly checking doors to make sure they are locked, constantly looking to see if the abuser is in view); avoidance of normal activities; restricted range of affect; a sense of foreshortened future; exaggerated startle response; and… most important for purposes of your interview: an inability to recall an important aspect of the trauma.
If you are interviewing a child who gives many appropriate details and then claims to not remember the most traumatic part of the event (for example, the intercourse), the child may well have PTSD. The fact that the child professes to not remember an important part of the trauma does not mean the rest of the report is false. Rather, the memory loss can sometimes be explained by a psychologist. When a child has a memory loss about an important aspect of the trauma, it is best to arrange for the child to see a therapist who will do a proper diagnosis. Over time, and with therapy, the child may be able to describe the traumatic event in more detail.
Other Disabilities
The most common disabilities seen in children who have been sexually abused are addressed here. Many more disabilities may affect your interview. If a child has a disability that you have not seen before, find out as much as you can. Speak to caregivers, teachers, and special educators. You may also want to do your own research on the Web. The Diagnostic and Statistical Manual of Mental Disorders (current version is the DSM-IV-TR) is a great tool to learn about the child and how to adjust your interview to fit the child’s needs.
Practitioners will need to tailor interviewing approach to the child’s specific disability. Advance planning and efforts to meet the needs of each child will go a long way in making the interview comfortable for the child and productive for the case. The guidance offered here offers a framework. Many simple steps can easily be incorporated into interviews that accommodate differences in how children with disabilities communicate.
Christina Rainville, JD, is the Chief Deputy State’s Attorney for Bennington County, Vermont, where she heads the Special Investigations Unit. She is also a former recipient of the American Bar Association’s Pro Bono Publico Award.