About 13,000 children testify each year in criminal sex abuse cases, increasing the pressure on the medical establishment to provide guidance for discerning when children can be counted on to tell the truth.
"Most of the time, a child can accurately describe what happened," says Dr. William Bernet, medical director at the Psychiatric Hospital at Vanderbilt in Nashville. Bernet has conducted studies on how to diagnose child sex abuse. "But there are cases when children can be indoctrinated (either on purpose or inadvertently) to believe that they have been abused when they have not."
The most notorious case of child indoctrination was in 1983, when a California preschool owner, Peggy Buckey McMartin, and her son Ray Buckey, were accused of the ritual sex abuse of 42 children. After a 28-month trial which ended in 1990 (the longest criminal trial in U.S. history), the two were acquitted. The case was chalked up to the hysteria of one mother and the suggestibility of dozens of children.
While Bernet says such large scale cases are increasingly rare, it is possible for children to vigorously deny abuse which actually happened, or seriously assert abuse which never occurred. For example, Bernet cites a case study he published last summer in the Journal of the American Academy of Child Adolescent Psychiatry. A baby sitter named Joyce noticed that little Betsy became agitated when she swept the floor. Joyce found out that Betsy played a game with her parents called "Sweep the Bootie."
Suspicious, Joyce got a tape recorder and questioned Betsy. In her haste to protect the child, Joyce used "incessant, repetitive, suggestive forced-choice questions." Betsy "was pressured to come up with answers, so she started adding information," writes Bernet.
By the end of the interview, Betsy had "confessed" that her parents had raped and sodomized her with a broom handle, that her father had vaginal and oral sex with her, that her parents had sex in front of her, and that her father killed animals (including a pink horse) and threatened to kill her if she told anyone. Betsy was removed from her home for 18 months, but returned after a child psychiatrist discredited Betsy's story.
"That case is remarkable because it shows how much can be done to a child in only one interview," says Bernet. "That is a rare occurrence, but it did happen. Think of what could happen with unskilled interviewers when a child is subject to multiple interviews over weeks or months."
To avoid such pitfalls, Bernet authored a set of practice procedures issued last year by the American Academy of Child Adolescent Psychiatry. The procedures encourage interviewers to weigh the context of the testimony (Is the child a pawn in a bitter divorce? Are family members modest or comfortable with nudity? How do teachers, sitters or other adults view the child?), and keep an open mind for explanations other than abuse.
In Michigan, the Governor's Task Force on Children's Justice recommended that each county adopt an interview procedure in child abuse cases which incorporates many of Bernet's recommendations.
"Come January 1, the Child Protection Act requires each county to adopt a protocol," says Wayne County Assistant Prosecutor Nancy Diehl, a member of the Task Force. "The important thing is that the interview must focus on what the child has to say, not on what the interviewer believes happened."
But Bernet's guidelines do include one sticking point for investigators: The suggestion that all interviews of children be audiotaped or videotaped.
"There's absolutely no way to know if the interview with a child was tainted by a poor interviewer unless the interview is taped," explains Bernet.
Diehl, who is also director of the Child and Family Abuse Bureau of the Wayne County Prosecutor's Office, has less confidence in the taping requirement, which is not part of the task force recommendations.
"Taping raises serious questions," says Diehl. "How do you protect the identity of (videotaped) children? Also, which interviews would be taped (assuming a child is interviewed by social service workers, police and prosecutors) and where would they be kept? Would all of them be transcribed? What do you do with them after the case is completed? These are all questions that the task force felt deserved further consideration."
Besides, says Diehl, the biggest problem is not with law enforcement repeatedly interviewing children.
"The problem is often with family members who have an agenda indoctrinating the children before any accusations even surface. No amount of videotaping will undo that.
"I've prosecuted a ton of these cases," adds Diehl. "When I'm not sure about the child's testimony, I don't prosecute. Most are not difficult. But there are a handful that cause a lot of sleepless nights."
