Vol. 20, No. 2
April 2015

Child Forensic Interviewing: A 30-Year Perspective

By Mark D. Everson, PhD, University of North Carolina at Chapel Hill

"You're a good therapist. Just wing it."

I was about to do my very first "forensic" interview in 1983 and this was my faculty supervisor's advice. I don't remember who was more terrified that day, the five-year-old who was to be interviewed or me, the UNC "expert."

This was the beginning of my 30+ year career devoted to improving the way children are interviewed in cases of suspected child sexual abuse (CSA). The field of child forensic interviewing has evolved substantially since its infancy in the early 1980's. Overwhelmingly, the changes have been significant improvements. However, there have been a few retreats from effective interview practice mixed in among the many advances.

This article offers one child abuse professional's appraisal of the field of child forensic interviewing during the last three decades.

Key Advances
My observations are listed in no particular order. Each represents a major step forward and away from the "wing it" approach to CSA interviews.

1. Paradigm shift from "clinical" to "forensic"
Our understanding of the impact of CSA and the nature of the disclosure process has changed markedly.

In the 1980's, accepted interview practice was shaped by three beliefs commonly held at the time:

1. Sexual abuse and the disclosure process itself are both highly traumatizing for most victims;
2. Most child victims are reluctant to disclose and require substantial psychological support and encouragement to do so; and
3. Suggestive interview approaches, including the use of dolls and puppets, are often necessary to aid children in the disclosure process.

During much of the 1980's, the "disclosure interview," as the interview with the alleged child victim was frequently called, was widely viewed as a clinical interview, ideally to be conducted by a trained clinician. The interviewer was given significant leeway to push the envelope of appropriate questioning to ensure no CSA victim was missed and left unprotected.

By the early to mid-1990's, the underlying assumptions as well as the methodology of the clinical interview paradigm were widely discredited. A number of factors contributed to this change in perspective, including new research on children's memory and suggestibility and several high profile cases in which "overly suggestive" interview techniques were believed to have resulted in criminal charges and convictions of innocent adults.

The forensic interview paradigm, with its emphasis on implementation of research-based practice, replaced all things clinical. The playroom stocked with toys and dolls was replaced by the bare interview room equipped with a marker and a pad of paper.

2. Development of structured interview protocols
Dissatisfaction with the inefficiency and errors of freelance interviews resulted in the development of structured and semi-structured interview protocols. Barbara Boat and I published a semi-structured protocol for using anatomical dolls in child interviews in 1986. The CornerHouse RATAC protocol was developed in the late 1980's. Early versions of structured protocols offered scaffolding for the interviewer to construct the interview around, guided by what the protocol developers considered to be best practice interview principles.

In the mid-1990's, Michael Lamb and colleagues introduced the highly innovative NICHD Investigative Interview protocol. With NICHD, the interview is largely scripted, providing many of the words for the interviewer to say in order to reduce interviewer error. Second, the protocol was the first to bring together all the elements of narrative interview technology in a single interview format.

The NICHD interview protocol has been widely researched and dominates the field today. While the original protocol comes across as formal and not child friendly, it has been widely adapted and softened. The RADAR forensic interview protocol, which is taught in the NC DSS-sponsored course Child Forensic Interviewing, is one such adaptation. RADAR offers scripting for the novice interviewer and scaffolding for more experienced interviewers.

3. Use of narrative interview technology
For decades researchers have been telling interviewers that the most open, least suggestive form of questions are narrative requests such as "Tell me about X."

During the 1980's, many of us tried the use of narrative requests, producing the following scenario:

Interviewer: Tell me about school today.

Child: We played.

The interviewer then follows up with a series of more direct questions.

In those days, narrative requests elicited, at most, a brief sentence; to elicit the substance of what occurred more directed questioning was required. As a result, people quickly gave up on narrative questioning.

Lamb and his colleagues demonstrated in their NICHD protocol that narrative interview strategies do work if the child is properly trained and encouraged to reply in narrative form. In brief, narrative interview technology includes building rapport through building narratives, formal narrative practice, and specialized narrative questioning concerning the target event.

When this approach is used, many children as young as 4 or 5 years old can provide rich, detailed narratives about the substantive events under investigation. These narratives often yield an abundance of leads that can be used to corroborate or refute the child's statement.

4. Specialization of the child forensic interviewer role
As the forensic interview has become more structured and research-based, the position of interviewer has required more specialized training. Best practice standards have been delineated and expectations for periodic video reviews have become established. This has led to increased specialization of the role of forensic interviewer. "Child forensic interviewer" is now a job title as well as a viable career choice. The professionalization and specialization of the role has substantially enhanced the quality of interviews.

5. Commitment to forensic balance in the investigative process
Sensitivity and specificity are two indices of diagnostic accuracy. Applied to our field, sensitivity is a measure of the success of CSA investigators in correctly identifying true cases of abuse while minimizing the number of true cases that are missed or not substantiated. Specificity defines accuracy as the rate of success in correctly identifying false cases and avoiding false positive errors.

The 1980's was a "Sensitivity Era": an overemphasis on making sure no victim was overlooked increased the risk that children who had not experienced abuse were nonetheless identified as victims (i.e., false positive errors). The early to mid-1990's marked the beginning of a "Specificity Era" in which preventing false positive errors became the priority at the risk of increased false negative errors.

To oversimplify slightly, the motto of the Sensitivity Era was "Tell me your secret so I can help." This was replaced in the Specificity Era with the motto "Convince me, if you claim you have been abused."

In the last decade or so, our field has begun to acknowledge that false positive and false negative errors both have devastating impacts on those affected. Both types of errors should be avoided without trading off one for the other. We have entered a new era of "forensic balance" where sensitivity and specificity receive equal emphasis.

Regrettable Retreats
As described above, the early to mid-1990's represent a critical dividing point in the field of child forensic interviewing. The field pivoted from a clinical perspective with an emphasis on minimizing false negative errors to a research-based perspective with an emphasis on preventing false positive errors. This shift meant that clinical insights which shaped interview practice in the 1980's were often dismissed as irrelevant or unproven. This section highlights what I believe are two unfortunate retreats from widely accepted interview practice in the 1980's.

1. Flexibility in the use of multiple interviews
Disclosure is a process. "Just ask, they'll tell" is not an effective interview strategy for most CSA victims. Many child and adolescent victims require time to develop rapport and the courage to provide a full disclosure to the stranger interviewing them. These truths were better appreciated in the 1980's, when interviewers had greater flexibility in scheduling follow-up interviews to better meet the needs of reluctant victims. This flexibility has been replaced in many child abuse programs and agencies with a rigid, one-interview model that fails to serve many child victims.

2. Recognition of the need to address barriers to disclosure
Current structured interview protocols work best for children who have made a deliberate, prior disclosure of the abuse. The interviews are less effective with children who are not in an active disclosure phase. Structured interviews are least effective with child victims who have significant psychological barriers or fears related to disclosure. Forensic interviewers seldom have the time within one interview to effectively address the existence of barriers to disclosure. Unfortunately, this means that today many of the most vulnerable children are therefore least well served.

Implications for Child Welfare Practice
The specialization of the child forensic interviewer role, complete with the requirement of substantial entry-level training, the use of a structured interview protocol, and expectation of periodic video review, has led to the increasing marginalization of child welfare personnel in the CSA interview process. Career interviewers in child advocacy centers and specialized medical clinics have taken over the heavy lifting--aided by the fact that they have access to video equipment. The strength of the child welfare approach in developing rapport and establishing relationships with child clients has been essentially neutralized by the dominance of the one-interview model.

As best practice standards evolve to reflect an emphasis on forensic balance rather than specificity, we can expect a reappraisal of several aspects of current practice. At the top of the list for reappraisal is our field's misplaced confidence in the single child forensic interview.

Dr. Everson is a professor and the director of the Program on Childhood Trauma and Maltreatment at UNC-CH.