1. Suggestibility: Understanding the Research
ChildFirst: Suggestibility
2009
Suggestibility: Understanding the Research

2. ChildFirst: Suggestibility
2009
By the age of 10, a child is no more suggestible than an adult.
(Cole & Loftus, 1987; Myers, 1998;
Warren & Marsil, 2002)

3. Suggestibility Defined (Olafson, 2007)
ChildFirst: Suggestibility
2009
Suggestibility Defined (Olafson, 2007)
Degree to which post-event influences alter memory for an event
All the influences on the encoding, storage and retrieval of events
Abuser reframes event during abuse experience to distort child’s perception of event
Encoding, storage, retrieval and reporting influenced by internal and external factors
Individuals make statements they know to be untrue under real or imaged pressure from someone else

4. Suggestibility Research (Vieth, 2002)
ChildFirst: Suggestibility
2009
Suggestibility Research (Vieth, 2002)
The First Wave
Prior to 1979 – A shortage of research
From – More than 100 studies
Much of the literature challenged the view that children are highly suggestible and prone to attack

5. First Wave Research Rudy & Goodman (1991)
ChildFirst: Suggestibility
2009
First Wave Research Rudy & Goodman (1991)
The Trailer Study
Pairs of children, ages 4-7, were sent into a trailer with an unknown man dressed as a clown
One child watches and the other interacts with the clown
10-12 days later, children individually asked open, direct and misleading questions
“He took your clothes off, didn’t he?”

6. ChildFirst: Suggestibility
2009
Rudy & Goodman (1991)
The Trailer Study Results
Not one of the children who interacted with the man made a false report
Only one 4 YO bystander made a false report of abuse claiming he and participant were spanked by clown

7. First Wave Research Saywitz, Goodman & Moan (1991)
ChildFirst: Suggestibility
2009
First Wave Research Saywitz, Goodman & Moan (1991)
Physical Exam Study
72 girls ages 5 and 7
standard check-up and vaginal and anal exam
standard non-genital check-up and scoliosis exam
Children questioned after 1 or 4 weeks
free recall, direct, and misleading questions
“Think about … Tell me everything you remember”
“Did the Dr. touch you there?” while pointing
“How many times did the doctor kiss you?”
anatomical dolls also used
“Tell me while you show me …”
Saywitz, K.J., Goodman, G.S., & Moan, S.F. (1991). Children’s memories of a physical examination involving genital touch: Implications for reports of child sexual abuse. Journal of Consulting and Clinical Psychology, 59, ]
Children questioned after 1 or 4 weeks
children’s memories were tested one or four weeks following their visits to the pediatrician (depending on delay condition). Children were asked (in this order):
free recall questions: i.e., “Think about your visit to the doctor who had the big crayons in the office. Tell me everything you can remember, from beginning to end.”
children were then asked to demonstrate with anatomical dolls: “Tell me while you show me.”
direct questions: using the doll and pointing, interviewer asks “Did the doctor touch you there, there, etc.
misleading questions including some that were abuse related: “How many times did the doctor kiss you?”
anatomical dolls were also used

8. Saywitz, Goodman & Moan (1991)
ChildFirst: Suggestibility
CH Advanced Forensic Interviewing
Saywitz, Goodman & Moan (1991)
Physical Exam Study Findings
Genital exam group:
genital/anal touch frequently unreported in free recall (only 11% disclosed anal touch & 22% disclosed vaginal touch)
more children reported with direct questions (69% for anal touch and 86% for vaginal touch)
Scoliosis exam group:
no false reports from 7YOs
no false reports in response to free recall
5YOs
direct questions  three commission errors (2.86% and 5.56% false reports)
misleading, abuse-related questions  four errors
Saywitz, K.J., Goodman, G.S., & Moan, S.F. (1991). Children’s memories of a physical examination involving genital touch: Implications for reports of child sexual abuse. Journal of Consulting and Clinical Psychology, 59,
Findings
Genital exam group
vast majority of genital/anal touch was not reported in response to free recall questions
only 11% disclosed anal touch & 22% disclosed vaginal touch
BUT, many more children reported when asked direct questions
69% for anal touch and 86% for vaginal touch
Scoliosis exam group
5YOs
direct questions = three commission errors about genital/anal touch
this constitutes 2.86% and 5.56% respective rates of false reports
as compared to the 21.74% rate of false reports of tapping to the spine (performed in scoliosis exam) by the genital exam group, the rate of false reports of genital/anal touch appears quite low
misleading, abuse-related questions = four errors
three of the four commission errors in response to misleading questions were made in response to the question: “How many times did the doctor kiss you?”

9. State v. Michaels 642 A.2d 1372 (N.J. 1993)
ChildFirst: Suggestibility
2009
State v. Michaels A.2d 1372 (N.J. 1993)
Multiple pre-school victims
Michaels convicted on 131 counts
Michaels “made us eat boiled babies”
“She put a sword in my rectum”
She “played piano naked”
Convictions reversed

10. Inappropriate Interviews – Michaels
Investigator: Did she put the fork in your butt? Yes or no?
Child: I don’t know, I forgot.
I: Oh, come on, if you just answer that you can go.
C: I hate you.
I: No you don’t.
C: Yes I do.
I: You love me, I can tell. Is that all she did to you, what did she do to your hiney?
I(2): What did she do to your hiney? Then you can go.
C: I forgot.

11. Inappropriate Interviews – Michaels
Investigator (2): Tell me what Kelly did you tour hiney and then you can go. If you tell me what she did to your hiney, we’ll let you go.
Child: No.
I: Please.
C: Okay, okay, okay.
I: Tell me now, what did Kelly do to your hiney?
C: I’ll try to remember.
I: What did she put in your hiney?
C: The fork.

12. Suggestibility Research (Vieth, 2002)
ChildFirst: Suggestibility
2009
Suggestibility Research (Vieth, 2002)
The Second Wave
Research is given great weight by some courts
Research reflects high profile cases with multiple victims
Research does not reflect typical abuse investigation
Focuses on expanded definition of suggestibility

13. Second Wave Research Leichtman & Ceci (1995)
ChildFirst: Suggestibility
CH Advanced Forensic Interviewing
Second Wave Research Leichtman & Ceci (1995)
Sam Stone Study
176 three- to six-year-old children in four groups
Suggestion Group
Shown evidence (ripped book & soiled teddy bear)
Repeated interviews using forced-choice, suppositional and misleading questions
Stereotype Group
Prior to visit, children told of 12 stereotyping events
Stereotype & Suggestion Group
Both stereotyped messages prior to Sam’s visit and suggestive questions after
Control Group
No stereotypes or suggestive questions used until final interview
Leichtman M.D., & Ceci, S.J., (1995). The effects of stereotypes and suggestions on preschoolers’ reports. Developmental Psychology, 31,
Suggestion Group:
following a visit from a man named “Sam Stone,” children were repeatedly interviewed using forced-choice, suppositional, and misleading questions
children were shown the book the teacher had been reading when Sam visited; the book was ripped
children were also shown a soiled teddy bear and asked multiple questions about events that did not really happen such as:
“Who ripped the book?” If the child reported (s)he did not know, the child was then asked “Who do you think might have… ripped the book?”
“When Sam got the bear dirty, was wearing long or short pants?”
“When Sam Stone got the bear dirty, did he do it by accident, or was it on purpose?”
“Did Sam Stone rip the book with his hands or did he use scissors?” (p. 577)
Stereotype Group:
over a one-month period prior to his visit, children were told of twelve different events that stereotyped “Sam Stone” as someone who was very clumsy and broke things that belonged to others. In one story, the interviewer told the children that “Sam Stone” had come over, borrowed a Barbie doll, and broke it; the story was filled with first-person contextual detail
Stereotype & Suggestion Group:
these children were subjected to both the suggestive questions after “Sam’s” visit and the stereotyped messages prior to his visit

14. Second Wave Research Leichtman & Ceci (1995)
ChildFirst: Suggestibility
2009
Second Wave Research Leichtman & Ceci (1995)
Sam Stone Study
Children interviewed for 2 minutes once a week for 4 weeks after visit
Children asked “leading” questions
“Who ripped the book?” If the child reported (s)he did not know, the child then asked “Who do you think might have… ripped the book?”
“When Sam got the bear dirty, was wearing long or short pants?”
“When Sam Stone got the bear dirty, did he do it by accident, or was it on purpose?”
“Did Sam Stone rip the book with his hands or did he use scissors?”
First interview: 25% surmised SS did it
Leichtman M.D., & Ceci, S.J., (1995). The effects of stereotypes and suggestions on preschoolers’ reports. Developmental Psychology, 31,

15. ChildFirst: Suggestibility
2009
Leichtman & Ceci (1995)
Sam Stone Study Findings:
No false reports when control group asked to tell about Sam’s visit
72% of 3-4 YOs claim SS ruined at least one item
45% 3-4 YOs claimed witnessing SS ruin one item
HOWEVER, when gently challenged, only 21% made same claims
Only 11% of 5-6 YOs claim to have witnessed SS ruin one of the items
Leichtman M.D., & Ceci, S.J., (1995). The effects of stereotypes and suggestions on preschoolers’ reports. Developmental Psychology, 31, ]
Event:
2 minute classroom visit from “Sam Stone”
“Sam Stone” visited a pre-school classroom for two minutes; he was not clumsy nor: did he break anything. The teacher or aid introduced Sam. Then Sam commented on a story being read to the children, walked around the classroom, and left.
All children were repeatedly interviewed
all children were then interviewed once weekly for five weeks
at the time of the fifth and final interview, all children were asked information introducing yes-no questions such as
“I heard something about a book. Do you know anything about that?” (p. 578).
questions were in regards to events that did not occur (i.e., ripping the book and soiling the teddy bear).
if children indicated they did know something, they were then asked if they saw it and if so, were then gently challenged about their report
“You didn’t really see him do this, did you?” (p. 571)
Findings:
No false reports when control group asked to tell about Sam’s visit
asked to “tell” everything they could remember about the day that Sam Stone visited their classroom
Despite multiple manipulation techniques, children overall were more accurate than not
leading and suggestive questions and stereotyping, three to four-year-olds’ reports were 72% accurate and five to six-year-olds were 86% accurate. Overall, the children demonstrated the following level of accuracy in their responses:
control group, 96% accurate
stereotype group, 83% accurate
suggestion group, 72% accurate
suggestion plus stereotype group, 64% accurate.

16. Second Wave Research Ceci, Huffman & Smith (1994)
ChildFirst: Suggestibility
2009
Second Wave Research Ceci, Huffman & Smith (1994)
Mousetrap Study
96 children ages three to six
Children were interviewed seven times
Instructions:
Real vs. fictitious events
Remember what “really” happened
Fictitious events:
Hand caught in a mousetrap
Hot air balloon ride 
Ceci, S.J., Huffman, M.L.C., Smith, E., & Loftus, E.F. (1994). Repeatedly thinking about a non-event: Source misattributions among preschoolers. Consciousness and Cognition, 3, ]
Instructions:
Real vs. fictitious events
children were asked about a list of events; children were instructed that some of the events really happened (these were given to researchers by parents) and others did not
Remember what “really” happened
children were encouraged to remember what “really” happened         

17. ChildFirst: Suggestibility
2009
Ceci, Huffman & Smith (1994)
Mousetrap Study Findings
Accurate recollection of real events
By the final (seventh) interview:
34% of the children assented to fictitious events
66% of children did not assent
No effect was found for repeated interviews
Ceci, S.J., Huffman, M.L.C., Smith, E., & Loftus, E.F. (1994). Repeatedly thinking about a non-event: Source misattributions among preschoolers. Consciousness and Cognition, 3,
Findings:
Accurate recollection of real events
children throughout the repeated interviews almost always remembered real events accurately
By the final (seventh) interview:
34% of the children assented to fictitious events
they indicated they had experienced events that they had, in fact, not experienced
66% of children did not assent to fictitious events
No effect was found for repeated interviewing
we would assume, and Ceci et al. hypothesized, that at the time of the first interview, no children would assent and the number would gradually increase as the interviews progressed
in fact, approximately 34% of children falsely assented to fictitious events from the first to final interviews
3-4YOs assented slightly less when repeatedly interviewed and 5-6 year olds assented slightly more
several children flip-flopped back and forth between assent and denial

18. Second Wave Research Ceci, Loftus, Leichtman & Bruck (1994)
ChildFirst: Suggestibility
2009
Second Wave Research Ceci, Loftus, Leichtman & Bruck (1994)
“Picture-in-the-Head” Game (Mousetrap #2)
48 children ages three to six
Interviewed 30 minutes once a week for eleven weeks about eight real and fictitious events
Fictional events:
Falling off a tricycle and getting stitches
Hot air balloon ride
Waiting for a bus
Observing another child waiting for the bus
Ceci, S.J., Loftus, E.F., Leichtman, M., & Bruck, M. (1994). The possible role of source misattributions in the creation of false beliefs among preschoolers. International Journal of Clinical and Experimental Hypnosis, 62, 4, ]

19. Ceci, Loftus, Leichtman & Bruck (1994)
ChildFirst: Suggestibility
2009
Ceci, Loftus, Leichtman & Bruck (1994)
“Picture-in-the-Head” Game
Mislead to believe events were real and happened when children were very little
Asked to make a picture in their head of the fictitious event and tell what they saw
Instructed to practice picturing events
Prompted with questions
At 12th session, new interviewer told of first interviewer’s mistake – events not real
Children then asked to recall only real events
SECOND WAVE RESEARCH
“Picture-in-the-Head” Game
[Reference: Ceci, S.J., Loftus, E.F., Leichtman, M., & Bruck, M. (1994) The possible role of source misattributions in the creation of false beliefs among preschoolers. International Journal of Clinical and Experimental Hypnosis, 62(4), ]
Instructed to practice picturing events
children were instructed to picture events in their head and practiced this technique
Asked to make a picture in their head of the fictitious event and tell what they saw
Prompted with questions
“What do you think you would have been wearing when it happened?
“Who would have been with you?”
“How do you think you would have felt?” (p.309)
At 12th session, new interviewer told of first interviewer’s mistake – events not real
children met with a second interviewer for a twelfth interview session - the new interviewer told the child that the first interviewer had made mistakes and told children that things happened to them that never really happened
Children then asked to recall only real events

20. Ceci, Loftus, Leichtman & Bruck (1994)
ChildFirst: Suggestibility
2009
Ceci, Loftus, Leichtman & Bruck (1994)
“Picture-in-the-Head” Game Findings
First 11 weeks:
Assents to the negative false event (falling off a tricycle and getting stitches)
31% age 3-4
28% age 5-6
12th week – previous interviewer made a mistake:
Assents to the negative false event
28% age 3-4
23% age 5-6
Children were more likely to assent to neutral or positive events
Ceci, S.J., Loftus, E.F., Leichtman, M., & Bruck, M. (1994) The possible role of source misattributions in the creation of false beliefs among preschoolers. International Journal of Clinical and Experimental Hypnosis, 62(4), ]
Findings
First 11 Weeks: (after 11 weeks of this type of practice)
Assents to the negative false event (falling off a tricycle and getting stitches)
only 31% of 3-4 assented to the negative false event (falling off a tricycle and getting stitches)
28% of 5-6 also assented.
12th week: (on the 12th week, when children were told that the interviewer made a mistake and the events were not real, the percentages of false assents dropped…)
Assents to the negative false events
28% age 3-4
23% age 5-6

21. Second Wave Research Bruck, Ceci, Francoeur & Barr (1995)
ChildFirst: Suggestibility
2009
Second Wave Research Bruck, Ceci, Francoeur & Barr (1995)
The Inoculation Study
Children ages 4-5 received a medical exam by a pediatrician
After exam, researcher stays during oral vaccine and inoculation
RA removes child, gives treats and reads story
11 months later, children were interviewed 4 times over two weeks

22. Bruck, Ceci, Francoeur & Barr (1995)
ChildFirst: Suggestibility
2009
Bruck, Ceci, Francoeur & Barr (1995)
The Inoculation Study Findings
Children told false information about prior visits
Interviewer minimized pain from inoculation
RA and pediatrician duties
During 4th interview, 40% of children falsely reported duties of one of medical professionals
Mislead children reported less hurt than control group

23. Does Research Apply to the Real World? (Vieth, 2002)
ChildFirst: Suggestibility
2009
Does Research Apply to the Real World? (Vieth, 2002)
New Wave research is less applicable to majority of interviews of abused children:
Average age of alleged victims in sexual assault court cases is 10 years old
Most investigative interviews occur shortly after report of abuse
Most real-world victims are abused by close family members
Most real-world cases do not involve multiple victim issues

24. Research in the Real World (cont.)
ChildFirst: Suggestibility
2009
Research in the Real World (cont.)
Interviews in new wave research involve multiple interviews of children who have denied an event
Although coercive or misleading questions may result in a false report, it does not necessarily produce a false memory
False reports reduced by half when children are “gently challenged” by researchers (Lyon, 1999)
Coercive practices employed in new wave research produced only a minority of false reports

25. ChildFirst: Suggestibility
2009
Why Children’s Suggestibility is Still a Concern (Warren & Marsil, 2002)
Suggestibility is not limited to preschool children
Suggestiveness is not limited to leading questions
Suggestibility is not confined to formal interviews
It is difficult to identify particular children most susceptible to suggestion
It is difficult to train children to resist potentially suggestive questions or to “gate-out” previously suggested information
It is difficult to train interviewers to avoid suggestive techniques and to use techniques designed to promote accuracy

26. Indicators a Child is Not Suggestible
Spunky, assertive personality
Corrects / disagrees with interviewer
Seeks clarification
“No” answers to yes/no questions
Selective in multiple choice questions
“I don’t know/remember” to Wh-questions
Avoids indiscriminate answers
Provides descriptive narratives

27. Charges of “Priming Disclosures”
Anatomical Diagrams

28. Concerns with Utilizing Anatomical Diagrams
“Obviously, human figure drawings can be suggestive intrinsically.”
(Aldridge et al., 2004)

29. Recent Recommendations about Use of Diagrams
“To minimize contamination, therefore, it is preferable that human figure drawings be introduced as late as possible in investigative interviews….” (Aldridge et al., 2004)
“We caution professionals against the use of body maps in clinical and legal interviews.” (Willcock et al., 2006)

30. Recent Recommendations about Use of Diagrams
“Despite relatively neutral questioning in association with the body diagrams, accuracy also declined, suggesting that the risks associated with HBD outweigh the advantages….” (Brown et al., 2011)
“Forensic interviewers should immediately ceases [sic] using body outlines to elicit initial disclosures of abuse.” (Dickinson, 2011)

31. How Diagrams / Body Maps Assisted in Interviews
Use of HFDs increased reports of new touches not previously disclosed in exhaustive interviews (Teoh et al., 2010)
HFDs produced large numbers of forensically relevant details not previously disclosed (Aldridge, et al., 2004)
Introduction of HFDs lead to elaborations of touches received (Teoh et al., 2010)

32. How Diagrams / Body Maps Assisted in Interviews
Visual body cues help younger children access memories (Teoh et al., 2010; Aldridge et al., 2004)
4 – 7 YOs particularly benefited from use of HFDs in eliciting details (Aldridge et al., 2004; Teoh et al., 2010)
HFDs helped clarify reports by older children (Teoh et al., 2010)

33. Encouraging Conclusions
“Perhaps HFDs could be used at the very beginning of interviews only to assess children’s knowledge of body part names while the interviewer is also assessing other cognitive functions.” (Bruck, 2009, p. 371)
Deirdre A. Brown, Margaret-Ellen Pipe, Charlie Lewis, Michael E. Lamb & Yael Orbach, Supportive or Suggestive: Do Human Figure Drawings Help 5- to 7-Year-Old Children to Report Touch? 75 JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY 33, 40 (2007). [33-42]

34. Encouraging Conclusions
“It appears that the advantages of using media outweigh the disadvantages…. Interviewers should use media in a planned manner.” Faller, 2007, p. 113)
Deirdre A. Brown, Margaret-Ellen Pipe, Charlie Lewis, Michael E. Lamb & Yael Orbach, Supportive or Suggestive: Do Human Figure Drawings Help 5- to 7-Year-Old Children to Report Touch? 75 JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY 33, 40 (2007). [33-42]

35. Defending the Use of Anatomical Diagrams
Understand and articulate purpose for use
Follow a recognized protocol
Distinguish use in interviews from articles critiquing their efficacy
Understand and reference suggestibility research
Be familiar with applicable research on anatomical diagrams and dolls
Work within an MDT
Clarify all reported touches and CORROBORATE

36. Suggestibility: Recommendations for Practice
ChildFirst: Suggestibility
2009
Suggestibility: Recommendations for Practice
“…the issue is not whether children can be led to make false allegations, but whether they are being led ….”
(Lyon, 2001)
Lyon, T. D. (2001). Let’s not exaggerate the suggestibility of children. Court Review, 38(3),

37. Avoiding the Suggestibility Pitfalls (Marsee, 2008)
ChildFirst: Suggestibility
2009
Avoiding the Suggestibility Pitfalls (Marsee, 2008)
Two ways an interviewer can be suggestive:
Language
Behavior

38. Examples of Suggestive Techniques (Kulkofsky & London, 2010)
Leading / misleading questions
Interviewer: He took your clothes off, didn’t he?
Repeated questions
Interviewer: Where did he touch you?
Child: He didn’t.
Interviewer: Tell me where he touched you.
Positive reinforcement
Interviewer: Did he touch you on your bottom?
Child: Yes
Interviewer: That’s right. You’re doing a really good job.

39. Examples of Suggestive Techniques (Kulkofsky & London, 2010)
Negative feedback
Interviewer: Did he kiss you?
Child: No
Interviewer: You’re not doing very well.
Peer, parental or interviewer pressure
Interviewer: The other kids told me he did these things. I just need you to tell me.
Creating a negative or accusatory emotional tone
Interviewer: These are bad guys. We’re going to put these bad guys in jail.
Inviting children to pretend or
speculate
Interviewer: What do you think it would have been like? What could have happened?

40. Interviewer Tips (Marsee, 2008; Reed, 1996)
ChildFirst: Suggestibility
2009
Interviewer Tips (Marsee, 2008; Reed, 1996)
Conduct interviews in a child-friendly location
Be friendly and supportive with the child
Avoid unnecessary, duplicative multiple interviews
Avoid pre-fixed ideas of the crime
Do not stereotype the perpetrator
Always explore alternative hypothesis

41. Interviewer Tips (Marsee, 2008; Reed, 1996)
ChildFirst: Suggestibility
2009
Interviewer Tips (Marsee, 2008; Reed, 1996)
Do not put the entire burden of the case on the child – search for corroborating evidence
Avoid suggestive tone
Avoid misleading and coercive questions
Do not repeat questions

42. Interviewer Tips (Marsee, 2008; Reed, 1996)
ChildFirst: Suggestibility
2009
Interviewer Tips (Marsee, 2008; Reed, 1996)
Remember that misleading can occur in any direction depending on the nature of the interviewer’s suggestions
Ask developmentally appropriate questions
Begin with open-ended questions and, after a free narrative is elicited, ask focused questions as needed and justified
Adequately document questions and responses

43. Interviewer Tips – As Needed (Marsee, 2008; Reed, 1996)
ChildFirst: Suggestibility
2009
Interviewer Tips – As Needed (Marsee, 2008; Reed, 1996)
Reinforce the child for correcting him/herself and you when you misstate the facts
Encourage the child to disagree with you
Encourage the child to admit confusion rather than guessing
Encourage the child to admit lack of memory or knowledge rather than guessing

44. Interviewer Tips – As Needed (Marsee, 2008; Reed, 1996)
ChildFirst: Suggestibility
2009
Interviewer Tips – As Needed (Marsee, 2008; Reed, 1996)
Explain to the child that you are uninformed, especially regarding facts of the case
Advise the child that if questions are repeated, previous answer was not incorrect
Emphasize the importance of being truthful
Give the child permission to decline answering questions that are too difficult to discuss at the moment

45. Questions and Comments
ChildFirst: Suggestibility
2009
Questions and Comments