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When a disclosure is obtained, tell the child that it was difficult for her and that you believed her. If you use the dolls, ensure the dolls are dressed again, as they must be treated as "persons". Invite the supportive parent( s) into the room and let the child relax. In the presence of the victim, tell them that you believe their child, that she is brave and needs support. Let them see non-vital parts of the video. Their sharing allows the child to talk and the parent(s) to understand what occurred during the interview. With the child's permission, the parents may wish to see the entire tape at a more convenient time. If you do not believe the story, do not challenge the disclosure at this time. More investigation will have to be conducted into why the story may not be true.


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The withdrawing or changing or denying of a sexual abuse complaint is not uncommon, especially among adolescents. Understanding, patience and judgement are required by the authorities.

The pressure placed on a victim by the supporting parent, siblings and other relatives can be unbearable. They may not believe her. Mother may see the financial support disappear at the same time as her own self-esteem and sexuality are being questioned. There are many hidden reasons which may lead a child to say she lied about her original charge. Maybe she was lying; perhaps the complaint is false.

If the charge has been laid against the suspect and a court date is imminent, it is suggested that a stay of proceedings be entered rather than a withdrawal of the charge. The child may 7 have initially told the truth. If the victim continues to receive support and understanding over the next few weeks/months, she may well feel strong enough to go through with it. If you initially believed the child and nothing has happened to change that except her recanting, then tell her you understand the problem. Has the accused threatened her? Try and find out through other avenues what pressures are being exerted. If you still believe her, keep in contact and provide whatever support you can.

Perhaps you do not believe the victim. In that case try and discover the motive for lying. The polygraph may be the technique of last resort. If the victim is too young, the suspect may agree to take the test.

If the child was counselled to recant, then appropriate action should be 8 taken against the counsellor, consult the crown counsel with any information you may receive.


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From a police perspective, there are two purposes for a medical examination. The forensic exam is performed to document any evidence of trauma to the victim including the presence of disease and to provide evidence in court. On the other hand, the medical exam is held in order to treat any physical or psychosomatic symptoms that mayor may not be related to the abuse.

Many children feel that they are "damaged goods" and it is paramount that these fears be dealt with by medical personnel to assist in the victim's emotional recovery.

The forensic exam ideally is conducted by a pediatrician or general practitioner who is willing to testify and is experienced in this field. If you cannot obtain the services of such a physician, then contact one who is willing but not that experienced. Explain that you only want them to document their findings. The interpretation can be done at a later date by an expert, obtained by the Crown. The cost of the forensic exam is usually paid by the Crown. If the matter involves a member of the immediate family, because of possible conflict of interest, you should not, if at all possible, use the victim's or suspect's family physician.

The order of such an exam depends on each case and its urgency. However, if the child is ill, the symptoms must be dealt with prior to the forensic exam. In recent violent assaults, the normal hospital rape protocol will  apply. The preservation of human fluids and other exhibits is facilitated by the use of a sexual assault kit (see recent article in Vol. 49, No.6, RCMP Gazette). In larger centres, the emergency room physician is an ideal resource to conduct the forensic exam in recent or violent assaults.

It is vital to liaise with your local hospital and medical personnel in order that the following are established:
a) an on-call list of interested doctors;
b) a sexual assault protocol; ,
c) a sexual assault evidence kit;
d) the availability of color photography; and
e) the rapid completion of medical reports.

Ideally, a non-urgent exam should be conducted away from the emergency room and preferably in the doctor's own office. Only the most urgent cases should be done at the emergency room.

The controversy surrounding AIDS, herpes, and other sexually transmitted diseases is a difficult issue for us to deal with. Do we test the victim? Vaginal and anal swabs can detect gonorrhea, chlamydia, trichomonas, and yeast infection. Genital herpes and warts may be present. Syphilis and AI DS are detected by blood tests.

The decision to test the victim must be made after consulting with the parent(s), family doctor and the investigator. The facts of the case and the profile of the suspect are keys to this difficult issue. Needless to say, the presence of any such disease will corroborate and support the disclosure. The presence of venereal disease in the victim may lead to discussion with crown counsel about more serious charges, especially if the suspect knowingly transmitted a possibly fatal disease. Every effort should be made to test the suspect or at least to get his/her medical records.

Many parents who are child abusers frequently change doctors and hospitals. It is important in cases involving serious injury or death that medical VOL. 50, No.3, 1988 records be obtained from the medical services plan in order that all physicians and hospitals used by the parent( s) be canvassed to identify the history of the child and family. In many cases, normal pathological procedures will also assist in identifying old injuries.

In order to question a suspect and test his or her excuses, it is important that we have knowledge of the key areas in sexual abuse. For example, the hymen is a thin membrane inside the vagina, with a small opening which allows fluid to discharge. In a young child, this membrane is usually intact. The size of the opening differs in children, however, it can be measured. The older a child becomes the larger the hymenal opening. There exist several norms for young children and an expert can testify as to what these measurements should be. If the hymenal opening is stretched or torn, the physician should be able to record his or her observations and, hopefully, measurements. Certain trauma can indicate what type of abuse occurred, whether self-inflicted or abuser inflicted.

Occasionally, a suspect will say the child fell on some hard object such as a bicycle crossbar. If the child's hyman or inner tissues are injured but the labia majora or outer lips of the vagina are normal, then it is safe to say that the crossbar is not the source of the injury. Similarly, if upon examination of the anus, the "wink reflex"* is not present, it is a good indication that it has been subjected to repeated penetration. It is important that investigators become familiar with and knowledgeable about the medical aspects of sexual abuse. [ *The doctor runs a "Q-tip" over the entrance to the rectum. If the anus tightens up reflexively, then it is probably normal. If upon the "Q-tip" test, the anus becomes flaccid and loose, it may well have been penetrated. Also, tears or fissures may emanate from the anus in all directions.]


These cases are the most complex we face - the age of the children, the number of victims and families to be interviewed, are just some of the problems. Many day care centres are licensed, but there are many that are not.

Sometimes the suspect is not known, especially if there are several employees and the children are very young and not verbal. How do we protect the children during the investigation? Sometimes the suspect may be the owner (licensee) or in the owner's family or an employee. How do we ensure everyone's rights are looked after? Do the authorities suspend the licence? Do we advise the owner before we have definite proof? All such questions must be considered.

Normally, we will be working with the day care licensing body during an investigation. In British Columbia, the Provincial Child Care Facilities Licensing Board has the mandate to look after the welfare of the residents of the facility. It must also consider the economic interest of the operator. In B.C., the medical health officer in each area can obtain assistance from the Ministry of Social Services & Housing by way of a social worker. The police are also mandated to assist. If criminal charges are not proceeded with, the Licensing Board can hold a hearing into the allegations.

The McMartin Day Care Centre investigation in Los Angeles, California, provided us with some important information. That case involved nearly 400 children who had to be interviewed. Many were 3 or 4 years of age. Some of the disclosures were so bizarre that credibility was an issue. The children were interviewed on video upon the first contact with investigators. Initially, the majority denied abuse, however, on subsequent interviews, some disclosures were obtained. As a result, the operators of the centre were charged criminally. The case is still before the courts and a civil suit has been launched by the defendants against the prosecutor and counsellor.





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In order to avoid some of the above pitfalls, a co-ordinated and planned approach must be taken. Once the issue of protection has been dealt with, the labourous task of interviewing multiple victims has to be undertaken. The result will have to be tabulated in a meaningful way.

Suggestions:
a) design interview forms to include information valid to that case (include child's and parents' statements);
b) design graph or charts to document results;
c) form male and female teams;
d) do the initial interviews without video (use forms);
e) if a disclosure seems possible, videotape subsequent interviews;
f) use the same interviewers for subsequent interviews; and, g) computerize results, if possible.



If a spouse is a witness to an act or utterance, it is important to get a written statement as soon as possible. The chances of spousal "amnesia" developing are high, especially when the ramifications of the process unfold. Under Sec. 4(2) of the Canada Evidence Act, spouses are compellable and competent witnesses.

Statements from other family members, including siblings, should be promptly obtained. Similar fact evidence is vital to sex cases where the victim is of tender age. This evidence often resides with relatives, neighbours (past and present) and work colleagues. Many times the other victims are older and can really give the edge to the prosecution. Occasionally a victim will tell you about incidents as long as she does not have to testify. These witnesses should be given consideration, if at all possible.


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 In most criminal offences, surprise is the best strategy when dealing with a suspect. In many abuse cases, this element is lost as the suspect knows that the child has disclosed. To offset the tactical disadvantage, investigation and thoroughness can often win the day.

When obtaining the disclosure, if the child describes a unique piece of furniture, pornographic material or key elements in the offence (i.e., a dildo), these items can be searched for when armed with a search warrant going to arrest the suspect. Often an offender will deny the child was ever in his/her residence. The more the individual denies or talks, the better. Get photographs and diagrams of the residence. Search for diaries, letters, memos, videos, computer discs that can be used to discover other victims and also may show predilection to certain kinds of acts. Children's underwear, sado-masochistic equipment and restraints are all important. Vaseline, rectal jelly, sedatives and illegal drugs are also used to facilitate sexual acts.

In the event that you are in a position to question the suspect at length, the fact that many offenders were victims at one time lends itself to using the same interview skills needed with nondisclosing child victims.* In the event that the suspect denies the offence, it is often appropriate to confront him or her with the video tape of the child's disclosure. [ *However, the skills/techniques needed in interviewing a suspected pedophile cannot be dealt with satisfactorily in an article of this length. ]


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The policy in the Victoria area of B.C. is to arrest, process and, if the suspect is to be released, be set free on stiff conditions. These conditions could stipulate:
a) no contact with the victim or his/ her family;
b) not be in presence of persons . under the age of 16 years;
c) not to frequent certain establishments.

The usual prohibition of alcohol or drugs, if involved in the offence, should be sought.


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The B.C. Ministry of the Attorney General has stated that vertical prosecution is the norm in that the same designated prosecutor will stay with the child right through all court levels.



If no support groups are available, then the police or the prosecutor will have to spend time with the child in and out of court in preparation for the court appearance.* The child should be taken to the courtroom and allowed to watch another case. When the courtroom is empty, he or she should be given the opportunity to stand in the witness stand and get her bearings, especially where to look when testifying. [ *The book So You Have to Go to Court (reviewed in Vol. 49. No.2, RCMP Gazette) is written for children and could be loaned to him/her. ]


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As a major social problem of the 80's, child sexual abuse requires a thorough and empathetic investigation. Such care, patience, and skill both protect an innocent person falsely accused and go a long way to making sure that a guilty person is tried, convicted and punished. Dramatic advances and improvements in ttie investigations of such crimes have been made in recent years but there is still a long way to go.

Reprinted with permission from British Columbia Medical Journal 26(7):435,1984. 11





Nonspecific symptoms in preschool children
- excessively clinging behavior
-poor sleep, excessive fear of the dark
-encopresis (especially secondary) [bowel incontinence]
-enuresis (especially secondary) [urinary incontinence]
-abdominal pain without any physiological basis
- fear of men, or of one particular individual
- urinary tract infections
- vaginal infections
- anal-fissures

Nonspecific symptoms in school-age children
- sudden worsening of performance in school
- sleep disturbances
- truancy
- running away from home
- fear states, phobias, hysteria
- fire-setting depression
- memory or concentration disturbances
- overly detailed, age-inappropriate knowledge of sexual behavior
- somatic complaints without any physiological basis [physical complaints]
- urinary tract infections
-  vaginal infections
- anal-fissures

Nonspecific symptoms in adolescents
- running away from home
- truancy
- depression
- abdominal pain and headaches without any physiological basis
- assuming a "wifely" role in the household
- prostitution
- drug abuse
- alcoholism
- stealing
-pregnancy
-preoccupation with sex in conversation 




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