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CHILD
PROTOCOL |
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Often a sexual assault with a child victim is referred to
as “sexual abuse.” However, for the purposes of this
Protocol, it will be referred to as "sexual assault" and
defined as set out in the North Dakota Century Code. See
Appendix I. |
Intra and Extra-Familial Child Sexual Assault
The sexual assault of children falls into three major
categories. |
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Sexual
assault of a child by a stranger, many times involves
kidnapping and/or the use of a weapon. These assaults
usually occur on a random basis, are more likely to result
in severe physical injuries to the child, and account for
a growing number of sexual assault related deaths of
children. |
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Sexual
assault of a child through the use of pornographic
materials and exploitation. Many of those involved are
"run away" or "throw away" children who are dependent upon
the exploiters for physical survival, and in some cases,
even affection. |
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Sexual
assault of a child by a family member or other person
known to the child and whom the child trusts to some
degree. |
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Intra-Familial: the offender
in child sexual assaults is related to the child victim
through blood, marriage, adoption, or common living
arrangement. Generally the following relationships are
involved: |
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The
offender is legally related and a member of the child
victim’s immediate family (natural or adoptive parent,
sibling). |
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The
offender is a member of the child victim’s extended family
(e.g., grandparent, aunt/uncle, cousin). |
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The offender
is not legally related but is seen by the child as part of
the immediate family because the offender lives or has
daily contact with the family (step parent,
guardian/foster parent, male or female friend of parent). |
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Extra-Familial: the offender
child sexual assault is not “considered” a part of the
child’s family. However, this person usually has an
opportunity for frequent contact with the child and/or
represents an authority figure that the child may believe
to be synonymous with trustworthiness. These relationships
include, but are not limited to: |
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Neighbor |
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Day
care/school employee |
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Clergy,
scout leader |
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Friend
of family |
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Baby
sitter |
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Many child victims have been
victimized over a period of years. Long-term sexual
activity is common in intra and extra-familial situations
beginning when the child was three or four years of age or
younger, and continuing well into adolescence or until the
child leaves home. |
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There is little opportunity
for young children to learn outside the home what
constitutes appropriate and inappropriate physical contact
with an adult or older child. Secrecy associated with the
sexual activity, or threats of personal harm to the child
or to the child’s family, may cause the child to sense
that something is wrong. However, unless children are
educated about proper and improper touching and the
importance of telling someone when inappropriate behavior
occurs, many children do not understand that they should
report the incident(s). |
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The situation is made even
more complicated when the offender is someone whom the
child loves and/or trusts, such as a parent or other close
family member. |
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Many times intra- and
extra-familial sexual assault begins as fondling or gentle
touching, and only escalates to manual penetration or full
intercourse after an extended period of time. The offender
is usually viewed as an authority who "must know what is
best" which often allows the offender to convince the
child that the sexual contacts are normal. |
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Some children become
adolescents before realizing, in educational settings or
through normal discussions with other teenagers about
family life and events, that the sexual contact they have
experienced is wrong and does not occur in other
households. By this time, however, the child may have
assumed a great amount of guilt about the sexual
activities and may be even more reluctant to reveal the
situation to a family member or any adult. |
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When an attempt is made to
talk to someone about the sexual activity many children
are unable to communicate what is happening. Even when the
child is quite verbal, the listener may dismiss the
account as "make believe" or accuse the child of lying.
When no action is taken to protect the child from further
abuse, the child may decline to initiate the subject
again. |
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Because of the inability of
most children to secure medical treatment on their own,
the majority of sexually assaulted children do not receive
immediate medical attention. When medical attention is
received, it is usually at the request of someone other
than the child. |
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This request is frequently
made by: a parent who notices unusual genital soreness,
discharge or urinary problems; a teacher who sees a sudden
change in the child’s behavior; a relative who suspects
physical abuse; or medical personnel who discovers
gonorrhea from a vaginal, urethral or throat culture. |
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Limitations on Prosecution |
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The law provides that the
prosecution of a sexual assault with a child victim must
be commenced within a certain number of years from the
time of the offense. |
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The determination of whether
an action can be commenced within the appropriate period
of time is one that is made by the legislature, law
enforcement, and the criminal justice system. However, an
awareness of the applicable statute of limitations will
provide a better understanding of the time parameters in
which assaults must be reported and prosecution commenced. |
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See Appendix I. |
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Treatment Facility |
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Ideally, each hospital that
treats adult victims of sexual assault will also have a
multi-disciplinary team, available on an on-call basis,
for the evaluation and examination of child sexual assault
cases. |
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This team ideally should
consist of a pediatrician for the physical examination,
and a social worker and/or nurse or SANE to provide victim
support and to provide coordination with the law
enforcement and child protection agencies. An
obstetrician/gynecologist should also be available on an
on-call basis to provide consultation and follow-up when
necessary. Each team member should be trained in the
management and psychodynamics of the child sexual assault
victimization. |
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In the absence of those
resources, the minimum requirements should be a readily
available physician and nurse, both of whom are trained in
the medical and psychodynamic aspects of a child victim of
sexual assault. |
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Intake |
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Children are often brought to
the hospital by a police officer and/or parents who are
seeking examination and treatment. |
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When an officer accompanies
the child, the officer should be directed immediately to
the emergency/pediatric department so that a brief history
of the assault can be provided to the attending medical
staff. |
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If the child’s parent or
guardian also is present, he or she should then be asked
if there is any additional information about the event
that should be shared with the attending medical
personnel. In cases involving young children, the
parent/guardian also should be asked to provide the
attending medical personnel with the child’s medical
history. |
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Since children may tell health
professionals things they will not tell their parents or
other adults, adolescents and older children should be
encouraged to provide much of their own medical history.
This interview should be conducted in a private area, and
information regarding sexual history (of both males and
females), menstrual history and use of birth control
should be recorded. |
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The child’s parents/guardians
should be informed about for the physical examination by
the attending medical personnel. They should also be told
that specific lab tests will be done, the purpose of each
test, and when the results will be available. |
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Reporting |
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Every case of known or
suspected child sexual assault must be: |
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Reported to
the appropriate child protection services and/or law
enforcement agency |
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Considered a
medical emergency |
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Seen without
delay by medical personnel only after other acute cases,
such as trauma or ingestions |
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See Appendix I. |
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Support Personnel |
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Under no circumstances should
the child be left alone during their time at the hospital.
Arrangements must be made to provide a support person who
can establish a good rapport with the child and remain
with the child. |
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As with adults, an important
first step in intervention is to help children regain a
sense of control over their bodies. For adolescents, this
may be aided by allowing them a choice of the support
person to be present during the physical examination. This
support person could be a trained hospital social worker
or nurse, a trained victim advocate, or a family member. |
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A support person, of the same
sex as the child, can be quite reassuring. In fact, this
may be required by many institutions to protect their
staff. |
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Consent |
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Consent to conduct a medical
examination and collect physical evidence should be
obtained from parents/guardians of all children under the
age of 18. Any child victim may personally consent to
emergency care, and any child victim age fourteen or older
may personally consent to receive examination, care, or
treatment for venereal infection. See Appendix I. |
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Fortunately, there are few
situations when the parent/guardian will refuse to consent
to these procedures. However, if consent cannot be
obtained from the parent or guardian of the child, and if
the child is in danger from his or her surroundings and
requires immediate attention, appropriate authorities,
such as a social service agency, should be notified
immediately. In the case of parental refusal, children may
be taken into protective custody by either law enforcement
or a child protective service agency – a representative of
the custodial agency can then sign an appropriate consent
form as temporary guardian of the child. |
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This temporary custodial
transfer will allow the medical staff to provide diagnosis
and treatment, the child protective and law enforcement
agencies to investigate the assault, and at least on a
short-term basis, protection of the child from further
abuse. |
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Child Interviews |
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The attending medical
personnel will get the information necessary to complete
the medical examination and for the collection of
evidence. The law enforcement representative in
conjunction with support personnel (preferably a child
protection services worker) has the responsibility of
investigating the allegations of suspected child sexual
assault or neglect. It is important for all responding
professionals to be aware of their role in order to
minimize the trauma to the child of multiple interviews. |
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General Information |
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Interviewing children about an
assault of any kind, physical or sexual, is not an easy
task. It can often be difficult to get the child to talk.
It can also be difficult to understand what the child
says. Many professionals are not really comfortable with
children and may be unaware of techniques for establishing
rapport with children. |
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When children are asked about
their sexual activities with adults or other children,
many times their inability or reluctance to answer these
types of questions is due to embarrassment, shyness, a
fear of being thought of as a "tattletale" or disloyal, or
simply due to a lack of understanding of the question
itself. |
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With children interviewers
must be aware of the long-term ramification of their
questions to a much greater degree than with adults. While
the immediate goal is to elicit the clearest possible
information from the child, the interviewer should be
aware of his/her own feelings about a child sexual assault
and not communicate any attitudes which might create or
increase the child’s trauma. This is especially important
in cases of sexual activity involving a family member
where, in the child’s mind, the action may have been
viewed as one of affection. |
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Prior to the interview, it is
important to determine what reactions the child has been
exposed to following the disclosure of the sexual
activity. For instance, the medical professional should
try to ascertain if the child’s family has been
supportive, ambivalent, disbelieving, angry or blaming. |
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Also, parents and others who
have regular contact with the child should be questioned,
whenever possible, about any behavioral changes they have
observed. |
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Indicators of a child sexual
assault perpetrated by a family member or other trusted
individual, however, are not always concrete. Therefore,
hospital staff should be alert for signals from the
parent/guardian which may indicate sexual activity,
including but not limited to: |
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The
child staying inside the house more frequently |
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The
child not wanting to go to school |
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The
child crying without provocation |
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The
child bathing excessively |
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A
sudden onset of bed wetting |
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An assessment of the child’s
emotional state is a vital part of the interview process.
This is an age-dependent interpretation based on factors
such as how the child relates, his or his body posture,
and the language used. |
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It is also important to assess
the child’s verbal skills level and to use terms that are
understandable to the child. This assessment can many
times be accomplished by asking topical questions about
family, school, television and everyday events. After a
degree of rapport has been established, the child can then
be asked to describe what happened. |
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The interviewer should be
supportive and sensitive through tone of voice, body
expression, and the maintenance of eye contact. The
interviewer should also sit at eye level with the child so
that the child is not intimidated and so that the
interviewer is perceived as genuinely interested. |
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The child must be allowed to
tell about the incident(s) with as few interruptions as
possible and to use his/her own words in describing what
happened. |
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It is absolutely vital that
the child be believed at all times, especially in cases of
disputed accounts by adults. The child’s account should be
taken at face value. Avoid making value judgments and
expressions of shock or surprise. |
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It must be made very clear to
the child, as often as needed throughout the interview,
that the child was not at fault for what happened and that
medical staff are there to help and protect him/her. |
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Statements made by the child
should be recorded accurately. The child should not be led
in such a manner that he or she answers questions to
"please" the interviewer. |
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Younger children often have
problems with times and dates. In order to establish a
time frame in which the abuse occurred, it can help to
discuss favorite events or activities. These could include
asking about television shows, a vacation or trip to see a
relative, going to the zoo, or a birthday. |
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Younger children also have a
short span of attention. Therefore, the interviewer should
avoid long and openended questions and provide short rest
periods at appropriate intervals during the interview. For
example, "Tell me about the assault?" would be an
open-ended question. Instead, it would be better to use a
series of short questions calling for direct response such
as, "Did someone touch you in a way that made you
uncomfortable?" |
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The use of interview aids is
extremely helpful. Drawings, pictures and anatomically
correct dolls are particularly effective. When using these
aids, ask the child to name the different body parts,
i.e., nose, fingers, knew, etc. Then, ask the child what
she or she calls the intimate areas without correcting
them. Make note of the terms used and what areas or body
parts these terms represent. |
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It may be necessary for the
interviewer to follow-up the child’s description with
clarifying questions in order to learn exactly what
happened. For instance, in situations where penetration
did not occur but where there was other sexual contact,
the child may not at first differentiate between oral and
manual stimulation. |
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It is important that medical
personnel be aware that multiple interviews can be very
traumatic for child victims. It is anticipated that the
information they need to obtain will be gathered during
this initial medical examination. |
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Medical History Interview |
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An experienced medical staff
member should conduct the preliminary medical history
interview of the child. |
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The purpose of this interview
is to obtain the information necessary to conduct a proper
medical examination and possible collection of physical
evidence. A more thorough, detailed investigative history
will be obtained by law enforcement and child protective
agency personnel at a later time. |
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The interview should be held
in a private room adjacent to the emergency or pediatrics
department and must be free from interruptions. |
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The interviewer must explain
his/her need to know what happened and what procedures
will be done. He/she should also use simple terms,
including the child’s vocabulary for body parts, acts, and
people. |
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Presence of Personnel |
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As few persons as possible
should be present during the medical interview/evaluation
or examination/evidence collection process. Attending
medical personnel should consist of the examining
physician, an authorized support person and/or nurse. |
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Presence of Parent/Guardian |
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In all cases of a known or a
suspected child sexual assault, the medical person in
charge must decide whether or not the presence of a parent
or guardian during the evaluation or medical examination
is desirable. |
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Many times it is not
preferable to have a family member present during the
medical history interview or physical examination of the
child, in order to minimize confusion and additional
trauma to the child, and for the purpose of obtaining
information that might otherwise be censored. |
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Some parents may be so
emotionally distraught or disbelieving upon hearing the
child’s narrative that their presence has a negative
impact upon the child and the interview/examination
process. When these situations occur, the parent/guardian
should be taken to a private area and provided with
support and comfort. |
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However, if the child
expresses a need for support from a parent/guardian, and
that parent/guardian is not the suspected offender, their
presence may be appropriate if they are supportive to the
child. |
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Under no circumstances,
however, should the interview/evaluation be held in the
presence of a parent/guardian who is a suspect offender. |
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Medical/Evidentiary
Examination |
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The medical examination should
consist of a general physical examination, a genital
examination, and where appropriate, the collection of
physical evidence. |
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Steps Prior to the
Examination |
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All equipment, containers, and
other materials necessary for the examination and evidence
collection procedures should already be in the room prior
to the child’s entry. |
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Basic examination equipment
list |
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Routine
examination equipment |
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Appropriate
lab slips and cultures |
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Blood
collection equipment |
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Speculum
for adolescent females |
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Wood’s
Lamp (Ultraviolet illuminator) |
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Sexual
Assault Evidence Collection Kit (if appropriate) |
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All
medical and evidence collection paperwork |
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The
use of a colposcope/medscope |
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In preparation for the
examination, the child should be completely undressed
(except for underwear), and be wearing an examination
gown. Help with this process can be provided by the
attending nurse, SANE, support person and/or parent
guardian (if present). |
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Throughout the examination,
great care must be taken to minimize additional trauma to
the child. For instance, many children have never before
been in a hospital environment. Factors such as the
presence of unfamiliar equipment (most of which can be
quite "scary" in appearance), and the necessity of
darkening the examining room in order to conduct the
Wood’s Lamp procedure properly, can be extremely
disconcerting and frightening to a child. Therefore, all
examination procedures must be explained to the child
prior to being performed. |
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It is important for the
examiner to be aware that children interpret statements
literally. For example, avoid making statements such as
"I’m doing cultures to see if there are bugs in there!"
Children may think this means they are dirty or have
something "alive" inside them. |
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The examiner should reinforce
the idea that the child is not "damaged goods", or
irrevocably marked in some obvious way. |
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The child should not be
restrained in order to do the examination and/or to gather
evidence. If the child is visibly upset, the physician
should determine what measures are to be taken to reduce
his/her anxiety. |
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Some cases may require the use
of sedation; however, it is recommended that general
anesthesia not be administered except in the most extreme
cases, such as in a life-threatening situation or when the
removal of a foreign object would cause undue pain and
trauma to the child. Careful explanation of any sedation
or anesthetic should be provided to both the family and to
the child. |
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Evidence Collection |
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Regardless of when the assault
might have occurred, valuable evidence can still be
obtained through a medical examination and interview of
the child. Therefore it is vital that such an examination
still be performed and that all paperwork be completed,
whether or not evidence specimen are collected. |
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If it was determined during
the medical history interview that the last sexual contact
took place more than 72 hours prior to the hospital visit,
the percentage of cases where trace evidence will still be
present on the child’s body or clothing will be low.
Therefore, a careful evaluation of each case must be made
to decide which, if any, evidence collection procedures
should be implemented. |
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If it was established that the
last sexual contact took place within the prior 72 hours
or if the time frame cannot be determined, then evidence
procedures should be implemented according to the adult
instructions with the following modifications: |
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If
it is determined that simultaneous use of two rectal swabs
is not desirable, swabs should be used one at a time. |
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For the young
female child and the adolescent female who is too
traumatized to have a full pelvic examination, evidence
specimen can be obtained by gently swabbing the exterior
vaginal areas, using a moist swab or pipette. |
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It is
recommended that head hair standards not be taken from
children at the time of the initial examination. Only
under the most extreme circumstances, and only after it
has been determined that hair evidence is crucial to the
successful prosecution of the offender, should a child’s
head hair be pulled. |
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It is further
recommended that under no circumstances should pubic hair
(if any existing) be pulled from children. |
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Medical Examination |
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An immediate assessment of the
child’s status must be made to determine the presence of
any significant vaginal, rectal, penile or other major
trauma/sites of bleeding. If present, their
control/stabilization must be the priority. |
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The more common medical
indicators of a sexual assault are: |
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Presence
of sexually transmitted infection |
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Unexplained
vaginal bleeding, discharge, or trauma |
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Inappropriate
sexual behavior for age |
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Suspicious
stains or blood in the underwear |
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Lesions,
bruising or swelling of the genital area not consistent
with history |
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Pain in the
anal or genital area |
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Unexplained
pain or soreness in the abdominal area. |
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The presence of genital and/or
other types of physical injuries or abnormalities can
serve as corroborative evidence and should be carefully
recorded in the medical record. The location of these
injuries should be recorded on drawings of the female and
male body. See Appendix D. Any specific explanations given
by the child for the injury should also be included in the
medical record, using the child’s exact words if possible. |
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The medical examination of a
sexually assaulted child may, in many cases, be negative.
Nonetheless, the lack of any specific injury/finding in no
way detracts from the likelihood that the assault
occurred. A lack of physical findings may be due to many
factors, such as the degree of force used, the type of
activity perpetrated upon the child and the diagnostic
skill of the examiner. |
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Prior to the full examination,
a Wood’s Lamp should be passed over the child. Dried semen
usually exhibits a green or blue fluorescence under this
light. If present, evidence specimens should be taken from
these areas for submission to the forensic laboratory. |
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The attending medical
personnel should: |
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Note the
presence of any bruises, abrasions, lacerations, burns or
other dermatologic lesions and record them |
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Make an
attempt to estimate the age of the injury; i.e. noting the
color of a hematoma and the degree of healing or an
abrasion |
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Record any
fractures, loose or absent teeth, grab marks, suction or
bite marks, all of which are helpful in providing further
confirmation of victimization |
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Examination of the Anal,
Perianal, and Perineal Area |
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The attending physician must
decide on a case-by-case basis the extent to which rectal
examinations should be performed with both female and male
children during the initial examination. |
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Recent anal trauma may
manifest itself by perianal erythema, edema or contusions,
skin tags and spasm of the anal sphincter. An examination
of the sphincter tone for spasm or laxity is important,
and any findings should be noted. |
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If an anal tear or bleeding is
present, an anoscopy should be performed. |
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Although "gaping" of the anus
can be the result of certain chronic medical conditions,
such as constipation, it can also be an indicator of
chronic sexual activity involving the rectum. |
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Use of Colposcope/Medscope |
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The colposcope is a binocular
optical instrument used by medical personnel to assist in
the medical examination of children who have allegedly
been sexually assaulted. It utilizes a light source,
provides five (5) to thirty (30) power magnification and
may be equipped with a camera which allows photographs to
be taken. Gynecologists have long used colposcopes for the
detection of cervical cancer. |
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If a colposcope is available
at your medical facility it can be of help when detecting
lacerations, scarring or other trauma of the vaginal or
anal area not easily discerned with the naked eyed. It
does not touch or penetrate the child. The physician must
be trained in colposcopy and experienced in the diagnosis
of sexual assault to use the equipment effectively. |
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Genitalia |
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It often is helpful at the
beginning of the genital examination to estimate the level
of sexual maturation of male and female children by Tanner
Staging. |
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Female Genital Examination |
The attending physician must
also decide on a casebycase basis the extent to which
vaginal examinations should be performed. For the young
female child, a complete gynecological exam is not
recommended unless there is evidence or reasonable
suspicion of genital trauma. However, a careful visual
inspection should still be made. Sexually active female
children should have pelvic examinations.
In all cases where a pelvic examination is conducted, a
small speculum should always be used. For victim comfort,
the speculum can be moistened with warm water, but no
lubricants of any kind should be used. |
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With
the young child present on the mother/caretaker’s lap (if
appropriate), or supine on the examining table, the
vaginal and perineal areas are inspected. The presence of
erythema, hematomas, excoriations, abrasions, old scars,
bleeding, discharge and odors as well as the overall
appearance of the introitus and the interlabial spread
should be recorded. |
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The
urethral meatus should be examined for any signs of trauma
or abnormal dilation. |
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An attempt to
visualize the hymen is usually successful in prepubescent
girls. |
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The hymen
most often is medically thin circular membrane originating
from the edges of the vaginal entrance. Frequently there
is a central opening or openings. |
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There are
anatomical variations in both the size and types of
openings ranging from unusually small and/or imperforate
to completely absent. |
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Hymenal
damage can occur from causes other than intercourse or
manipulation, such as athletic activities or falls.
Conversely, the presence of the untraumatized hymen does
not preclude ejaculation through an intact hymen. |
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Inspection
should also be directed at any discharge (seminal or
purulent), as well as odors, evidence of a foreign body,
tears, skin tags and tenderness. |
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Male Genital Examination |
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Both the glans and the scrotal
area are targets of trauma in acute sexual assault. |
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Evidence of erythema, bruises,
suction marks, excoriations, burns, or lacerations of the
glans and frenulum should be recorded. The presence of
testicular or prostatic tenderness or discharge from the
urethra are important signs and may reflect trauma or
infection. |
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Rectal Examination |
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Anal area for both male and
female children needs to be visualized for any trauma. |
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Non-Authorization to
Release Evidence |
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Although there have been
instances where a parent or guardian has refused to
authorize the release of evidence to law enforcement in
child sexual assault cases, the actual incidence of this
has been very low. |
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If this does happen, the
attending medical personnel may be able to assert
authority and sign for the release. If the local child
protective service or law enforcement agency are not
already involved in the case, they should be contacted for
assistance by hospital personnel. Each individual hospital
should ascertain the policy of their particular legal
jurisdiction. |
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Victim Information Form |
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A “Victim Information Form”
should be completed. The victim’s parent or guardian
should sign the form at the bottom, and be given the
original copy. |
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See Appendix E. |
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The provisions of
psychological or counseling services for children and
their parents or guardian is just as important as for
adults. If this service is not available through the
hospital, a referral should be made to an appropriate
agency or individual with approved credentials and
training in the field of child sexual assault. |
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It is extremely important that
children return for a follow-up visit within one week to
reevaluate any genital or other injuries, and to perform
follow-up cultures, if necessary. |
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This visit will also provide
the examining team an opportunity to assess how well the
child and/or family are handling the stress and whether or
not counseling has been received or is necessary. |
|
Law Enforcement Interview |
|
Depending upon the
circumstances surrounding the case, some child victims
will be interviewed by law enforcement and/or child
protective service representatives at a location away from
the hospital, such as the child’s home, school or an
agency facility. |
|
It is the responsibility of
the investigating officer to ascertain the most supportive
environment for the child during the followup enforcement
interview. However, space adjacent to the emergency room
or pediatrics unit of the examining hospital should always
be provided for those situations where the interview must
be held immediately after the medical examination. Privacy
is, of course, crucial to the success of this interview. |
|
The goal of the social worker
or investigator’s interview with the child victim is: |
|
|
To determine
whether the assault was committed by a stranger, family
member or other trusted adult |
|
|
To avoid
further trauma to the child and offer protection to the
child |
|
|
To obtain
accurate information needed for case investigation and
medical treatment |
|
Ideally, the law enforcement
interview would include the presence of a child protective
services social worker, so that the trauma of multiple
interviews is minimized. It will also be helpful to have a
support person present who has established a good rapport
with the child during the medical examination/interview.
This type of “joint response team” effort has proven
effective in many areas of the country. To avoid
confusion, however, it is important that only one person
be the primary interviewer. |
|
In all cases, the people
present during the interview must be there for a specific
purpose and must be psychologically supportive to the
child. |
|
Presence of Parent/Guardian |
|
Although some children are
more relaxed and informative without a parent/guardian
present, others, particularly very young children, may not
be willing to cooperative in an interview without such
support. Also, parents or relatives may be the only adults
to whom the child will talk. When this happens, questions
can be directed to the child through these family members,
but only after initial efforts of the interviewer to talk
directly with the child are unsuccessful. |
|
If a parent/guardian is
present, the purpose of the interview should be explained
in a straight-forward manner, and cooperation should be
elicited to reassure the child that it is "safe" to talk
with the interviewer. |
|
The parent/guardian should
also be told that any facial expressions of shock,
disbelief or disapproval, or any verbal or physical
signals to the child could impede the interview. |
|
As with the medical history
interview, if it is suspected that the parent/guardian is
the perpetrator, then under no circumstances should the
interview of the child be held in his/her presence. |
|
The support personnel/law
enforcement officer should conduct the interview using the
general guidelines previously discussed, with one
important addition. It is preferable that the officer be
dressed in civilian clothing and not have handcuffs or
weapons visible to the child. If wearing civilian clothes
is not feasible, great care should be taken to minimize
the amount of equipment carried during the interview so
that it does not further intimidate or traumatize the
child. |
|
When the interview is
concluded, it is important for the interviewer to thank
the child for his or her cooperation, and with older
children, to give them a telephone number where the
interviewer can be reached if they have any further
problems or questions. |
