Dynamics of abuse and disclosure for children with special needs

Introduction

In the field of forensic interviewing there are several protocols developed to assist in obtaining disclosures from children with special needs. The extended forensic interview is commonly used to provide additional processing time for the victim. Additionally, many child advocacy centers have adopted an inclusive model where developmental specialists are called to consult on these types of cases prior to the interview. However, the larger understanding of how developmental delays impact a victim's understanding of abuse as well as how to obtain a full disclosure is still under-examined in the field of trauma. Children with disabilities are abused at a higher rate than their typically functioning peers (Sullivan & Knutson, 2000), though they are rarely seen for forensic interviews. This discrepancy in the rates of abuse versus the number of investigations conducted highlights the need for more developmentally supportive measures.

Blurred lines

Offenders often insert themselves into roles where they have increased access to vulnerable children (Robertiello & Terry, 2007). Children with special needs are often especially vulnerable as a result of the typical interventions of developmental therapy, which usually begins before the age of three when sensory, cognitive and language abilities are forming (Guralnick, 2005). These children receive several hours of therapy each week where adults set the rules and reinforce their behavior based on developmental goals. If the child protests the intervention the therapist responds by decreasing the demand (i.e., expectation of the child) until the child increases compliance with the task. Additionally, many interventions at this age require hands-on manipulation of the child's body (i.e., deliberately moving the child's body), to facilitate motor skills.

Interaction with a variety of adults from different disciplines (occupational therapy, speech/language therapy, physical therapy, behavioral therapy) who set expectations and reward the child's compliant behaviors influences the child's understanding of typical adult-child relationships. Children with special needs are conditioned to tolerate more demand from both familiar and unfamiliar adults as a result of their routine treatment regimen. This is not to imply that the practice of developmental intervention is harmful, but it is important to consider when evaluating abuse prevention programming, assessment and intervention techniques for children with special needs. Additionally, the built-up tolerance for following adults' directives, physical contact compliance around body movement/manipulation changes the way trauma is processed and stored in the brain (Perry, 2004).

Trauma, the brain and the child with special needs

Trauma is an experience that affects the brain across many different structures from the primitive and sensory portions to the emotional and cognitive areas ( Perry, Pollard, Blakley, Baker, & Vigilante, 1995) . Depending on the type and severity of the developmental delay, a child with special needs will spend disproportionate amounts of time operating in those brain structures as compared to their neuro-typical peers. In typical neurodevelopment as a child ages he/she is able to maintain function within the higher brain structures as the ability to self-regulate increases. This ability to operate within the cortex requires the underlying structures to coordinate information while sustaining nervous system regulation (Perry et al., 1995). As a person experiences stress the brainstem becomes dysregulated causing a movement away from the higher-level skills associated with the cortex (language and cognition; Perry 2004) and pulling the individual down into the more primitive areas of the brain. This “downward movement” impacts cognition around an event, especially a traumatic event, causing the memory to be stored more connected to emotional, sensory and regulatory aspects (Perry et al., 1995).

The forensic interview

Forensic interviews are structured to elicit information about an alleged incident by starting with open-ended questions and then focusing questions on more specific aspects of the event (Lyon, 2002). The interview depends heavily on the child's ability to clearly describe specific detail about the offender and victim's own behavior. Completing a forensic interview for a neuro-typical child is challenging, especially when disclosing traumatic memories, but for a child with special needs the additional stress makes accessing language skills in the neo-cortex even harder. For example, children with autism have delays in their limbic (emotional) system as well as certain areas of the cortex that control language processing. Additionally, these children have an impacted sensory processing system that causes indiscriminate reporting of sensory information. Indiscriminate sensory processing can cause the brain to “over-register” or “under-register” sense information ( Castelli, Frith, Happé, & Frith, 2002) . This processing delay typically causes children with autism to focus more on the sensory aspects of the abuse over the emotional impact, thereby requiring the forensic interviewer to adjust their inquiry more towards the sensory aspects of the experience for the child.

Recommendations

Child victims with special needs have atypical disclosure patterns making it difficult for investigators to gather substantial information to pursue abuse claims. The best way to support functioning of the child's higher brain structures during an interview is to regulate the primitive areas first. Prior to starting the interview, it is recommended to obtain information about the child's sensory needs (i.e., sensitivity to light, seating preference) as this can help the interviewer provide a more appropriate environment that supports language and cognitive skills. In addition to establishing a sensory-supportive environment, it is also necessary to understand the processing time needed by the child to both understand and respond to questions. Language-processing ability is typically evaluated during the rapport-building phase of the forensic interview. During rapport building the interviewer should ask different types of questions (open/close ended, sensory questions, etc.) to identify the type of question the child best understands and can respond to. This information is then used to inform the question typology for the identified event. Note: this is not permission to ask leading/ non-forensically sound questions. When conducting forensic interviews with children who have special needs, this preparation also creates a strong foundation if the case moves to trial. These steps enable the interviewer to explain the child's body movements, language patterns, processing times and question format when defending the interview.

Forensic interviewers should consider the following when attempting to conduct an interview with a child who has special needs:

• Review of Individualized Education Plan or 504B Support Plan
• Reducing exterior and interior noise (e.g., outside chatter, clock in the room)
• Consulting the caregiver:

What type of seated position is best for attention? For example, a cube chair, beanbag seat or couch can provide proprioceptive input, which assists in nervous system regulation.

How does your child respond to certain types of lighting? For example, florescent lighting can cause auditory dysregulation that competes with the interviewer's questions.

Using lamps can help children with sensory processing difficulty.  Does your child use fidget items to focus in class?

Occupational therapists advocate the use of fine motor activities for regulation in cases of sensory processing disorders and PTSD.

Intricate fine motor tasks can include drawing, finger fidgets, stringing beads and lacing cards. What type of support helps your child process information? (i.e., visual, auditory, experiential)

The use of visual information, such as pictures of the space where the abuse occurred and body parts inventories can help clarify the detail specific questions. How do you know when your child is disregulated? What works to get them re-regulated?

Conclusion

Child advocacy centers and investigative agencies should continue to strive towards an inclusive model that provides developmentally supportive approaches to working with the special needs community. When developing an inclusive model, it is imperative to start with prevention education for children with different learning abilities and informative classes for their families. Community outreach helps build a connection with this population and establishes the relationship needed to increase the likelihood of reporting. Modifying prevention curriculum requires consideration of learning abilities, providing practice materials for parents to take home and offering basic information about body checks and behavior screening for non-verbal children.

When cases come to light, investigators and forensic interviewers should pay particular attention to the interview space, tone of the interviewer and sensory stimulations occurring in and outside of the space in order to ensure that the environment is appropriate to support the neurodevelopmental functioning of the child.

Finally, trauma professionals benefit greatly when collaborating with developmental specialists in their area. These experts can provide insight into developing a framework that is supportive for both the forensic interview and courtroom testimony. This can most easily be accomplished by establishing an “Ask the Expert” panel that is available to answer questions before the interview and to integrate them into the peer review process when reviewing forensic interviews of children with special needs.

References

Castelli, F., Frith, C., Happé, F., & Frith, U. (2002). Autism, Asperger syndrome and brain mechanisms for the attribution of mental states to animated shapes. Brain,  125 (8), 1839-1849.

Guralnick, M. J. (2005). Early intervention for children with intellectual disabilities: Current knowledge and future prospects.  Journal of Applied Research in Intellectual Disabilities,  18 (4), 313-324.

Lyon, T.D. (2002). Applying suggestibility research to the real world: The case of repeated questions. Legal and Contemporary Problems, 65 (1), 98-126.

Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: How “states” become “traits.”  Infant mental health journal,  16 (4), 271-291.

Robertiello, G., & Terry, K. J. (2007). Can we profile sex offenders? A review of sex offender typologies.  Aggression and Violent Behavior,  12 (5), 508-518.

Sullivan, P. M., & Knutson, J. F. (2000). Maltreatment and disabilities: A population-based epidemiological study.  Child abuse & neglect,  24 (10), 1257-1273.