How to Talk to Children & The Ethics of Reporting What They Say Marolyn Morford, Ph.D., State College, PA Steven Cohen, Ph.D., Southhampton, PA Kathryn Vennie, M.S., Hawley, PA PPA Fall Workshop, November 6, 2009 Exton, PA

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Goals Types of interview contexts Types of interview contexts Ethical issues in gathering information Ethical issues in gathering information Factors that influence what the child says and what we understand they've said Factors that influence what the child says and what we understand they've said Ethical issues in using the information Ethical issues in using the information

Why we interview children Clinical purposes Clinical purposes Assessment/DiagnosisAssessment/Diagnosis Treatment PlanningTreatment Planning Rapport/relationshipRapport/relationship

Why we interview children Forensic purposes: Civil or Criminal Forensic purposes: Civil or Criminal Answer a question that has legal implicationsAnswer a question that has legal implications Child Custody, Personal Injury (school bus accidents, bad dentist experience), Crime, Sexual abuse Child Custody, Personal Injury (school bus accidents, bad dentist experience), Crime, Sexual abuse

How we interview children General guidelines General guidelines Methods of recording Methods of recording Hand/typewritten recordingHand/typewritten recording Audio recordingAudio recording Video recordingVideo recording

Strategies Arrange to meet a young child first in the company of a parent or familiar adult if possible Arrange to meet a young child first in the company of a parent or familiar adult if possible The actual interview should take place with only the child and the interviewer in the room. The actual interview should take place with only the child and the interviewer in the room. Employ a warm, open style of communicating with the child. Employ a warm, open style of communicating with the child.

Begin the interview with a general explanation of the nature and purpose of the interview. Begin the interview with a general explanation of the nature and purpose of the interview. As the child some general questions which are appropriate to the child's age. As the child some general questions which are appropriate to the child's age. Be sure to clarify any concerns the child may have. Be sure to clarify any concerns the child may have.

Avoid ambiguity in questions and clarify ambiguity Avoid ambiguity in questions and clarify ambiguity Be aware of evidence of coaching Be aware of evidence of coaching Stick as closely as possible to the purpose of the interview and nature of the case (clinical or forensic). Stick as closely as possible to the purpose of the interview and nature of the case (clinical or forensic).

Interviewing.. Involves hypothesis testing Involves hypothesis testing Is Child Centered Is Child Centered Poole & Lamb, 2002

Hypothesis testing Not wed to one outcome of interview Not wed to one outcome of interview Open to multiple possibilities: What other explanation might there be (for this behavior, for this statement)? Open to multiple possibilities: What other explanation might there be (for this behavior, for this statement)? Aware of cognitive bias possibilities, for example, confirmation bias, illusory correlations, availability heuristic Aware of cognitive bias possibilities, for example, confirmation bias, illusory correlations, availability heuristic

Has anything happened? Has anything happened? If so, what happened? Who was involved? If so, what happened? Who was involved? Is the child use (understanding) of terms the same as adult use? Is there some other meaning the term may have for the child? Is the child use (understanding) of terms the same as adult use? Is there some other meaning the term may have for the child? Does this event address the concern? Is there any relationship? Does this event address the concern? Is there any relationship?

Aware of the context of the interview : Aware of the context of the interview : Demand characteristicsDemand characteristics How many prior interviews of what quality?How many prior interviews of what quality? Quest for information from child that does not require interpretation and is unambiguous Quest for information from child that does not require interpretation and is unambiguous Use of methods that have been scrutinized vs. validated in experimental or field research Use of methods that have been scrutinized vs. validated in experimental or field research

Child Focused Aware of child language development (use and comprehension) Aware of child language development (use and comprehension) Aware of child cognitive development (memory, ability to recount an event, understanding of others needs) Aware of child cognitive development (memory, ability to recount an event, understanding of others needs) In environment that puts child at ease but does not encourage fantasy play or distractibility In environment that puts child at ease but does not encourage fantasy play or distractibility

Awareness of Child Language Pragmatics Pragmatics Phonological Development Phonological Development Vocabulary Vocabulary Syntax Syntax Question words/types of questions Question words/types of questions

Pragmatics of talking to children Adults make reasonable requestsAdults make reasonable requests I try to respond and please an adult if I canI try to respond and please an adult if I can What an adult says makes sense (even if its convoluted for an adult to understand)What an adult says makes sense (even if its convoluted for an adult to understand) Adults know (almost) everythingAdults know (almost) everything Lack of understanding of what an adult needs to know to understandLack of understanding of what an adult needs to know to understand Limited narrative structureLimited narrative structure

What to listen for Phonology – use of sounds Phonology – use of sounds Children simplify consonant clusters (pusgetti, soos, peas) and leave off ending sounds [ba(ll), no(se)]Children simplify consonant clusters (pusgetti, soos, peas) and leave off ending sounds [ba(ll), no(se)] Sounds that are voiced (b, d) are easier than unvoiced (p, t), glides (w, y) area easier than liquids (l, r): whips or yips for lips.Sounds that are voiced (b, d) are easier than unvoiced (p, t), glides (w, y) area easier than liquids (l, r): whips or yips for lips. If you dont understand or arent sure, ask the child to repeat or to show you If you dont understand or arent sure, ask the child to repeat or to show you

Vocabulary: things to know Children may overextend a word (daddy refers to all males), or underextend a word (doggie refers only to childs pet) Children may overextend a word (daddy refers to all males), or underextend a word (doggie refers only to childs pet) As a result, children may use or understand words idiosyncratically, especially category words, such as clothes (does this include bathing suit? Underwear?) As a result, children may use or understand words idiosyncratically, especially category words, such as clothes (does this include bathing suit? Underwear?) Use basic terms (dog, shoe) rather than superordinate terms (animal, clothing) Use basic terms (dog, shoe) rather than superordinate terms (animal, clothing)

Use noun phrases, not pronouns (he, it) or other referential (deictic) terms (there, here); repeat noun phrases whenever possible – practice this Use noun phrases, not pronouns (he, it) or other referential (deictic) terms (there, here); repeat noun phrases whenever possible – practice this Vague noun phrases may seem specific to child: Did anyone else come in? Did anything else happen? May be incorrectly answered no. Vague noun phrases may seem specific to child: Did anyone else come in? Did anything else happen? May be incorrectly answered no. Prepositions can be confusing since they are based on context and dont have a fixed meaning: in a childs body may be different for child than for adult. (Child has no concept of interior anatomy). Prepositions can be confusing since they are based on context and dont have a fixed meaning: in a childs body may be different for child than for adult. (Child has no concept of interior anatomy).

Problems with words for actions touch – child may understand this meaning as for hands only touch – child may understand this meaning as for hands only move may not be understood by child move may not be understood by child Actor and agent may be clear for child and muddled for adult for certain verbs, e.g., put: Actor and agent may be clear for child and muddled for adult for certain verbs, e.g., put:

Def. Atty: And then you said you put your mouth on his penis? Def. Atty: And then you said you put your mouth on his penis? Child: No Child: No Def. Atty: You didnt say that? Def. Atty: You didnt say that? Child: No Child: No … Def Atty: Well, why did you tell your mother that you dad put his penis in your mouth? Def Atty: Well, why did you tell your mother that you dad put his penis in your mouth? Child: My brother told me to. Child: My brother told me to.

Pros. Atty: J., you said that you didnt put your mouth on daddys penis. Is that right? Pros. Atty: J., you said that you didnt put your mouth on daddys penis. Is that right? Child: Yes Child: Yes P.A.: Did daddy put his penis in your mouth? P.A.: Did daddy put his penis in your mouth? Child: Yes Child: Yes P.A. What made you decide to tell? P.A. What made you decide to tell? Child: My brother & I talked about it, & he said I better tell or dad would just keep doing it. Child: My brother & I talked about it, & he said I better tell or dad would just keep doing it. From Berliner and Barbieri (1984), p. 132, cited in Poole & Lamb (2002)

Number & Time Number acquisition occurs in stages. Number acquisition occurs in stages. Number names (1, 3, 8): numbers as a listNumber names (1, 3, 8): numbers as a list Number names in order (1, 2, 3, 4..)Number names in order (1, 2, 3, 4..) Understanding one to one correspondence: one number per one object; later still: one number per one eventUnderstanding one to one correspondence: one number per one object; later still: one number per one event Simple distinction: one and more than one:You said he came into your room. Did that happen one time or more than one time? Then, tell me about the time you remember the bestSimple distinction: one and more than one:You said he came into your room. Did that happen one time or more than one time? Then, tell me about the time you remember the best

Time Like number, time is understood gradually. Like number, time is understood gradually. Being able to recite days of week does not mean child understands the name Tuesday applied to a certain day. Being able to recite days of week does not mean child understands the name Tuesday applied to a certain day. Yesterday may mean not today, some time in the past. Yesterday may mean not today, some time in the past. Use meaningful time markers, such as holidays, breakfast time, nighttime, school day, what tv show was on Use meaningful time markers, such as holidays, breakfast time, nighttime, school day, what tv show was on

Time as sequence of events Before/After Before/After Children understand questions about the natural sequence of events (What happened after you ate breakfast?) rather than out of order (Before you ate breakfast, did you tell your brother?)Children understand questions about the natural sequence of events (What happened after you ate breakfast?) rather than out of order (Before you ate breakfast, did you tell your brother?) To indicate sequence, use first instead of beforeTo indicate sequence, use first instead of before

Syntax Avoid passive voice: Was your mom bothered by Joey? – this can be interpreted as Subj-V-Obj: Your mom bothered Joey Avoid passive voice: Was your mom bothered by Joey? – this can be interpreted as Subj-V-Obj: Your mom bothered Joey Embedded clauses are confusing or misinterpreted: Was the boy who was wearing a red hat touching you? Embedded clauses are confusing or misinterpreted: Was the boy who was wearing a red hat touching you? Use Subj-V-Object statements and questions whenever possible Use Subj-V-Object statements and questions whenever possible

Wh- Questions Who, What, Where understood first, but there can still be problems: Who, What, Where understood first, but there can still be problems:Example: A: What are you going to eat with it?A: What are you going to eat with it? C: A fork.C: A fork. When, Why, How understood later When, Why, How understood later

Problems with why questions Objective: Why is the sky blue? Why is your leg red? Objective: Why is the sky blue? Why is your leg red? Subjective: Why do you say the sky is blue? Why did you go to the hospital? Subjective: Why do you say the sky is blue? Why did you go to the hospital? Pragmatic/situational demands: why is often part of a criticism, asking for justification Pragmatic/situational demands: why is often part of a criticism, asking for justification Cognitive demands: time, social understanding, interviewers intentions, etc. (complexity of assumptions) Cognitive demands: time, social understanding, interviewers intentions, etc. (complexity of assumptions)

Problems with How questions How long = time concept How long = time concept How often/how many times = number How often/how many times = number How come he did that = why concept How come he did that = why concept

Problems with forced-choice questions Recency effects: last item mentioned may be best remembered and chosen Recency effects: last item mentioned may be best remembered and chosen When adult offers limited choices, assumption is that the answer is among the choices when it may not be there When adult offers limited choices, assumption is that the answer is among the choices when it may not be there Use more than two options. Use more than two options. If only using two options, repeat your forced choice questions to vary the order If only using two options, repeat your forced choice questions to vary the order

Nominalizing: Avoid changing a verb or verb phrase into a noun: When was he doing this, touching of you? Nominalizing: Avoid changing a verb or verb phrase into a noun: When was he doing this, touching of you?

Benefits of interview protocol Current protocols are based on assessing amount and accuracy of information acquired Current protocols are based on assessing amount and accuracy of information acquired Reduction of interviewer bias & contamination Reduction of interviewer bias & contamination Ethical problems of altering or creating memories for childEthical problems of altering or creating memories for child Increase in accuracy Increase in accuracy

Structured Interview Greet child Greet child Establish rapport Establish rapport Explain purpose of interview & remind child not to guess or make things up Explain purpose of interview & remind child not to guess or make things up Ask child to give free report Ask child to give free report Ask child if s/he can remember more Ask child if s/he can remember more Questioning Questioning Ask child to remember more Ask child to remember more Closing (Thanks child for cooperation) Closing (Thanks child for cooperation)

Cognitive Interview Introduction Introduction Open ended narration Open ended narration Probing (guiding to explore contents of memory) Probing (guiding to explore contents of memory) Review (interviewer checks accuracy of notes and provides more opportunities for recall) Review (interviewer checks accuracy of notes and provides more opportunities for recall) Closing Closing

Problems of Cognitive Interview for children General requests for repeated recall General requests for repeated recall Child might feel pressured to change answers (If s/hes asking me again, there must be something different/else I should have said)Child might feel pressured to change answers (If s/hes asking me again, there must be something different/else I should have said) Requests to recall in varied temporal orders Requests to recall in varied temporal orders Ability varies by ageAbility varies by age Requests to recall from a variety of physical perspectives Requests to recall from a variety of physical perspectives Ability varies by ageAbility varies by age Poole & Lamb, 2002, pp

Examples of Interview Protocols Memorandum of Good Practice (UK) Memorandum of Good Practice (UK) APSAC APSAC NICHD NICHD

Memorandum of Good Practice Phased approach: general to specific Phased approach: general to specific Rapport building Rapport building Free narrative Free narrative Open-ended questions Open-ended questions Specific, nonleading questions Specific, nonleading questions Closed questions Closed questions Leading questions (rare) Leading questions (rare) Closure Closure Home Office & Dept.. Of Health, England & Wales, 1992, cited in Poole & Lamb, 2002, p. 100.

American Professional Society on the Abuse of Children Guidelines (APSAC) Interview of primary caretaker for background information & collateral info Interview of primary caretaker for background information & collateral info Open-ended questions Open-ended questions Specific questions (as necessary) Specific questions (as necessary)

NICHD Interview Introductions (names, roles) Introductions (names, roles) Rapport building, establish context, explain nature of interview, model relaxed atmosphere, allowing child time to respond Rapport building, establish context, explain nature of interview, model relaxed atmosphere, allowing child time to respond Distinguish if child understands Truth & Lies (Fantasy/Pretend) difference. Distinguish if child understands Truth & Lies (Fantasy/Pretend) difference. Ground Rules (OK to say I dont know or what do you mean? or I dont know what that word is and resisting tricky questions Ground Rules (OK to say I dont know or what do you mean? or I dont know what that word is and resisting tricky questions

Rapport building with practice interview about neutral event, establish level of childs recounting ability Rapport building with practice interview about neutral event, establish level of childs recounting ability Introduce the topic Introduce the topic Free recall/narrative Free recall/narrative Questioning/clarification (use guides): less directive toward more directive Questioning/clarification (use guides): less directive toward more directive Closure (neutral topics, thank child for coming, provide contact information) Closure (neutral topics, thank child for coming, provide contact information)

Guide for questions Open-ended prompts: Open-ended prompts: Tell me everything you can about (introduced topic)Tell me everything you can about (introduced topic) Start with the first thing you remember and tell me everything you think of even if it doesnt seem importantStart with the first thing you remember and tell me everything you think of even if it doesnt seem important You said he took you to the car. Tell me all about the car.You said he took you to the car. Tell me all about the car.

Specific but nonleading questions: Specific but nonleading questions: Ask for details about topics mentioned by the child (You said he wanted to show you something in the car. What did he show you in the car?)Ask for details about topics mentioned by the child (You said he wanted to show you something in the car. What did he show you in the car?) Who gets up first in the morning?Who gets up first in the morning? Closed questions: limited options, forced choice, yes/no (preferable to offer more than two options) Closed questions: limited options, forced choice, yes/no (preferable to offer more than two options)

Explicitly leading questions: Explicitly leading questions: Your mom told me somebody spanks you and hits you. (no reply) Is your dad hitting you?Your mom told me somebody spanks you and hits you. (no reply) Is your dad hitting you? Your teacher told me somebody touched you and you didnt like it. Did your pawpaw touch you?Your teacher told me somebody touched you and you didnt like it. Did your pawpaw touch you?

Dos and Donts Do appear relaxed and do not show surprise or emotion at statements or behaviors of child Do appear relaxed and do not show surprise or emotion at statements or behaviors of child Express interest and attention Express interest and attention Give minimal vocal cues of encouragement: mmhm, go on Give minimal vocal cues of encouragement: mmhm, go on Watch out for selective reinforcement of some statements only: either give neutral feedback or none at all, or the same to all (nodding to encourage). Watch out for selective reinforcement of some statements only: either give neutral feedback or none at all, or the same to all (nodding to encourage).

Do use short words, concrete words Do use short words, concrete words Do use short sentences, without multiple clauses Do use short sentences, without multiple clauses Use Subj-Verb-Ojb questions when possible Use Subj-Verb-Ojb questions when possible Be careful with When, Why, & How Questions Be careful with When, Why, & How Questions Follow guidelines when asking about Number & Time Follow guidelines when asking about Number & Time

Dont give qualitative feedback good, right that must have been scary that must have hurt Dont give qualitative feedback good, right that must have been scary that must have hurt Dont offer breaks or refreshments as an incentive to finish up or answer a few more questions Dont offer breaks or refreshments as an incentive to finish up or answer a few more questions Dont touch child Dont touch child Dont ask child to demonstrate events that require clothing removal Dont ask child to demonstrate events that require clothing removal

Dont phrase something to child you didnt hear clearly: ask child to repeat, dont ask, e.g., did you say X?, ask Could you say that again, I didnt hear what you said? Dont phrase something to child you didnt hear clearly: ask child to repeat, dont ask, e.g., did you say X?, ask Could you say that again, I didnt hear what you said? Dont ask Do you understand? How would they know if they didnt? Ask them to repeat back what they heard you say. Dont ask Do you understand? How would they know if they didnt? Ask them to repeat back what they heard you say.

Ethics of Using What They Say Informed consent for children with and without court-ordered evaluations: Informed consent for children with and without court-ordered evaluations: How to explain your role to a child/children when you begin to interview them How to explain your role to a child/children when you begin to interview them

How do you explain the limits on confidentiality? How do you explain the limits on confidentiality? How do you explain to the child if you record the interview? How do you explain to the child if you record the interview?

I dont want to tell you because I dont want my parents to find out I dont want to tell you because I dont want my parents to find out How do you explain your role if a child asks if you will tell mom and dad what s/he has said? How do you explain your role if a child asks if you will tell mom and dad what s/he has said?

Do psychologists feel a dual role sharing information with the parents or, in a forensic matter, sharing with the court as the client? Do psychologists feel a dual role sharing information with the parents or, in a forensic matter, sharing with the court as the client? How do you protect a child from the repercussions of what s/he has said? How do you protect a child from the repercussions of what s/he has said?

How do you explain how you will report the childs statements? How do you explain how you will report the childs statements?

How do you handle this differently for younger children and teens? How do you handle this differently for younger children and teens? If you are in a jurisdiction in which the court expects/requires you to make specific recommendations, do you explain this role vis-a-vis information gathering and decision making? If you are in a jurisdiction in which the court expects/requires you to make specific recommendations, do you explain this role vis-a-vis information gathering and decision making?

How do we report what they say? How do we report what they say? ExamplesExamples What do we pick and choose to quote? What do we pick and choose to quote? The presence of video/audio recording: permissions The presence of video/audio recording: permissions What is our ethical responsibility at this point? What is our ethical responsibility at this point?