EPSDT Care for Kids Newsletter

Talking with Children about Sexual Abuse Summer 2003

Eighty percent of sexually abused children do not show physical signs of abuse. This means that what a child tells you about abuse is very important. The information you gather as part of diagnosis and treatment may be admissible in court, so document questions and answers carefully and verbatim. When you talk with a child about abuse, be friendly, non-judgmental, and sensitive to the child’s mental state.	Eighty percent of sexually abused children do not show physical signs of abuse. For this reason, what a child tells you about abuse is very important.

To prepare for the interview
Be prepared to take careful notes. Have only the child and the interviewer in the room. Sit at the same level as the child. Begin with general questions about friends, family, sports. Listen. Be patient. Give the child time to tell you what happened.
To get an idea of the child’s developmental level:
Determine how well they understand basic concepts — numbers, colors, spatial referents.	Can you tell me what color this is? How many brothers and sisters do you have? Is that book beside or beneath the toy?
Ask questions to learn whether the child knows the difference between reality and fantasy.	Who is your favorite TV hero? Does Harry Potter live in our town?
Use drawings or other visual aids to assess how well the child understands the human body.	What is this? Do you have one of these? What do you do with it? What do grown-ups do with it?
Use questions that:
Are open-ended and not leading.	What happened? Who was there?
Allow the child to tell you what happened.	Do you like hugs? Are there ways you don’t like to be touched? Has anyone ever touched you that way?
Let the child know they are the expert.	Can you tell me about this? I need your help to understand.
Invite the child to fill in the details.	And then what? Could you tell me more about that?
Ask the child to verify the information.	Let’s see, you told me that [repeat the child’s statement]. Is that right?”
Encourage them to correct you when necessary.	You’re right, I got that mixed up, but now I think I understand.
Encourage them to tell you when they don’t know the answer.	Sometimes this is confusing, I know. It’s OK to say, “I don’t know,” “I don’t understand,” “I don’t remember.”
Help the child stay focused on what really happened.	Don’t say, “let’s make believe,” “let’s pretend,” “imagine if.”
Gently investigate alternatives.	Sometimes a big kid or a grown-up will help a little kid practice what to say. Did anybody help you? Sometimes someone gets really, really mad at somebody else, and makes up stories to hurt them. Have you ever done that?”
When you have gathered the child’s history, tell them how much you appreciate their help.	You did a really good job of helping me to understand. Thank you.
If you suspect that sexual abuse has occurred, you are required by law to contact the Iowa Department of Human Services (800-362-2178) within 24 hours. For a child in imminent danger, call 911.